Tomas Pueyo published “Uncharted Territories” in the New York Times today. Here we give you his final summary of the data:

 In kids, the Pfizer vaccine reduces the odds of myocarditis by ~3x and makes it milder (1617). That, right there, should be enough incentive to vaccinate kids.

“The pediatric hospital experience shows that the risk of patients at any age having cardiac involvement from COVID is uniformly worse than vaccination myocarditis risk.”—Frank Han, pediatric cardiologist, OSF Healthcare, Central Illinois.

And then, on top of that, it reduces deaths, hospitalizations, ICU stays, PICS, PIMS, and CFS (18):

  • It 10x reduces infections.

  • It 10x reduces hospitalizations, from 1 in 280 to 1 in 2,800.

  • It probably reduces the rest of consequences by a proportional amount. Which means:

    • Deaths would go from ~1 per 100k to ~1 in 1 million.

    • PICS would be reduced from 1 in 16k to 1 in 160k.

    • PIMS would be reduced from 1 in 4k to 1 in 40k.

    • CFS would be reduced from 1 in 500 to 1 in 5,000 (10-19) and 1 in 2,500 to 1 in 25,000 for 0-9.

  • All these numbers should probably be doubled given Omicron is likely more virulent than the original variant / alpha and has a lot of immune escape. Meaning for example the risk of PIMS might not be going from 1 in 4k to 1 in 40k, but rather from 1 in 2k to 1 in 20k.

  • Vaccination also probably reduces the infection of other people in the household. Kids spread the original variant in about 25% of households. Probably more with Delta / Omicron. Vaccines reduce Delta infections by 50%, so if we take that number as an order of magnitude, you’d go from 25% of kids infecting adults in households down to ~10-15%.

 

Depending on your kid, there are some nuances:

  • If your kid has comorbidities, it’s a no-brainer: the vaccine will prevent their death and other things, such as PICS, PIMS, CFS… All of these are quite bad, and you want to protect your kids from them.

  • If your kid is healthy and older than 12 years old, the odds of death from COVID are very, very low. However, vaccines will protect them from PIMS (including myocarditis), PICS (including myocarditis), or Long COVID, and will reduce their myocarditis.

  • If she is healthy, older than 12 years old, and a female, it’s even more of a no-brainer, since the risk of vaccine-induced myocarditis is about 5x lower.

  • If your kid is healthy and between 5 and 12 years old, they’re not likely to die of COVID, but it's still possible they'll develop PIMS, PICS, or CFS. We have clinical trials telling us that the vaccines are safe for them, and now one million of these kids vaccinated in the wild with no serious side-effects. I have two kids in that category. I will vaccinate them as soon as I can.

  • If your kid is healthy and below 5 years old, you can’t vaccinate them yet: vaccines haven’t been approved. But from what we know today, vaccines are probably safe for them, and probably prevent COVID deaths, which is important since this group has more risk of death. With what we know today, it’s a no-brainer to vaccinate them once vaccination safety is confirmed.

 

If you’re on the fence, here are some additional thoughts to consider:

  • The first dose is much more valuable than the second dose, while the second dose has more side-effects. If you are in doubt, just give the first dose and then wait and see.

  • Spacing also matters. If the two shots are taken within 30 days, the rate of myocarditis is 5x higher than if they’re spaced by 60 days or more. Space the shots by 2-3 months instead of 2-3 weeks and you should be good.

  • Also, Moderna appears to have more myocarditis than Pfizer, which might be why Pfizer is approved for kids and Moderna isn’t yet in the US. In Denmark, that rate was 3x. In Canada, 5x. So just have your kid take Pfizer19.

 

I started this article not knowing whether I should vaccinate my kids. But it turns out the worst side-effects of vaccines are mild myocarditis—mostly 12-17 year old males—and there have been no deaths from mRNA vaccines in kids. Compared to all the bad stuff that COVID can do to kids (death, PIMS, PICS, CFS), including more common and worse myocarditis than with vaccines, I think the answer is clear based on the data we have: you should vaccinate your kids. I will definitely vaccinate mine.

 

Post-Intensive Care Syndrome (PICS)

Pediatric Inflammatory Multisystem Syndrome (PIMS)

Chronic fatigue syndrome (CFS)