This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.
An inaccurate Canadian study suggesting an extremely high rate of heart inflammation after COVID-19 vaccines has been retracted due to a major mathematical error — but not before it spread like wildfire on anti-vaccination websites and social media.
The preprint study, which was released by researchers at the Ottawa Heart Institute last week but has not been peer-reviewed, looked at the rate of myocarditis and pericarditis cases after Moderna and Pfizer-BioNTech vaccinations in Ottawa from June 1 to July 31.
The study identified 32 patients with the rare side effects out of a total of 32,379 doses of mRNA vaccines given in Ottawa in the two-month period, finding an inordinately high rate of close to 1 in 1,000 — significantly higher than other international data has shown.
But the researchers made a critical error that experts say caused the study to be “weaponized” by the anti-vaccination movement at a time when concern over COVID-19 vaccine side effects are top of mind for parents whose kids may soon get the shot.
Black Creek Community Health volunteer Jasleen Kambo, 18, gets her first dose of the Moderna COVID-19 vaccine at a clinic run by Humber River Hospital at the Yorkgate Mall, in Toronto, on Apr. 14, 2021. (Evan Mitsui/CBC)
Risk of heart inflammation after shot ‘not correct’ in study
The researchers mistakenly failed to record the accurate number of vaccinations given out during that two-month period, despite the data on total doses being publicly available, and the figure turned out to be astronomically higher than what was presented in the study.
Instead of 32,379 mRNA vaccine doses administered in June and July, as the study suggests, there were actually more than 800,000 shots given out at that time, according to Ottawa Public Health.
That means the true rate of side effects is closer to 1 in 25,000 — not 1 in 1,000.
“We recalculated the rate, and the rate is not correct in that paper,” said Dr. Peter Liu, scientific director of the Ottawa Heart Institute and a co-author of the study, in an interview with CBC News.
“We were doing this on the run, in a way, and we were getting kind of the preliminary vaccination rate data, and so it turns out that that number was not complete.”
Dr. Andrew Crean, co-director of the cardiac MRI service at the Ottawa Heart Institute and the study’s lead author, confirmed to CBC News in an email Thursday that the preprint was being retracted.
Late Friday night, the study was officially marked as “withdrawn” on the medRxiv preprint server, with a link to a statement citing “a major underestimation” of the rate of occurrence.
“In order to avoid misleading either colleagues or the general public and press, we the authors unanimously wish to withdraw this paper on the grounds of incorrect incidence data,” the statement read.
“We thank the many peer reviewers who went out of their way to contact us and point out our error. We apologize to anyone who may have been upset or disturbed by our report.”
Crean said the authors uncovered the “significant error” days after posting it to the server, finding a “substantial overestimate” of the risk of heart inflammation after vaccination, then moved quickly to get the study withdrawn.
“As you know, preprints are not full peer-reviewed publications,” he said. “The peer-review process worked quickly and efficiently to detect our error and we were happy to retract this data once the error was confirmed.”
And Crean is absolutely right — this is exactly how the process is supposed to work.
Preprints are traditionally a way for academics to share early information on important subjects before the data is peer-reviewed and published, said Ivan Oransky, co-founder of Retraction Watch, a website that tracks errors in science journals.
“If in fact this is retracted quickly and withdrawn quickly based on what seems to be a pretty significant error, then it’s actually science doing what it should,” he said.
“The problem is not the preprint server, the problem is that nobody ever provides any context around it.”
Side effect remains rare, treatable
The Ottawa Heart Institute issued a tweet late Wednesday night, a week after the study was released, saying the authors “have requested the retraction of the preprint” due to “incorrect data” that “vastly inflates the incidence of post-vaccine myocarditis.”
“We are sorry a preprint paper citing incorrect data led to misinformation on the incidence of post-vaccine myocarditis,” a spokesperson for the institute said in a followup statement to CBC News on Friday morning.
“COVID-19 vaccines are safe and have been proven effective against the disease. We invite anyone who has not yet received the shot to please get vaccinated.”
While some real-world data has shown an increased risk of heart inflammation after COVID-19 vaccines among younger age groups, it’s important to remember the side effect is rare.
“Even if you took the worst-case scenario, it doesn’t happen in 99.9 per cent of cases,” said Montreal cardiologist and epidemiologist Dr. Christopher Labos. “So the vast majority of people, even young people, are going to get vaccinated and not have an issue with myocarditis.”
A small proportion of people who do experience the side effect will experience mild symptoms that are treatable without hospital care, Labos said, and don’t appear to cause “any major heart damage.”
Benefits of COVID-19 vaccine outweigh low risk of heart inflammation, experts say
3 months ago
A small number of cases of heart inflammation — specifically, myocarditis and pericarditis — have occurred in teens and young adults following mRNA COVID-19 vaccination, but experts say the benefits of a vaccine far outweigh the risk. 2:00
“So it looks as if this is a relatively mild side effect that should not dissuade anybody from getting vaccinated,” he said. “Because the benefits really outweigh the risks.”
Despite this reassuring conclusion, experts say the speed in which preliminary data is being uploaded, manipulated and disseminated in the pandemic means one error can cause a lot of damage.
“Mistakes happen; I have no major criticisms to level against anybody here. They did exactly what they’re supposed to do: When you make a mistake — you fix it,” said Labos.
“The real problem here is that I worry that people are going to keep using the wrong version of the study to advance their agenda.”
Cherry-picking ‘rotten’ data
Despite not getting any mainstream media coverage in Canada or anywhere else at the time it was published, the study quickly spread around the world on social media and anti-vaccination websites, where it was incorrectly claimed as evidence of the damage COVID-19 vaccines cause.
The preprint has been shared on Twitter more than 11,000 times in the week since it’s been published, according to Altmetric, a company that tracks where published research is posted online. That’s in the top five per cent of all research it’s ever tracked.
University of Ottawa Heart Institute Retrospective Study Finds 1 in 1,000 mRNA Vaccinations Leads to Myopericarditis<a href=”https://t.co/tcRauKapjR”>https://t.co/tcRauKapjR</a>
The study also showed up on numerous anti-vaccination websites, misrepresented as evidence that the rate of myocarditis had been intentionally underestimated and that thousands of children could be at risk of heart failure after vaccination in the future.
Timothy Caulfield, Canada Research Chair in health law and policy at the University of Alberta who has studied the challenges with preprints in the pandemic, says the way in which the erroneous study has been shared widely online to promote an anti-vaccination agenda is “incredibly frustrating.”
“First of all, the topic is so sensitive with parents, with young adults. When people are doing this risk-benefit calculus and they see a study like this, even if it just crosses their radar on social media, it can have an impact on their intentions,” he said.
“So a mistake like this can do real, serious harm — and I think it probably already has, unfortunately.”
The error highlights the challenges with preprints, Caulfield said. On the one hand, they can create an open dialogue with academics and get research into the public domain quickly on important topics, but on the other hand, they can do irreparable long-term damage.
“Preprints can quickly be weaponized by activists when the data seems to bolster their ideology, and they lend credibility to claims that might otherwise appear non-scientific,” added Jonathan Jarry, a biological scientist with McGill University’s Office for Science and Society in Montreal.
“And when a preprint gets retracted because it was fraudulent or just simply incorrect, that bell is hard to un-ring in the public square that is the internet.”
Reports of heart inflammation among small number of children that got Pfizer vaccine
4 months ago
A small number of children who received the Pfizer-BioNTech vaccine have reported swelling in the heart. Researchers and officials are tracking the phenomenon closely, but so far they’ve found no cause for alarm. 2:03
Caulfield said that once an inaccurate preprint gets released, it can “take on a life of its own.”
“And that’s exactly what has happened here,” he said. “I can guarantee that you are going to continue to see references to this version of the paper for a long time to come.”
These so-called “zombie papers” are often intentionally shared within anti-vaccination circles long after they’re retracted or corrected in order to disingenuously influence public opinion and fuel misinformation, said Caulfield.
“It’s extreme cherry-picking,” he said. “And the cherry is rotten.”
New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.
Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.
A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.
Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.
On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.
While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.
This report by The Canadian Press was first published Oct. 7, 2024.
EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.
The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.
The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.
She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.
The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.
The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.
This report by The Canadian Press was first published Oct. 4, 2024.
WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.
But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.
These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.
It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.
On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.
Here’s what to know about veneers and how to avoid bogus providers and services:
What are dental veneers?
Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.
Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.
Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.
In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.
“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”
What are the risks of getting veneers from someone who isn’t licensed?
Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.
Patients need to be anesthetized before the enamel is removed from their teeth.
“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”
One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.
“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.
Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.
How can I spot bogus veneer providers online?
One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”
Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.
Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.
Performing dental work without an appropriate license is illegal, the ADA notes.
Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.
Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.
What are the best ways to find legitimate dental providers?
The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.
“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
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