MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

risk

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The General Chiropractic Council (GCC) has signed a memorandum of understanding with NHS England, the Crown Prosecution Service and the National Police Chiefs’ Council to collaborate where there is suspected criminal activity on the part of a GCC member in relation to the provision of clinical care or care decision-making.

I find this interesting and most laudable!

But I also have seven questions, e.g.:

  1. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor explains that the patient’s problem is caused by a subluxation of the spine, an entity that does not even exist? Apparently this happens every day.
  2. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor treats a patient without prior informed consent? Apparently, this happens regularly.
  3. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor fails to warn a patient that his/her manipulations can cause harm and even put him/her in a wheelchair? Apparently this (the lack of warning) happens all the time, and some chiropractors even insist that their manipulations are entirely safe.
  4. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor claims that spinal manipulations are effective for curing the patient’s problem, while the evidence does not support the claim? Apparently this happens more often than not.
  5. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor persuades a patient to have expensive long-term maintenance therapy for preventing health problems, while the evidence for that appoach is less than convincing? Apparently this happens rather frequently.
  6. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if the chiropractor issues advice that is both outside his/her competence and detrimental to the health of the patient (for instance, advising parents not to vaccinate their kids)? Apparently this happens a lot.
  7. Does it amount to criminal activity in relation to the provision of clinical care or care decision-making, if a chiropractor advises a patient not to do what a real doctor told him/her to do? Apparently this is far from a rare occurance.

I would be most grateful, if the GCC would take the time to answer the above questions.

Many thanks in advaance.

“An American doctor invented a drug that claims to cure COPD within three days.” Does this announcement herald a medical sensation or a bogus and potentially dangerous falsehood?

The inventors proudly opt for the former: “we have created a revolutionary pill that combines over 60 natural herbs specifically designed to treat respiratory diseases such as chronic obstructive pulmonary disease, chronic bronchitis, and pulmonary fibrosis”

There are also videos promoting a “revolutionary pill” that allegedly cured chronic obstructive pulmonary disease (COPD) “within three days” went viral on Facebook. The videos featured public figures like Fox News anchor Jesse Watters, as well as the alleged developer of the drug, surgeon and TV personality Mehmet Oz, popularly known as “Dr. Oz”. Although the images used in the videos varied from post to post, all the videos we found used the exact same narration and promised “to pay one million dollars” if the drug failed to cure COPD. However, these videos showed clear signs of manipulation.

Altered or artificial intelligence-generated videos featuring celebrities and major TV networks have been profusely used for scams over the past few years. Science Feedback documented several examples of such doctored videos falsely promoting diabetes cures and cannabidiol (CBD) gummies as a treatment for a wide range of medical conditions. “Dr. Oz” has often been mentioned either as a developer of these products or as endorsing them, though he’s repeatedly denied any involvement in these ads. In a 2019 article for the Wall Street Journal that he also shared on Facebook and Twitter, Oz stated that these ads weren’t “legit” and warned about potential scams exploiting his image.

Likewise, the COPD videos posted on Facebook are also false. First, COPD currently has no known cure, so any product claiming to cure it is simply a scam. Second, the poor synchronization between video and audio suggests that the audio isn’t authentic.

SCIENCE FEEDBACK‘ thus conclused as follows:

Chronic obstructive pulmonary disease (COPD) is a chronic progressive lung disease for which no cure currently exists. Along with medication, lifestyle changes like quitting smoking, avoiding polluted environments, and keeping physically active can help manage the symptoms and slow down the progression of the disease. Products claiming to cure COPD are deceptive and potentially dangerous, as they may contain harmful ingredients or interact with medications in unpredictable ways.

I could not agree more and might add that – as always in suspect cases – if it sounds too good to be true, it probably is.

It has been reported that Kash Patel, Donald Trump’s pick to lead the FBI. Patel seems to be a scary man. During 2023 appearance on Steve Bannon‘s “War Room” podcast, Patel agreed that Trump is “dead serious” about his intent to seek revenge against his political enemies should he be elected in 2024. Patel stated:

“We will go out and find the conspirators — not just in government, but in the media … we’re going to come after the people in the media who lied about American citizens, who helped Joe Biden rig presidential elections … We’re going to come after you. Whether it’s criminally or civilly, we’ll figure that out. But yeah, we’re putting you all on notice, and Steve, this is why they hate us. This is why we’re tyrannical. This is why we’re dictators … Because we’re actually going to use the Constitution to prosecute them for crimes they said we have always been guilty of but never have.”

Meanwhile, Patel has been flogging a range of very odd products aimed at the MAGA crowd, making hundreds of thousands of dollars from Trump-aligned businesses. In particular, Patel promoted pills that claim to reverse the effects of the Covid-19 vaccine. Marketed under the trademark “Nocovidium,” the pills from a company called ‘Warrior Essentials’ contain a range of ‘natural ingredients none of which has been shown to do anything significant in relation to Covid-19 or vaccines:

“Spike the Vax, order this homerun kit to rid your body of the harms of the vax,” Patel said in a Truth Social post promoting the SCAM remedy. Another advert stated: “You were immune to the propaganda, but are you immune to the shedders.”

The website explains:

“The ingredients are listed above, but they break down into a few distinct categories.  Polyamines are the driving force that helps to push the body into autophagy. These are found in many foods and are also in all living organisms.  Our formula is designed to give a boost of externally supplied polyamines, while also working to turn your body into a polyamine producing gigafactory.  This is done by providing the body the precursors, activators, and synthesizers to ramp up production.  The third goal is to inhibit pathogens, including the spike protein, from interfering with the process. It’s a 1-2-3 patent-pending punch.  Every ingredient was specifically chosen and balanced for its ability to promote autophagy, polyamine production, the inhibition of factors that can stop the process, or a combination of all three.”

The website even explains how the supplement works: “With regards to the spike protein, the body identifies this as a foreign object, and the autophagy process is designed to help protect your body by completely eliminating items like the spike.  Many indicators show that the spike’s ability to block this process may be why the spikes are lasting far longer in the body than anybody ever expected.  Our formula was developed to counter these measures allowing the process to complete and the objects, including the spike, identified by the body for removal, to be eliminated.”

Is there any evidence?

One should not ask such probing questions!

Why not?

The answer is as simple as it is scary: “We’re going to come after you!”

Being a dedicated crook and a liar himself, Donald Trump has long had an inclination to surround himself with crooks and liars. As discussed repeatedly, this preferance naturally extends into the realm of healthcare, Some time ago, he sought the advice of Andrew Wakefield, the man who published the fraudulent research that started the myth about a causal link between MMR-vaccinations and autism.

Early November this year, Trump stated that, if he wins the election, he’ll “make a decision” about whether to outlaw some vaccines based on the recommendation of Robert F. Kennedy Jr., a notorious vaccine critic without any medical training. The president doesn’t have authority to ban vaccines but he can influence public health with appointments to federal agencies that can change recommendations or potentially revoke approvals.

Now that he did win the election, Trump suggested that Robert F. Kennedy Jr., his pick to run Health and Human Services, will investigate supposed links between autism and childhood vaccines, a discredited connection that has eroded trust in the lifesaving inoculations.

“I think somebody has to find out,” Trump said in an exclusive interview with “Meet the Press” moderator Kristen Welker. Welker noted in a back-and-forth that studies have shown childhood vaccines prevent about 4 million deaths worldwide every year, have found no connection between vaccines and autism, and that rises in autism diagnoses are attributable to increased screening and awareness.

Trump, too stupid to know the difference between correlation and causation, replied: “If you go back 25 years ago, you had very little autism. Now you have it.” “Something is going on,” Trump added. “I don’t know if it’s vaccines. Maybe it’s chlorine in the water, right? You know, people are looking at a lot of different things.” It was unclear whether Trump was referring to opposition by Kennedy and others to fluoride being added to drinking water.

Kennedy, the onetime independent presidential candidate who backed Trump after leaving the race, generated a large following through his widespread skepticism of the American health care and food system. A major component of that has been his false claims linking autism to childhood vaccinations. Kennedy is the founder of a prominent anti-vaccine activist group, Children’s Health Defense. The agency Trump has tasked him with running supports and funds research into autism, as well as possible new vaccines.

The debunked link between autism and childhood vaccines, particularly the inoculation against mumps, measles and rubella, was first claimed in 1998 by Andrew Wakefield who was later banned from practicing medicine in the UK. His research was found to be fraudulent and was subsequently retracted. Hundreds of studies have found childhood vaccines to be safe.

Autism diagnoses have risen from about 1 in 150 children in 2000 to 1 in 36 today. This rise has been shown to be due to increased screening and changing definitions of the condition. Strong genetic links exist to autism, and many risk factors occurring before birth or during delivery have been identified.

If Trump does, in fact, ‘outlaw’ certain vaccinations, he would endanger the health of the US as well as the rest of the world. Will he really be that stupid?

We had to deal with Hongchi Xiao several times before:

Slapping therapy is based on the notion that slapping patients at certain points of their body has positive therapeutic effects. Hongchi Xiao, a Chinese-born investment banker, popularised this SCAM which, he claims, is based on the principles of Traditional Chinese Medicine. It is also known as ‘Paida’—in Chinese, this means ‘to slap your body’. The therapy involves slapping the body surface with a view of stimulating the flow of ‘chi’, the vital energy postulated in Traditional Chinese Medicine. Slapping therapists believe that this ritual restores health and eliminates toxins. They also claim that the bruises which patients tend to develop after the treatment are the visible signs of toxins coming to the surface. Hongchi Xiao advocates slapping as “self-healing method” that should be continued until the skin starts looking bruised. He and his follows conduct workshops and sell books teaching the public which advocate slapping therapy as a panacea, a cure-all. The assumptions of slapping therapy fly in the face of science and are thus not plausible. There is not a single clinical trial testing whether slapping therapy is effective. It must therefore be categorised as unproven.

Now it has been reported that Hongchi Xiao has been sentenced to 10 years in prison for the death of a 71-year-old diabetic woman who stopped taking insulin during one of his workshops.

Hongchi Xiao, 61, was convicted of manslaughter by gross negligence for failing to get medical help for Danielle Carr-Gomm as she howled in pain and frothed at the mouth during the fourth day of a workshop in October 2016. The Californian healer promoted paida lajin therapy which entails getting patients to slap themselves repeatedly to release “poisonous waste” from the body. The technique has its roots in Chinese medicine and has no scientific basis and patients often end up with bruises, bleeding — or worse.

Xiao had extradited from Australia, where he had been convicted of manslaughter after a 6-year-old boy died when his parents withdrew his insulin medication after attending one of his workshops in Sydney. “I consider you dangerous even though you do not share the characteristics of most other dangerous offenders,” Justice Robert Bright said during sentencing at Winchester Crown Court. “You knew from late in the afternoon of day one of the fact that Danielle Carr-Gomm had stopped taking her insulin. Furthermore, you made it clear to her you supported this.” Bright added Xiao only made a “token effort” to get Carr-Gomm to take her insulin once it was too late and had shown no sign of remorse as he even continued to promote paida lajin in prison.

Carr-Gomm was diagnosed with type 1 diabetes in 1999 and was desperate to find a cure that didn’t involve injecting herself with needles, her son, Matthew, said. She sought out alternative treatments and had attended a previous workshop by Xiao in Bulgaria a few months before her death in which she also became seriously ill after ceasing her medication. However, she recorded a video testimonial, calling Xiao a “messenger sent by God” who was “starting a revolution to put the power back in the hands of the people to cure themselves and to change the whole system of healthcare.”

Xiao had congratulated Carr-Gomm when she told other participants at the English retreat that she had stopped taking her insulin. By day three, Carr-Gomm was “vomiting, tired and weak, and by the evening she was howling in pain and unable to respond to questions,” prosecutor Duncan Atkinson said.

A chef who wanted to call an ambulance said she deferred to those with holistic healing experience. “Those who had received and accepted the defendant’s teachings misinterpreted Mrs. Carr-Gomm’s condition as a healing crisis,” Atkinson said.

______________

A healing crisis?

A crisis of collective stupidity, I’d say!

More reason to worry about our royal family? Apparently, Camilla (I apologise for calling her thus, as I am never entirely sure whether she is Queen or Queen Consort: Camilla, the wife of Prince Charles, will be formally known as Queen Consort now that her husband is King12When Camilla and Charles married in a civil ceremony in 2005, it was announced Camilla would become known as Princess Consort – rather than Queen Consort – due to public sensitivity3However, Queen Elizabeth II granted her the title of Queen Consort in February last year during the Platinum Jubilee45.) has been urged to take more time to recover after a bout of pneumonia.

At the start of November it was announced that she had been diagnosed with a ‘chest infection’ and was under doctors’ supervision. The 77-year-old Camilla was forced to withdraw from her engagements so she could rest at home. She has now revealed that she was suffering from a form of pneumonia.

It is understood Camilla’s condition was viral. She seems to be suffering significantly diminished reserves of energy following her chest infection. This led to her having to pull out of a number of events over recent weeks. Even though the lung infection has now cleared, she says she is still feeling tired. She has been advised by her doctors to take more time to recover. It was confirmed yesterday on the eve of the state visit that the Queen was also reducing her role at the glam state banquet later on Dec. 3 in light of her health.

So, is there anything special that might have triggered this unfortunate turn of events? To answer this question, I refer you to my post of 31 October this year:

… King Charles arrived in Bengaluru directly from Samoa, where he attended the 2024 Commonwealth Heads of Government Meeting from October 21-26. His visit to Bengaluru was strictly kept under wraps, and he was directly taken to Soukya International Holistic Health Centre (SIHHC), where he was also joined by his wife, Camilla.

According to sources, the couple’s day begins with a morning yoga session, followed by breakfast and rejuvenation treatment before lunch. After a brief rest, a second round of therapies follows, ending with a meditation session before dinner and lights out by 9 pm. They have been enjoying long walks around the campus, visiting the organic farm and cattle shed. Considering the high-profile secret visit, a high-security ring was thrown around SIHHC.

The health centre, founded by Dr. Issac Mathai, is located in Samethanahalli, Whitefield, on Bengaluru’s outskirts. This integrative medical facility combines traditional systems of medicine, including Ayurveda, Homoeopathy, Yoga, and Naturopathy, along with over 30 complementary therapies like reflexology, acupuncture, and dietetics.

… The royal couple has earlier taken wellness treatments, including anti-ageing, detoxification and rejuvenation. On November 14, 2019, the couple celebrated the then Prince Charles’ 71st birthday at SIHHC, an event that attracted a lot of publicity, unlike this visit.

Yes, you may well ask: isn’t Ayurvedic medicine supposed:

  • to strengthen the immune system,
  • to fortify you against infections,
  • to replenish your reserves of energy,
  • to enable you to recover swiftly from infections?

Of course, I know, correlation is not causation! Perhaps the recent Ayurvedic pampering in India and Camilla’s inability to make a timely recovery from what started merely as a ‘chest infection’ are not at all linked in any way. Yet, it does seem tempting to speculate that the stay in the SIHHC with all the Ayurvedic medicine did her not a lot of good.

Whatever might be the case, I would like to take this opportunity to wish Camilla a full recovery for her condition.

 

The ‘Healy’ has featured on this blog before and is thus known to my regulars: The ‘Healy’: deep cellular healing with quantum bollocks. Now the ‘Healy’ has won an award … albeit a negative one: the Austrian Skeptiks necative prize ‘GOLDENES BRETT VORM KOPF’ (Golden Plank before the Head)

Other nomineed for the award were:

At yesterday’s gala in the Vienna City Hall, it was announced that the ‘Healy’ is the proud winner.

A total of 160 nominations were received by the Vienna Sceptics (Gesellschaft für kritisches Denken, GkD), which awards the prize on behalf of the Gesellschaft zur Wissenschaftlichen Untersuchung von Parawissenschaften (GWUP). On the basis of all these nominations, a ‘shortlist’ of three was subsequently agreed upon by the jury.

The organisers explained in their press release that the ‘Healy’ is advertised as a medical device for the treatment of pain, including chronic pain and migraines, as well as for the supportive treatment of mental illnesses such as depression and anxiety with a lot of pseudo-scientific phraseology.

A ‘quantum sensor’ allegedly measures the ideal ‘frequency’ of the user and causes a ‘bioenergetic field harmonisation’. However, the ‘quantum sensor’ turns out to be nothing more than a simple infrared diode, available for 20 cents. By contrast, consumers are asked to pay up to 4,500 Euros for the  ‘Healy’!

Several research platforms, medical information portals and consumer centres have come to damning conclusions about the device. There is talk of ‘bioresonance scams’, ‘dubious frequency therapy’ for which there is a lack of scientific evidence and an ‘esoteric scam’. In addition to the considerable commercial interest and widespread use, the jury said that the manufacturer’s way of dealing with critics was also decisive for the win.

Having recently favoured the Austrian Veterinary Association (AVA) to win the award, I am in two minds. On the one hand, I am disappointed that the AVA did not make it. On the other hand, having reported about the ‘Healy’s extraordinary quantum bollocks some time ago, I am delighted that a worthy winner has been found and crowned.

This update of a systematic review evaluated the effectiveness of spinal manipulations as a treatment for migraine headaches.

Amed, Embase, MEDLINE, CINAHL, Mantis, Index to Chiropractic Literature, and Cochrane Central were searched from inception to September 2023. Randomized clinical trials (RCTs) investigating spinal manipulations (performed by various healthcare professionals including physiotherapists, osteopaths, and chiropractors) for treating migraine headaches in human subjects were considered. Other types of manipulative therapy, i.e., cranial, visceral, and soft tissue were excluded. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the certainty of evidence.

Three more RCTs were published since our first review; amounting to a total of 6 studies with 645 migraineurs meeting the inclusion criteria. Meta-analysis of six trials showed that, compared with various controls (placebo, drug therapy, usual care), SMT (with or without usual care) has no superior effect on migraine intensity/severity measured with a range of instruments (standardized mean difference [SMD] − 0.22, 95% confidence intervals [CI] − 0.65 to 0.21, very low certainty evidence), migraine duration (SMD − 0.10; 95% CI − 0.33 to 0.12, 4 trials, low certainty evidence), or emotional quality of life (SMD − 14.47; 95% CI − 31.59 to 2.66, 2 trials, low certainty evidence) at post-intervention. A meta-analysis of two trials showed that compared with various controls, SMT (with or without usual care) increased the risk of adverse effects (risk ratio [RR] 2.06; 95% CI 1.24 to 3.41, numbers needed to harm = 6; very low certainty evidence). The main reasons for downgrading the evidence were study limitations (studies judged to be at an unclear or high risk of bias), inconsistency (for pain intensity/severity), imprecision (small sizes and wide confidence intervals around effect estimates) and indirectness (methodological and clinical heterogeneity of populations, interventions, and comparators).

We cocluded that the effectiveness of SMT for the treatment of migraines remains unproven. Future, larger, more rigorous, and independently conducted studies might reduce the existing uncertainties.

The only people who might be surprised by these conclusions are chiropractors who continue to advertise and use SMT to treat migraines. Here are a few texts by chiropractors (many including impressive imagery) that I copied from ‘X’ just now (within less that 5 minutes) to back up this last statement:

  • So many people are suffering with Dizziness and migraines and do not know what to do. Upper Cervical Care is excellent at realigning the upper neck to restore proper blood flow and nerve function to get you feeling better!
  • Headache & Migraine Relief! Occipital Lift Chiropractic Adjustment
  • Are migraines affecting your quality of life? Discover effective chiropractic migraine relief at…
  • Neck Pain, Migraine & Headache Relief Chiropractic Cracks
  • Migraine Miracle: Watch How Chiropractic Magic Erases Shoulder Pain! Y-Strap Adjustments Unveiled
  • Tired of letting migraines control your life? By addressing underlying issues and promoting spinal health, chiropractors can help reduce the frequency and severity of migraines. Ready to experience the benefits of chiropractic for migraine relief?
  • Did you know these conditions can be treated by a chiropractor? Subluxation, Back Pain, Chronic Pain, Herniated Disc, Migraine Headaches, Neck Pain, Sciatica, and Sports Injuries.
  • When a migraine comes on, there is not much you can do to stop it except wait it out. However, here are some holistic and non-invasive tips and tricks to prevent onset. Check out that last one! In addition to the other tips, chiropractic care may prevent migraines in your future!

Evidence-based chiropractic?

MY FOOT!

 

If you live in the UK, you could not possibly escape the discussion about the ‘Assisted Dying Bill’ which passed yesterday’s vote in the House of Commons (MPs have voted by 330 to 275 in favour of legalising voluntary assisted suicide). Once the bill passed all the further parliamentary hurdles – which might take several years – it will allow terminally ill adults who are

  • expected to die within six months,
  • of sound mind and capable of managing their own affairs

to seek help from specialised doctors to end their own life.

After listening to many debates about the bill, I still I have serious concerns about it. Here are just a few:

  1. Palliative care in the UK is often very poor. It was argued that the bill will be an incentive to improve it. But what, if this is wishful thinking? What if palliative care deteriorates to a point where it becomes an incentive to suicide? What if the bill should even turn out to be a reason for not directing maximum efforts towards improving palliative care?
  2. How sure can we be that an individual patient is going to die within the next six months? Lawmakers might believe that predicting the time someone has left to live is a more or less exact science. Doctors (should) know that it is not.
  3. How certain can we be that a patient is of sound mind and capable of managing their own affairs? By definition, we are dealing with very ill patients whose mind might be clouded, for example, by the effects of drugs or pain or both. Lawmakers might think that it is clear-cut to establish whether an individual patient is compos mentis, but doctors know that this is often not the case.
  4. In many religions, suicide is a sin. I am not a religious person, but many of the MPs who voted for the bill are or pretend to be. Passing a law that enables members of the public to commit what in the eyes of many lawmakers must be a deadly sin seems problematic.

In summary, I feel the ‘Assisted Dying Bill’ is a mistake for today; it might even be a very grave mistake for a future time, if we have a government that is irresponsible, neglects palliative care even more than we do today and views the bill as an opportunity to reduce our expenditure on pensions.

The alleged harm of Covid-vaccinations is a topic that still leads to misunderstandings, perhaps nowhere more than in the realm of so-called alternative medicine. Therefore, this paper seems relevant.

The first dose of COVID-19 vaccines led to an overall reduction in cardiovascular events, and in rare cases, cardiovascular complications. There is less information about the effect of second and booster doses on cardiovascular diseases. Using longitudinal health records from 45.7 million adults in England between December 2020 and January 2022, this study compared the incidence of thrombotic and cardiovascular complications up to 26 weeks after first, second and booster doses of brands and combinations of COVID-19 vaccines used during the UK vaccination program with the incidence before or without the corresponding vaccination.

The incidence of common arterial thrombotic events (mainly acute myocardial infarction and ischaemic stroke) was generally lower after each vaccine dose, brand and combination. Similarly, the incidence of common venous thrombotic events, (mainly pulmonary embolism and lower limb deep venous thrombosis) was lower after vaccination. There was a higher incidence of previously reported rare harms after vaccination: vaccine-induced thrombotic thrombocytopenia after first ChAdOx1 vaccination, and myocarditis and pericarditis after first, second and transiently after booster mRNA vaccination (BNT-162b2 and mRNA-1273).

The authors concluded that these findings support the wide uptake of future COVID-19 vaccination programs.

The authors stress that their study has several limitations.

  • First, residual confounding, including that linked to delayed vaccination in high-risk individuals, may persist despite extensive adjustments for available covariates. We were able to identify some, but not all people who were clinically vulnerable (and hence might have been eligible for earlier vaccination): for example, younger adults in long-stay settings could not be reliably identified.
  • Second, we did not adjust for potential confounding by time-varying post-baseline factors that may have influenced receipt of vaccination and the outcomes of interest: for example, development of respiratory symptoms or being admitted into hospital leading to postponement of vaccination. Such confounding may explain estimated lower hazard ratios soon after vaccination.
  • Third, ascertainment of some outcomes may have been influenced by public announcements from regulatory agencies, such as the European Medicines Agency Pharmacovigilance Risk Assessment Committee announcement or the CDC announcement on myocarditis. This was addressed in sensitivity analyses for myocarditis and pericarditis, censoring follow-up at the time of public announcements of these adverse effects of vaccination, although the shorter follow-up times and corresponding smaller numbers of events in the restricted analyses meant that aHRs were estimated with reduced precision.
  • Fourth, outcomes may be underreported, particularly from people in nursing homes or among those with severe health conditions, due to diagnostic challenges; also, routine electronic health records, not intended for research, may under-ascertain less severe, non-hospitalised events. Both forms of potential underreporting, however, are expected to be uncommon for hospitalised thrombotic events.
  • Fifth, we restricted follow-up to 26 weeks after vaccination to prevent an influence of subsequent vaccinations on estimated associations and limit the impact of delayed vaccination on our findings. Horne et al. demonstrated selection bias in estimated HRs for non-COVID-19 death arising from deferred next-dose vaccination in people with a recent confirmed COVID-19 diagnosis or in poor health.
  • Sixth, we did not address long-term safety of vaccination, or the impact of subsequent booster doses.

Nonetheless, this study offers reassurance regarding the cardiovascular safety of COVID-19 vaccines, with lower incidence of common cardiovascular events outweighing the higher incidence of their known rare cardiovascular complications. No novel cardiovascular complications or new associations with subsequent doses were found. These findings support the wide uptake of future COVID-19 vaccination programs. The authors express their hope that this evidence addresses public concerns, supporting continued trust and participation in vaccination programs and adherence to public health guidelines.

Will the evidence convince the notorious anti-vaxers that regularly comment on my blog?

I very much doubt it – not because of the limitations of the study but because of the fact that anti-vaxers seem to be immune to any evidence that is out of line with their beliefs and conspiracy theories.

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