Monday night, I was flipping channels—mainly because I’m old and often, rather than streaming my content, I actually still flip channels—when I came across a shocking and disturbing scene. Actually, what I saw wasn’t so much shocking at first as it was puzzling. It was an NFL football game, with the action stopped and a player apparently injured. However, the tableau struck me immediately as odd and disturbing because there were so many players milling around on the field, seemingly all of both teams. This sort of thing usually doesn’t happen if the injury is a run-of-the-mill sprain; it usually only happens when the injury is very, very bad. And so it was, as it quickly became apparent to me that CPR was being administered to a player on the field, with the shocked announcers commenting on what was happening in hushed and horrified voices, not knowing how to discuss what was happening. I soon learned that the player was Buffalo Bills safety Damar Hamlin, who had gotten up after a tackle but then collapsed. As the CPR on Hamlin continued for what seemed like an interminable amount of time, I had two thoughts. First, I—like the millions watching—wondered if Hamlin had died and was saddened, even though I didn’t know who he was. My second thought, unfortunately, was: Have antivaxxers started blaming Hamlin’s cardiac arrest on vaccines yet?
Why? To antivaxxers, it’s always about the vaccines. It’s always been about the vaccines. It always will be about the vaccines. In these days of “died suddenly” narratives, they immediately blame any sudden collapse, heart attack, or death suffered by a young person on COVID-19 vaccines.
I hate that this is now how my brain is now wired to think when faced with the tragic collapse and potential death of a young athlete (or anyone, for that matter), but it is, unfortunately, no longer unreasonable to think that way, as much as I detest it. This is where we are as a society, nearly three years into the pandemic, when any sudden death or collapse of a young person is immediately seized upon by antivaxxers as being due to COVID-19 vaccines. Unfortunately, that stray thought (which was shared by many people), was prescient, not that it took a lot of savvy to predict what antivaxxers would do, for example:
And, from the anonymous antivax Twitterverse:
Even Dr. Drew got into the action:
Because Damar Hamlin’s cardiac arrest and resuscitation have been such a big story over the last couple of days, I thought it worth discussing, both in terms of what probably happened and what the probable cause was, compared, of course, to the antivax narrative. Long before the pandemic, I used to emphasize repeatedly how, to antivaxxers, it’s all about the vaccines, always and above all. However, if you weren’t paying close attention to the antivaccine blogosphere and social media you probably didn’t see it, and many didn’t believe it or downplayed it as rare. With the rollout of COVID-19 vaccines two years ago, those of us who knew the antivaccine movement predicted that antivaxxers would weaponize every death that occurred within even a month of vaccines because that’s what they did. We were, of course, correct, as claims of a “vaccine holocaust” were on full display within weeks to a few months after the mass vaccination program really got underway two years ago, and by 2021 antivaxxers were in full “vaccines are depopulation” mode. It was all utterly and sadly predictable, and not even new, given that antivaxxers used to blame vaccines for sudden infant death syndrome and then later blamed Gardasil for killing the adolescent girls who received it. In case you didn’t get the point, there was even an antivax movie about Gardasil called Sacrificial Virgins…in 2018! This same sort of narrative blaming vaccines for the sudden cardiac deaths of young people was resurrected during the pandemic as the “died suddenly” narrative, even though the phenomenon of sudden arrhythmic death syndrome (SADS) had been described as early as the 1970s.
Again, to antivaxxers, it’s always about the vaccines. It’s always been about the vaccines. It always will be about the vaccines.
So, as we continue to hope that Damar Hamlin recovers, given that he is still in the intensive care unit on a ventilator and apparently had to be resuscitated a second time after arriving at the hospital, I don’t think it’s a bad thing to discuss what probably happened and why antivaxxers falsely seize on vaccines as the supposed cause of his cardiac arrest. I will also acknowledge that antivaxxers have been claiming that it’s “unethical” for doctors to make a speculative “diagnosis” of Hamlin without having examined him or seen his test results, but that, too, is projection, given that the “died suddenly” narrative is nothing but speculating that every sudden death of a relatively young and healthy person had to be due to COVID-19 vaccines, to the point of harassing the grieving families of the deceased.
Commotio cordis: Cardiac arrest due to a blow to the chest
The first thought that came to mind among emergency room doctors, and trauma surgeons on social media was that the most likely cause of Hamlin’s collapse was commotio cordis:
One cardiologist mentioned:
This is a phenomenon when a blow to the chest can result in disruption of the heart rhythm and ventricular fibrillation and cardiac arrest. It’s not common, but it is a described phenomenon. As is the case with any cardiac arrest, survival is inversely proportional to how quickly effective CPR and electrical cardioversion are administered, and because commotio cordis happens outside of the hospital, like other cardiac arrests in the community, it has a high mortality rate. A 2012 review article noted:
Approximately 10 to 20 cases are added to the Commotio Cordis Registry yearly.3,4 Until the late 1990s, commotio cordis was only rarely reported. It is thought that this increase in the number of cases is not due to an increase in incidence but rather to a greater awareness based on the 1995 New England Journal of Medicine report on commotio cordis.2 Many more cases of commotio cordis are now recognized as such. Indeed, what was thought to be a uniquely North American phenomenon is increasingly being reported in countries outside the United States.5
Commotio cordis primarily affects young individuals, generally in adolescence. In the Registry, the mean age is 15 years4; there have been very few commotio cordis victims over the age of 20 years. It traditionally has been thought that the stiffening of the chest wall contributes to this decrease in incidence in older individuals; however, this decreased incidence in those over 20 years of age is likely also influenced by the reduced ball-related sports participation by older individuals. Victims are overwhelmingly male. A partial explanation for the overwhelming predominance of males is that they populate the majority of sports in which commotio occurs, but it appears unlikely that the 95% predilection for males reflects a 95% incidence of chest wall impact in sports and activities of daily living. I suspect that there may also be some gender-related biological susceptibility to chest wall impact induced sudden cardiac death. Indeed, other arrhythmic conditions demonstrate a gender predilection for arrhythmia, including females with long-QT syndrome6,7 and males with Brugada syndrome.8 Genetic differences in ion channels between the sexes or biological modification of these channels by sex hormones may be involved in the male susceptibility to commotio cordis.
You can see where one antivax narrative has gone given that Hamlin is 24 years old and therefore older than the age range in which this condition is most commonly seen, but I’ll get to that later. One common misconception about commotio cordis is that it requires a blow hard enough to damage the heart muscle and cause a cardiac contusion, something that I used to see not infrequently in victims of vehicular trauma back in the 1990s when I still did trauma surgery. Timing is likely more important, as commotio cordis is much more likely to happen if the blow lands at a specific point in the cardiac electrical cycle, as shown in this nice graphic from Wikipedia:
Of course, commotio cordis is not the only potential diagnosis in the differential diagnosis. Another doctor mentioned:
In case you don’t know what HOCM is:
Others didn’t think hypertrophic obstructive cardiomyopathy was likely. Why? Remember when I wrote about SADS and how the reason that we do sports physicals on student athletes in grade school on up is to try to catch the known inherited heart abnormalities that can predispose to sudden unexpected cardiac arrest? If we do sports physicals on kids before letting them participate in sports, imagine how much more rigorous the physical assessment is of professional athletes, many of whom are paid millions of dollars a year, before they are signed:
The point, however, is that Damar Hamlin’s tragic collapse, given what was witnessed and what we know, was so incredibly unlikely to be due to COVID-19 vaccines as to be near homeopathic, but antivaxxers immediately put vaccine injury at the very top of their delusional “differential diagnosis,” to the point where it’s nearly the only possibility, other than perhaps to consider and dismiss far more likely possibilities. We can say with a very high degree of confidence just based on what we know now that vaccines did not cause Damar Hamlin to try to “die suddenly,” but in the bizarro world of antivaxxers it is taken as an article of faith that it was vaccines that caused Hamlin’s cardiac arrest.
Before I move on and discuss how the antivax narrative has…evolved…to contort itself to justify the claim that vaccines are why Damar Hamlin is in the ICU after an on-field cardiac arrest, I have to mention how he is doing. Last night, a sports reporter noted::
Stories from overnight indicate that Hamlin is still on the ventilator and has been placed in the prone position. CNN Chief Medical Correspondent Dr. Sanjay Gupta reported:
CNN Chief Medical Correspondent Dr. Sanjay Gupta explained that when the heart is not beating well, fluid can sometimes back up into the lungs and make it hard for medical staff to oxygenate the patient. So, they will flip the person on their stomach into a prone position to make breathing easier.
This is one possibility, but another possibility is that Hamlin has post-arrest acute respiratory distress syndrome (ARDS), which can occur in nearly half of patients successfully resuscitated after an out-of-hospital cardiac arrest. Whatever the cause, it’s not good, and doctors are doing everything they can to support Hamlin’s heart and lungs until they can (hopefully) heal. Also, I note that prone positioning was used to treat ARDS before the pandemic, when people became more familiar with it as a means of treating the ARDS due to COVID-19.
Again, it’s not the vaccine, but that’s not what antivaxxers have been saying.
How the antivax narrative about Damar Hamlin evolved
I started this post by saying something simple, which I will repeat again because I want you to understand it:
To antivaxxers, it’s always about the vaccines. It’s always been about the vaccines. It always will be about the vaccines.
If you don’t believe me, just watch how the narrative about Damar Hamlin evolved among antivaxxers from what I described at the beginning of this post and will repeat now:
As more and more reporting suggested that it was probably the blow to the chest, possibly combined with a congenital heart conduction defect, that had resulted in Hamlin’s cardiac arrest, the antivax narrative…changed. Basically, antivaxxers started claiming that commotio cordis is incredibly rare and never been reported in the NFL before. Unsurprisingly, the pandemic’s wrongest man Alex Berenson was at the forefront of pushing this narrative based on a cherry picked article:
Of course, as I noted that was a decade-old article. It has since become appreciated that the condition is very likely underdiagnosed:
Although commotio cordis usually involves impact from a baseball, it has also been reported during hockey, softball, lacrosse, karate, and other sports activities in which a relatively hard and compact projectile or bodily contact caused impact to the person’s precordium. While only 216 instances have been reported to the US Commotio Cordis Registry (as of 2012), [4, 5] this is probably a considerable underestimation of its true incidence since this entity still goes unrecognized in many instances and continues to be underreported.
And, in case you didn’t get it the first time:
Approximately 15-25 commotio cordis deaths are added to the US Commotio Cordis Registry every year.  The actual incidence is, in all likelihood, considerably greater because of lack of recognition and underreporting.
Moreover, just because Damar Hamlin is 24 years old does not mean that he couldn’t have been the victim of commotio cordis:
Although reported in a wide range of ages (6 wk to 50 y), commotio cordis occurs most frequently in male children aged 10-18 years, with a mean age of 15 ± 9 years. Data from the US Commotio Cordis Registry show that 26% are younger than 10 years and 75% are younger than 18 years. 
Also, even if commotio cordis is every bit as rare as Berenson and his sycophants, toadies, and lackeys are trying to portray it, that wouldn’t mean that Damar Hamlin didn’t suffer from it. Given the thousands of hits NFL players are subject to each and every year and have been subject to for decades, eventually one would expect that even a rare tragic event like this would happen. The law of large numbers applies, in which, when the numbers are large enough, eventually even rare events occur.
As more discussion occurred, the antivax narrative…evolved…further, for example:
Actually, no, you cannot “safely assume that those known preconditions were not present,” a statement that Malone made after having cited the same article I just cited above, which he apparently did not read:
Autopsy of those with fatal commotio cordis typically shows normal cardiac morphology. Small oval or circular abrasions or bruises are often noted over the precordium, primarily over the left ventricle. In general, there’s no evidence of rib fractures, hemothorax, hemopericardium, external myocardial contusion; no congenital or acquired structural entities known to predispose young people and athletes to sudden death; no evidence for aortic rupture or traumatic injury; and no evidence of either damage or thrombosis of the coronary arteries.
So, no. NFL physicians very well might not have found anything that would predispose Damar Hamlin to commotio cordis because there probably wasn’t anything to find. Unsurprisingly, throughout yesterday and last night, the antivax narrative continued to…evolve…further. Enter Dr. Peter McCullough, who told Steve Kirsch:
I watched the play live both as a fan and a cardiologist and I saw blunt neck and chest trauma, a brief recovery after the tackle and then a classic cardiac arrest. I have communicated to one of the most experienced trainers in the world and we agree that it was a cardiac arrest in the setting of a big surge of adrenalin. If Damar Hamlin indeed took one of the COVID-19 vaccines, then subclinical vaccine-induced myocarditis must be considered in the differential diagnosis.
Also, according to Kirsch:
Note that McCullough originally speculated that the injury that Buffalo Bills safety Damar Hamlin was due to commotio cordis (a phenomenon in which a sudden blunt impact to the chest causes sudden death in the absence of cardiac damage). The time delay from the hit until he collapsed is expected in commotio cordis.
Note that Dr. McCullough started out by going with his gut as a cardiologist and latching onto the most likely diagnosis from an actual science-based perspective, namely commotio cordis. Then he realized his error and…corrected course:
Peter believes that the ventricular tachycardia and ventricular fibrillation could have been set up by the vaccine if he took it.
“If he took it.” After all, the NFL never imposed a vaccine mandate on its players, although for the 2021 season it did impose policies in which a game canceled due to a COVID-19 outbreak would, if it couldn’t be rescheduled during the regular season, be forfeited by the team that had the outbreak and no one on the team would be paid for the forfeited game. The league has reported that 95% of its players and personnel have been vaccinated.
NFL policies aside, there you have it. To antivaxxers, it’s always about the vaccines. It’s always been about the vaccines. It always will be about the vaccines, to which I will add: No matter how much the antivaxxer has to torture events and data or string together different claims and conspiracy theories to make it about the vaccines. In this case, Dr. McCullough combined the fear mongering about the small risk of myocarditis in young men due to COVID-19 vaccines with the whole false “died suddenly” conspiracy narrative, but cleverly made it a “just asking questions” sort of wild speculation, rather than outright saying that this is what happened. He didn’t have to say it outright. He knew that his JAQing off would, when it hit antivax social media, be transformed into assertions rather than speculation, particularly after the appearance in antivax Substacks of links to a case series of two rugby players who died after a blow to the chest, one of whom had a distant history of viral myocarditis and the other of whom had evidence on autopsy of fibrosis of the heart consistent with previous myocarditis, leading the authors to conclude:
The occurrence of chest wall trauma during sports activities is frequent and, under very specific conditions, can be associated with severe ventricular arrhythmia. A sequela of myocarditis increases the risk of lethal ventricular arrhythmias following blunt chest trauma. Further studies and systematic CMR assessments should be performed to evaluate the potentially higher risk of LVTA and the benefit of and an adaptation of the rules, in terms of health and medico-economic aspects.
Moreover, going back to the same article on commotio cordis:
Histologic findings are almost always normal. There’s typically no evidence of acute or chronic myocardial infarction, infection, or inflammation, nor evidence of active or healed myocarditis or arrhythmogenic right ventricular cardiomyopathy. Hemorrhage has been reported in the anterior left ventricular wall and in the A-V node and specialized conduction system, but the significance of these findings is uncertain.
In other words, nearly all commotio cordis happens without any evidence of heart inflammation, acute or chronic. On autopsy, histologic findings in the heart of the young athletes who die of commotio cordis are almost always stone cold normal. Basically, antivaxxers cherry picked a two patient case series that speculates that a history of myocarditis might predispose athletes to commotio cordis and use it to speculate that it must have been vaccine-induced myocarditis that predisposed Damar Hamlin to suffering the same.
Everything old is new again
I will conclude by noting, as is my wont when it comes to COVID-19 antivax claims, that there is nothing new under the sun and that everything old is new again. The claim that young people are “dying suddenly” after vaccines is not new to COVID-19 vaccines. It dates back to antivaxxers attributing the deaths of young women and adolescent girls to HPV vaccines. The predecessor of the “died suddenly” lie is the related and longstanding antivax claim that vaccines cause sudden infant death syndrome (SIDS), a seeming association that derives from the unfortunate fact that the most common age for SIDS (2-4 months) happens to coincide with the time frame when infants receive a lot of vaccines, never mind that there is no evidence of even association and, if anything, vaccines might actually be inversely associated with the risk of SIDS.
Meanwhile, antivaxxers have been taking it even further into more despicable territory. For example, Steve Kirsch is intertwining claims that the vaccine did it with calls for Nuremberg 2.0-style “justice” for Damar Hamlin and doing it in the most despicable way possible, starting with:
The medical experts I consulted believe that there is a high likelihood that Damar Hamlin was brain dead within 10 minutes after he dropped to the ground.
The primary reason for this conclusion is the 9 minutes of CPR. It is simply very rare for someone not to be brain dead at that point. Nobody I talked to has ever heard of such a case. That doesn’t mean it hasn’t happened. It just means it is rare.
I pray that this is not the case, but I think we need to prepare for that possibility.
And then demanding:
We need to prepare for the very likely possibility that Damar Hamlin is brain dead.
If he is brain dead, there is nothing we can do to bring him back.
If he is brain dead, the COVID vaccine must be considered as a possible suspect.
If Damar Hamlin is dead, I hope that there will be transparency and a full autopsy to discover whether the COVID vaccine was responsible for his death.
If we do not consider the possibility that the COVID vaccine killed Damar Hamlin, we will have let a killer roam free to kill again. And again. And again.
And, of course, he quotes a commenter spewing a conspiracy theory:
There is ZERO chance the NFL lets the family have an autopsy performed for possible link to vaccine. If it showed a link and that information became public, the league would probably shut down the rest of the year at least since every player would be considered a ticking time bomb. Players Association will go nuts. I’d say they pay off his family to prevent posthumous analysis if that’s where this ends up.
Kirsch, however, is not alone in his despicable assumption that Hamlin is dead and that vaccines killed him that he then uses to call for a “Nuremberg 2.0” (without using the actual term) and claim that the “true cause” of his collapse is being “lied about” and “covered up.” A quick trip to Paul Alexander’s Substack revealed this headline:
In his post, Dr. Alexander tries to make it a racial issue, while spewing racist invective about “illegals from South America.” I’m going to liberally quote him so that you don’t actually have to visit his Substack to see just how bad this rhetoric is getting:
It is time to lay murder charges on Pfizer, Moderna, CDC, NIH, FDA, NIAID, Fauci, Francis Collins, Walensky, Ashish Jha etc. It is time. These beasts killed a black man openly on live television and the black activists must step up now! Black live DO NOT matter to these beasts like Pfizer et al., never did for public health people like Fauci, so it is time we lay murder charges for this time, they were actually at the scene of the crime with their murder weapon. No trial even needed!
Blacks in America must stand up now. The Biden administration is flooding the border with illegals from South America who with my own eyes, get preference over blacks in New York and Buffalo. I imagine across the US. I saw sitting shocked in hospitals how whites and blacks are sidelined and sent to the back over illegals from South America. This is wrong. The assault with this vaccine that acts like a biological weapon of sorts, delivers differential morbidity and mortality on minorities. Blacks must stand up! They killed a black man on national television. This is too much ‘in your face’.
Later in his post, Dr. Alexander rants:
I say under NO condition will we. Yes, they killed him, they killed DAMAR and know it and we will continue to go after them for we want all who did this, who brought this fraud so called vaccine, this entire pandemic fraud, all of it from lockdowns to the fraud vaccine, properly deposed in proper legal settings, proper tribunals with proper judges and we want accountability and justice. If judges rule that all of their money is to be taken, we take it. If judges rule those involved must be imprisoned, at the highest levels of government, we jail them for life. We lock them up! If judges rule capital punishment is the remedy, we seek the death penalty! Does not matter to me who.
They killed a black man, they stopped his heart in front of you, stopped his breathing with their death shot. DAMAR died for 10 minutes. From all we know so far. New reports indicate they had to bring him back to life in the hospital too.
They committed murder on live national television during an NFL game! They killed a black man! Their gun, weapon of choice was a mRNA/DNA gene injection ‘so called vaccine’. They know it. They know we are beginning to grapple with it and ask the right questions and they know the players on that field who cried, they cried out of love and horror for their teammate, yet they cried too because they know they are juiced up with the gene fraud injection and they know that that means, the bell may toll for thee too! Soon.
I’d be willing to bet that, before he saw a Black football player collapse on the field on national television, Dr. Alexander never gave a second thought to racial inequality other than to dismiss it as no longer a major problem or to attack the Black Lives Matter movement. (He did, after all, willingly join the Trump administration to serve as an advisor on the pandemic for his HHS Secretary.) Then he saw an opening to blame that Black player’s cardiac arrest on COVID-19 vaccines. Meanwhile, Dr. McCullough was on Tucker Carlson’s show promoting an only somewhat less histrionic narrative about how COVID-19 vaccines were responsible for Damar Hamlin’s condition. The level of hysteria among antivaxxers has gotten even more despicable than usual, and remember that these are the people who before the pandemic routinely used to try to convince mothers whose babies died of SIDS that vaccines did it.
Again, to antivaxxers, it’s always about the vaccines. It’s always been about the vaccines. It always will be about the vaccines, no matter how much it hurts the families of those who suffer a tragic sudden medical condition, like Damar Hamlin. Moreover, it’s not just about the vaccines, it’s about the conspiracy theories that they can weave that it is the vaccines, in which vaccines “killed” Damar Hamlin and the NFL is going to cover it up. Far be it from me to defend the NFL’s behavior after this incident, particularly given how long after Hamlin’s collapse the NFL took to officially announce that the game was postponed, but I would also point out that, in the horrific and tragic event that Hamlin does die, the pressure for an autopsy would be almost impossible to resist; law enforcement might even demand it. (I would also point out that, were Hamlin actually brain dead, it is unlikely that they would be putting him in the prone position and trying to optimize his cardiac and pulmonary status.) In any event, all his faux claims that he really hopes that Hamlin is not brain dead, Kirsch and other antivaxxers promoting the lie that vaccines are responsible for his condition come across a “protesting too much” as they appear to be salivating over the possibility that this young man might tragically die after his unexpected collapse.
Finally, I debated whether or not to write about this, to the point where early this morning I even dithered, while revising what I had written last night and dithering more before finally scheduling the post to publish now. If Damar Hamlin’s family happens to see this, I really do hope that it doesn’t add to their pain; in fact, I hope that refuting the lies and disinformation swirling around Hamlin’s collapse, thanks to antivaxxers and conspiracy theorists, has the opposite effect. I also join his teammates, family, and people everywhere hoping that Hamlin eventually recovers fully to play again.
And I still very much resent how antivax ghouls have led me to the point that one of the first things I think when I see a media report of a young person collapsing suddenly—or, as in this case, see it on live television—is to wonder whether antivaxxers have started blaming vaccines yet. I hate that.
ADDENDUM 1/6/2023: I wrote more about this, in particular how the conspiracy theory that COVID-19 vaccines are killing young athletes appears to have started and been continually amplified starting at least a year ago.