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Interesting article on so-called "long vax", rare long-COVID-like syndrome linked to COVID vaccines.
Risk clearly far lower than getting longCOVID from COVID itself (which everyone will of course get at some point), really hard to convincingly demonstrate a connection, and I worry about confounders here. Plus of course anti-vaxxers will try to make hay.
But as Harlan says, as a scientists there's "an obligation to have an open mind". https://www.science.org/content/article/rare-link-between-coronavirus-vaccines-and-long-covid-illness-starts-gain-acceptance
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I'm quite surprised that the phenomenon of developing these symptoms after a vaccination wasn't easily foreseen as simply a natural consequence of rolling out a virus vaccine to the public — right in the middle of an epidemic of said virus.
(continued)
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Before the pandemic, we already knew that:
1) Most viral symptoms are not direct results of the virus, but are rather results of the immune system's response to the virus.
2) A large percentage of viral infections are asymptomatic, some simply because the immune system does not recognize the virus.
3) If you receive the vaccination at the same time that you have an asymptomatic infection, your new immune response can lead to the development of new symptoms.
(continued)
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We already knew all this.
Therefore, shouldn't we have been able to predict that this phenomenon would happen as simply a natural consequence of rolling out a virus vaccine to the public — right in the middle of an epidemic of said virus?
@pyrrhus @richardsever I wonder too about the assumption that those who developed adverse reaction X to a vaccine would somehow avoid a more severe bout of X when infected with the virus if it is the immune response that appears to be the cause.
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I think the assumption is that the immune response to a viral infection is quite different from the immune response to a vaccine, and therefore the symptoms associated with a viral infection can be quite severe while the symptoms associated with a vaccine can be barely noticeable.
(continued)
@pyrrhus @richardsever “I think the assumption is that the immune response to a viral infection is quite different from the immune response to a vaccine”
Can you maybe explain this to me a little more. I’ve worked from the assumption that the immune response is not different as much as it is less or modified?
To my simplified understanding the myo/pericarditis seems to demonstrate this?
@auscandoc @pyrrhus I assume there will be a lot more antigens with viral infection and a broader response to 'disease'. With the vaccine it's basically just Spike. that might underlie myocarditis in both cases but still be a subset of what's experienced in viral infection - no? I mean there is no way you're gonna get a cytokine storm with the vaccine.
@richardsever @pyrrhus My “wondering” is if it is antigen volume (+/- genetic/sex/age predisposition) that plays a part in triggering the cytokine storm rather than antigen diversity (wondering as I really know so little about it). What reading I have done seems to implicate the spike and not the other antigens. Very interested in other reading though #myocarditis #SARSCOV2 #mRNAVaccine
E.g. (now I don’t claim to understand much of this :). https://www.science.org/doi/10.1126/sciimmunol.adh3455
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I'm sorry, I should have clarified what I meant by "immune response". Similar to what Richard replied, but in a bit more detail:
The immune response to a vaccine includes:
• Vaccine is taken up into cells, which presents the spike protein to the immune system.
• The immune system responds by producing antibodies and T cells that recognize the spike protein.
• That's pretty much it. There's not much in this immune response to result in noticeable symptoms.
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In contrast, the immune response to a virus infection includes:
• Virally infected cells are attacked by the immune system. (if it recognizes that the cells are infected)
• As a result of the attack on virally infected cells, there is inflammation and tissue damage.
• Inflammation and tissue damage can lead to noticeable tissue-specific symptoms. (or system-wide symptoms if the nervous system is infected)
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To provide a concrete example:
Last year I received a shingles vaccine. It triggered 12 weeks of severely debilitating meningitis.
Was the meningitis a "side-effect" of the vaccine?
Not really. I have a history of recurring shingles, which may be due to the fact that my mother intentionally infected me with chickenpox as a newborn, before my immune response had fully developed.
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What probably happened was that I just happened to have an ongoing infection of the virus in my brain at the same time that I happened to receive the shingles vaccine.
Then, the new immune response from the vaccine triggered a stronger immune response to the pre-existing infection.
The stronger immune response to the pre-existing infection led to the development of new symptoms, in this case meningitis, post-vaccination.
I hope this is clear. 
@pyrrhus @richardsever No need to apologize. Appreciate you taking the time to talk me through it :). The extra information is really helpful. Thanks.
Quite the example though! Nasty. And I was ticked just because I got a small patch of shingles at the injection dermatome when I got my first dose. Pales in comparison! 
@pyrrhus @auscandoc @richardsever This interests me because I had a booster vaccination 4 weeks after a Covid infection in late 2021, and have had Long Covid ever since. Could be coincidence of course. (I've since had a further booster which had no obvious effects on the condition either way.)
@eleanorrees @pyrrhus @richardsever Can I ask why you chose to have the booster so soon after (but don’t feel obliged to answer if you don’t wish)?
@auscandoc @pyrrhus @richardsever Waiting 28 days was the advice at the time. (in the UK)
@eleanorrees @pyrrhus @richardsever Thanks. Interesting. Memory obviously a bit fuzzy but I think our recommendation here was consistently at least three months.
@auscandoc @pyrrhus @richardsever At the time it felt sensible to lower chances of reinfection as soon as possible (with two kids in school and my husband's job involving going into lots of people's homes, just staying away from people wasn't really an option).