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Duffy J, Myers TR, Marquez P, Rouse D, Brown H, Zhang B, Shay DK, Moro PL. JYNNEOS Vaccine Safety Surveillance During the 2022 Mpox Outbreak Using the Vaccine Adverse Event Reporting System and V-safe, United States, 2022 to 2023. Sex Transm Dis 2024; 51:509-515. [PMID: 38647241 PMCID: PMC11239308 DOI: 10.1097/olq.0000000000001978] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
BACKGROUND In response to the 2022 mpox outbreak in the United States, people with higher potential for exposure to mpox were recommended to receive 2 doses of the JYNNEOS vaccine. Vaccine safety was monitored using 2 complementary systems. METHODS The Vaccine Adverse Event Reporting System (VAERS) is a passive surveillance system that accepts reports of adverse events after vaccination. VAERS is capable of rapidly identifying rare adverse events and unusual reporting patterns. Medical records were requested and reviewed for adverse events of special interest, including myocarditis. Adverse event reporting rates were calculated as the number of verified adverse event cases divided by the number of JYNNEOS doses administered. V-safe for mpox was a voluntary smartphone-based vaccine safety surveillance system that sent enrolled persons text messages linked to health surveys asking about reactions and health impact events occurring after vaccination. RESULTS There were 1,207,056 JYNNEOS doses administered in the United States. VAERS received 1927 reports for JYNNEOS. The myocarditis reporting rate per million doses was 2.69 after dose 1 and 8.64 after dose 2. V-safe had 213 participants complete at least one health survey. Rates of injection site and systemic reactions were similar in the first week after dose 1 and dose 2. CONCLUSIONS JYNNEOS vaccine safety surveillance findings from VAERS and v-safe did not identify any unexpected safety concerns. The VAERS reporting rate for myocarditis was similar to previously published population background rates.
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Affiliation(s)
- Jonathan Duffy
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - Tanya R. Myers
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - Paige Marquez
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - Douglas Rouse
- Office of Biostatistics and Pharmacovigilance, Food and Drug Administration, Silver Spring, MD
| | - Hannah Brown
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - Bicheng Zhang
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - David K. Shay
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
| | - Pedro L. Moro
- Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA
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2
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Soe P, Wong H, Naus M, Muller MP, Vanderkooi OG, Kellner JD, Top KA, Sadarangani M, Isenor JE, Marty K, De Serres G, Valiquette L, McGeer A, Bettinger JA. mRNA COVID-19 vaccine safety among older adults from the Canadian National Vaccine Safety Network. Vaccine 2024; 42:3819-3829. [PMID: 38714447 DOI: 10.1016/j.vaccine.2024.04.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/14/2024] [Accepted: 04/30/2024] [Indexed: 05/09/2024]
Abstract
This study examined short-to-medium term safety of COVID-19 vaccines among adults aged ≥65 years using the Canadian National Vaccine Safety Network active safety surveillance data. Both vaccinated and unvaccinated older adult participants recruited from seven provinces and territories were included in the analysis. Safety was assessed at 7 days after COVID-19 vaccination (dose 1, 2 and 3), and 7 months after dose 1. Multivariable logistic regression was used to examine the association between BNT162b2/mRNA-1273 COVID-19 vaccines and two short-term health events: 1) health event preventing daily activities and/or required medical consultation, 2) serious health events resulting in an emergency department visit and/or hospitalization within 7 days following each dose. We also assessed the rates of serious health events for the period between dose 1 and 2, and 7-months following dose 1. Between December 2020 and February 2022, a total of 173,038, 104,452, and 13,970 older adults completed dose 1, dose 2, and dose 3 surveys, respectively. The control survey was completed by 2,955 unvaccinated older adults. Health events occurred more frequently among recipients after dose 2 homologous mRNA-1273 (adjusted odds ratio [95 % confidence interval]: 2.91 [2.24-3.79]) and dose two heterologous (BNT162b2 followed by mRNA-1273): 1.50 [1.12-2.02] compared to unvaccinated counterparts. There was no difference in event rates after any dose of BNT162b2 and unvaccinated participants. The rates of serious health events following COVID-19 vaccination were very low (≤0.3 %) across all vaccine products and doses, and were not higher compared to unvaccinated controls, and were not associated with an emergency department visit or hospitalization within 7 days following vaccination. Reported symptoms were self-limited and rarely required medical assessment. Our findings further strengthen the current evidence that mRNA COVID-19 vaccines are safe and can be used to inform older adults about expected adverse events following COVID-19 vaccination.
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Affiliation(s)
- Phyumar Soe
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Hubert Wong
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Monika Naus
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; BC Center for Disease Control, Vancouver, British Columbia, Canada
| | | | - Otto G Vanderkooi
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - James D Kellner
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer E Isenor
- Canadian Center for Vaccinology, IWK Health and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Kimberly Marty
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | | | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Canada
| | - Allison McGeer
- Department of Microbiology, Sinai Health, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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Lee JJY, Bernatsky S, Benchimol EI, Kuenzig ME, Kwong JC, Li Q, Widdifield J. COVID-19 vaccination safety and associated health care utilization among adults with inflammatory bowel disease - a population-based self-controlled case series analysis. BMC Gastroenterol 2024; 24:189. [PMID: 38816836 PMCID: PMC11137996 DOI: 10.1186/s12876-024-03273-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 05/22/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND AND AIMS There is an incomplete understanding of the full safety profiles of repeated COVID-19 vaccinations in patients with inflammatory bowel disease (IBD). Among individuals with IBD, we assessed whether COVID-19 vaccines were associated with serious adverse events of special interest (AESI) and health care utilization [all-cause hospitalizations, Emergency Department (ED) visits, gastroenterology visits, IBD-related visits]. METHODS Using comprehensive administrative health data from Ontario, Canada, adults with IBD who received at least one COVID-19 vaccine from December 2020-January 2022 were included. Self-controlled case series analyses were conducted to evaluate the relative incidence rates of AESI and health care utilization outcomes across post-vaccination risk and control periods. RESULTS Among 88,407 IBD patients, 99.7% received mRNA vaccines and 75.9% received ≥ 3 doses. Relative to control periods, we did not detect an increase in AESI. IBD patients had fewer all-cause hospitalizations during post-vaccination risk periods. Patients experienced more all-cause ED visits after dose 2 [Relative Incidence (RI):1.08(95%CI:1.04-1.12)] but fewer visits after doses 3 [RI:0.85 (95%CI:0.81-0.90)] and 4 [RI:0.73 (95%CI:0.57-0.92)]. There was no increase in gastroenterologist visits or IBD-related health care utilization post-vaccination. There were fewer IBD-related hospitalizations after dose 1 [RI:0.84 (95%CI:0.72-0.98)] and 3 [RI:0.63 (95%CI:0.52-0.76)], fewer IBD-related ED visits after dose 3 [RI:0.81 (95%CI:0.71-0.91)] and 4 [RI:0.55 (95%CI:0.32-0.96)], and fewer outpatient visits after dose 2 [RI:0.91 (95%CI:0.90-0.93)] and 3 [RI:0.87 (95%CI:0.86-0.89)]. CONCLUSION This population-based study did not detect increased AESI, all-cause or IBD-related health care utilization following COVID-19 vaccination, suggesting a lack of association between vaccination and increased disease activity.
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Affiliation(s)
- Jennifer J Y Lee
- ICES Central, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
| | - Sasha Bernatsky
- Division of Rheumatology and Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Eric I Benchimol
- ICES Central, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - M Ellen Kuenzig
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jeffrey C Kwong
- ICES Central, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
- Public Health Ontario, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Qing Li
- ICES Central, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
| | - Jessica Widdifield
- ICES Central, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada
- Sunnybrook Research Institute, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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4
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Amer SA, Al-Zahrani A, Imam EA, Ishteiwy EM, Djelleb IF, Abdullh LR, Ballaj D, Amer YA, El-Sokkary RH, Elshabrawy AM, Eskander G, Shah J, Raza ML, ALsafa AMAA, Ali HT, Fawzy HM. Exploring the reported adverse effects of COVID-19 vaccines among vaccinated Arab populations: a multi-national survey study. Sci Rep 2024; 14:4785. [PMID: 38413637 PMCID: PMC10899622 DOI: 10.1038/s41598-024-54886-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/17/2024] [Indexed: 02/29/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been a major challenge worldwide for the past years with high morbidity and mortality rates. While vaccination was the cornerstone to control the pandemic and disease spread, concerns regarding safety and adverse events (AEs) have been raised lately. A cross-sectional study was conducted between January 1st and January 22nd, 2022, in six Arabic countries namely Saudi Arabia, Egypt, Syria, Libya, Iraq, and Algeria. We utilized a self-administered questionnaire validated in Arabic which encompassed two main parts. The first was regarding sociodemographic data while the second was about COVID-19 vaccination history, types, doses, and experienced AEs. A multistage sampling was employed in each country, involving the random selection of three governorates from each country, followed by the selection of one urban area and one rural area from each governorate. We included the responses of 1564 participants. The most common AEs after the first and second doses were local AEs (67.9% and 46.6%, respectively) followed by bone pain and myalgia (37.6% and 31.8%, respectively). After the third dose, the most common AEs were local AEs (45.7%) and fever (32.4%). Johnson and Johnson, Sputnik Light, and Moderna vaccines showed the highest frequency of AEs. Factors associated with AEs after the first dose included an increase in age (aOR of 61-75 years compared to the 12-18 years group: 2.60, 95% CI: 1.59-4.25, p = 0.001) and male gender (OR: 0.72, 95% CI: 0.63-0.82, p < 0.001). The cumulative post-vaccination COVID-19 disease was reported with Sinovac (16.1%), Sinopharm (15.8%), and Johnson and Johnson (14.9) vaccines. History of pre-vaccination SARS-CoV-2 infection significantly increases the risk of post-vaccination COVID-19 after the first, second, and booster doses (OR: 3.09, CI: 1.9-5.07, p < 0.0001; OR: 2.56, CI: 1.89-3.47, p < 0.0001; and OR: 2.94, CI: 1.6-5.39, p = 0.0005 respectively). In conclusion, AEs were common among our participants, especially local AEs. Further extensive studies are needed to generate more generalizable data regarding the safety of different vaccines.
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Affiliation(s)
- Samar A Amer
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagzig University, Zagazig, Egypt.
- Membership at the Royal Colleague of General Practitioners [INT], London, UK.
- Department of Mental Health Primary Care, Nova University, Lisbon, Portugal.
| | - Ali Al-Zahrani
- Research and Innovation Group, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Esraa A Imam
- Department of Family Medicine, Faculty of Medicine, MOH, Riyadh, Saudi Arabia
| | - Ehab M Ishteiwy
- Internship Year at Albayda Medical Center (AMC), Omar-Almukhtar University, Albayad, Libya
| | - Ines F Djelleb
- Faculty of Medicine, Badji Mokhtar, 23000, Annaba, Algeria
| | - Lina R Abdullh
- Department of Dermatology, Faculty of Medicine, University of Baghdad, Baghdad, Iraq
| | - Dana Ballaj
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Youmna A Amer
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Zagzig University, Zagazig, Egypt
| | - Rehab H El-Sokkary
- Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Arafa M Elshabrawy
- Endocrinology and Diabetes Division, Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Georgette Eskander
- Department of Biochemistry, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | | | | | | | | | - Hebatallah M Fawzy
- Lecturer of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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5
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Lin CH, Chen TA, Chiang PH, Hsieh AR, Wu BJ, Chen PY, Lin KC, Tsai ZS, Lin MH, Chen TJ, Chen YC. Incidence and Nature of Short-Term Adverse Events following COVID-19 Second Boosters: Insights from Taiwan's Universal Vaccination Strategy. Vaccines (Basel) 2024; 12:149. [PMID: 38400133 PMCID: PMC10892656 DOI: 10.3390/vaccines12020149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 02/25/2024] Open
Abstract
This study evaluates the incidence and characteristics of adverse events (AEs) following the second COVID-19 booster dose, leveraging Taiwan's distinctive approach of extending booster vaccinations to all citizens, unlike the targeted high-risk group strategies in other countries. Utilizing data from Taipei Veterans General Hospital's Vaccine Adverse Event Reporting System (VAERS) from 27 October 2022 to 19 January 2023, this research examines AEs in 441 out of 1711 booster recipients, considering factors like age, vaccine brands, and booster combinations. The findings revealed incidence rates (IRs) of 25.6% (95% CI: 21.1-30.8) after the first booster and 24.9% (95% CI: 20.5-30.0) after the second, mostly non-serious, with those having AEs post-first booster being five times more likely to report them again (incidence rate ratio, 5.02, p < 0.001). Significantly, switching from the mRNA1273 vaccine to another brand reduced AE risk by 18%. This study underscores that AEs are more repetitive than cumulative with additional booster doses, advocating for personalized vaccination strategies based on individual medical histories and previous vaccine reactions. These insights are valuable for healthcare providers in discussing potential AEs with patients, thereby improving vaccine compliance and public trust, and for policymakers in planning future booster vaccination strategies.
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Affiliation(s)
- Ching-Hao Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.L.); (T.-A.C.); (K.-C.L.); (M.-H.L.); (T.-J.C.)
| | - Tsung-An Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.L.); (T.-A.C.); (K.-C.L.); (M.-H.L.); (T.-J.C.)
| | - Pin-Hsuan Chiang
- Big Data Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (P.-H.C.); (Z.-S.T.)
| | - Ai-Ru Hsieh
- Department of Statistics, Tamkang University, New Taipei City 251, Taiwan;
| | - Bih-Ju Wu
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112, Taiwan;
| | - Po-Yu Chen
- Department of Family Medicine, Cheng Hsin General Hospital, Taipei 112, Taiwan;
| | - Kuan-Chen Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.L.); (T.-A.C.); (K.-C.L.); (M.-H.L.); (T.-J.C.)
| | - Zih-Syun Tsai
- Big Data Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (P.-H.C.); (Z.-S.T.)
| | - Ming-Hwai Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.L.); (T.-A.C.); (K.-C.L.); (M.-H.L.); (T.-J.C.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.L.); (T.-A.C.); (K.-C.L.); (M.-H.L.); (T.-J.C.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu 31064, Taiwan
| | - Yu-Chun Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.L.); (T.-A.C.); (K.-C.L.); (M.-H.L.); (T.-J.C.)
- Big Data Center, Taipei Veterans General Hospital, Taipei 112, Taiwan; (P.-H.C.); (Z.-S.T.)
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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6
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Hayes KN, Harris DA, Zullo AR, Djibo DA, Smith-Ray RL, Taitel MS, Singh TG, McMahill-Walraven C, Chachlani P, Wen KJ, McCarthy EP, Gravenstein S, McCurdy S, Baird KE, Moran D, Fenson D, Deng Y, Mor V. Data resource profile: COVid VAXines effects on the aged (COVVAXAGE). Int J Popul Data Sci 2023; 8:2170. [PMID: 38425722 PMCID: PMC10900297 DOI: 10.23889/ijpds.v8i6.2170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Background To improve the assessment of COVID-19 vaccine use, safety, and effectiveness in older adults and persons with complex multimorbidity, the COVid VAXines Effects on the Aged (COVVAXAGE) database was established by linking CVS Health and Walgreens pharmacy customers to Medicare claims. Methods We deterministically linked CVS Health and Walgreens customers who had a pharmacy dispensation/encounter paid for by Medicare to Medicare enrollment and claims records. Linked data include U.S. Medicare claims, Medicare enrollment files, and community pharmacy records. The data currently span 01/01/2016 to 08/31/2022. "Research-ready" files were created, with weekly indicators for vaccinations, censoring, death, enrollment, demographics, and comorbidities. Data are updated quarterly. Results As of November 2022, records for 27,086,723 CVS Health and 23,510,025 Walgreens unique customer IDs were identified for potential linkage. Approximately 91% of customers were matched to a Medicare beneficiary ID (95% for those aged 65 years or older). In the final linked cohort, there were 38,250,873 unique beneficiaries representing ~60% of the Medicare population. Among those alive and enrolled in Medicare as of January 1, 2020 (n = 33,721,568; average age = 73 years, 74% White, 51% Medicare Fee-for-Service, and 11% dual-eligible for Medicaid), the average follow-up time was 130 weeks. The cohort contains 16,021,055 beneficiaries with evidence a first COVID-19 vaccine dose. Data are stored on the secure Medicare & Medicaid Resource Information Center Health & Aging Data Enclave. Data access Investigators with funded or in-progress funding applications to the National Institute on Aging who are interested in learning more about the database should contact Dr Vincent Mor [Vincent_mor@brown.edu] and Dr Kaleen Hayes [kaley_hayes@brown.edu]. A data dictionary can be provided under reasonable request. Conclusions The COVVAXAGE cohort is a large and diverse cohort that can be used for the ongoing evaluation of COVID-19 vaccine use and other research questions relevant to the Medicare population.
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Affiliation(s)
- Kaleen N. Hayes
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
| | - Daniel A. Harris
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
| | - Andrew R. Zullo
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA, 02903
- Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA, 02903
| | - Djeneba Audrey Djibo
- CVS Health Clinical Trial Services, Safety, Surveillance & Collaboration, Blue Bell, PA, USA, 19422
| | - Renae L. Smith-Ray
- Walgreens Center for Health & Wellbeing Research, Walgreen Company, Deerfield, IL, USA, 60015
| | - Michael S. Taitel
- Walgreens Center for Health & Wellbeing Research, Walgreen Company, Deerfield, IL, USA, 60015
| | - Tanya G. Singh
- Walgreens Center for Health & Wellbeing Research, Walgreen Company, Deerfield, IL, USA, 60015
| | - Cheryl McMahill-Walraven
- CVS Health Clinical Trial Services, Safety, Surveillance & Collaboration, Blue Bell, PA, USA, 19422
| | - Preeti Chachlani
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
| | - Katherine J. Wen
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN, USA, 37240
| | - Ellen P. McCarthy
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA, 02131
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA, 02215
| | - Stefan Gravenstein
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
- Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA, 02903
- Division of Geriatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA, 02903
| | | | | | | | | | - Yalin Deng
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
| | - Vincent Mor
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA, 02903
- Center of Innovation in Long-Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, RI, USA, 02903
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7
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Phillips A, Jiang Y, Walsh D, Andrews N, Artama M, Clothier H, Cullen L, Deng L, Escolano S, Gentile A, Gidding G, Giglio N, Junker T, Huang W, Janjua N, Kwong J, Li J, Nasreen S, Naus M, Naveed Z, Pillsbury A, Stowe J, Vo T, Buttery J, Petousis-Harris H, Black S, Hviid A. Background rates of adverse events of special interest for COVID-19 vaccines: A multinational Global Vaccine Data Network (GVDN) analysis. Vaccine 2023; 41:6227-6238. [PMID: 37673715 DOI: 10.1016/j.vaccine.2023.08.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND The Global COVID Vaccine Safety (GCoVS) project was established in 2021 under the multinational Global Vaccine Data Network (GVDN) consortium to facilitate the rapid assessment of the safety of newly introduced vaccines. This study analyzed data from GVDN member sites on the background incidence rates of conditions designated as adverse events of special interest (AESI) for COVID-19 vaccine safety monitoring. METHODS Eleven GVDN global sites obtained data from national or regional healthcare databases using standardized methods. Incident events of 13 pre-defined AESI were included for a pre-pandemic period (2015-19) and the first pandemic year (2020). Background incidence rates (IR) and 95% confidence intervals (CI) were calculated for inpatient and emergency department encounters, stratified by age and sex, and compared between pre-pandemic and pandemic periods using incidence rate ratios. RESULTS An estimated 197 million people contributed 1,189,652,926 person-years of follow-up time. Among inpatients in the pre-pandemic period (2015-19), generalized seizures were the most common neurological AESI (IR ranged from 22.15 [95% CI 19.01-25.65] to 278.82 [278.20-279.44] per 100,000 person-years); acute disseminated encephalomyelitis was the least common (<0.5 per 100,000 person-years at most sites). Pulmonary embolism was the most common thrombotic event (IR 45.34 [95% CI 44.85-45.84] to 93.77 [95% CI 93.46-94.08] per 100,000 person-years). The IR of myocarditis ranged from 1.60 [(95% CI 1.45-1.76) to 7.76 (95% CI 7.46-8.08) per 100,000 person-years. The IR of several AESI varied by site, healthcare setting, age and sex. The IR of some AESI were notably different in 2020 compared to 2015-19. CONCLUSION Background incidence of AESIs exhibited some variability across study sites and between pre-pandemic and pandemic periods. These findings will contribute to global vaccine safety surveillance and research.
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Affiliation(s)
- A Phillips
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - Y Jiang
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - D Walsh
- Department of Statistics, University of Auckland, New Zealand; Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - N Andrews
- UK Health Security Agency, London, UK
| | - M Artama
- Faculty of Social Sciences, Tampere University, Finland
| | - H Clothier
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - L Cullen
- Public Health Scotland, Edinburgh, Scotland, UK
| | - L Deng
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - S Escolano
- Université Paris-Saclay, UVSQ, Inserm, CESP, High Dimensional Biostatistics for Drug Safety and Genomics, Villejuif, France
| | - A Gentile
- Hospital de Niños Ricardo Gutierrez Epidemiology Department Buenos Aires City, Argentina
| | - G Gidding
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia; The University of Sydney Northern Clinical School, Australia
| | - N Giglio
- Hospital de Niños Ricardo Gutierrez Epidemiology Department Buenos Aires City, Argentina
| | - T Junker
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - W Huang
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan; National Taiwan University Children's Hospital, Taipei, Taiwan
| | - N Janjua
- British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
| | - J Kwong
- ICES, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine and the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - J Li
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - S Nasreen
- ICES, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - M Naus
- British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Z Naveed
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - A Pillsbury
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales, Australia
| | - J Stowe
- UK Health Security Agency, London, UK
| | - T Vo
- Faculty of Social Sciences, Tampere University, Finland; Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - J Buttery
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - H Petousis-Harris
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand; Associate Professor, School of Population Health, University of Auckland, New Zealand
| | - S Black
- Global Vaccine Data Network, Global Coordinating Centre, Auckland, New Zealand
| | - A Hviid
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Hromić-Jahjefendić A, Sezer A, Aljabali AAA, Serrano-Aroca Á, Tambuwala MM, Uversky VN, Redwan EM, Barh D, Lundstrom K. COVID-19 Vaccines and Myocarditis: An Overview of Current Evidence. Biomedicines 2023; 11:biomedicines11051469. [PMID: 37239140 DOI: 10.3390/biomedicines11051469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19 vaccines have been widely used to reduce the incidence and disease severity of COVID-19. Questions have lately been raised about the possibility of an association between COVID-19 vaccines and myocarditis, an inflammatory condition affecting the myocardium, or the middle layer of the heart. Myocarditis can be caused by infections, immune reactions, or toxic exposure. The incidence rate of myocarditis and pericarditis was calculated to be 5.98 instances per million COVID-19 vaccine doses delivered, which is less than half of the incidences after SARS-CoV-2 infection. Myocarditis rates in people aged 12 to 39 years are around 12.6 cases per million doses following the second dose of mRNA vaccination. Adolescent men are more likely than women to develop myocarditis after receiving mRNA vaccines. The objectives of this systematic review and meta-analysis are to find out how often myocarditis occurs after receiving the COVID-19 vaccine, as well as the risk factors and clinical repercussions of this condition. Nevertheless, the causal relationship between vaccination and myocarditis has been difficult to establish, and further research is required. It is also essential to distinguish between suggested cases of myocarditis and those confirmed by endomyocardial biopsy.
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Affiliation(s)
- Altijana Hromić-Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71000 Sarajevo, Bosnia and Herzegovina
| | - Abas Sezer
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka cesta 15, 71000 Sarajevo, Bosnia and Herzegovina
| | - Alaa A A Aljabali
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, P.O. Box 566, Irbid 21163, Jordan
| | - Ángel Serrano-Aroca
- Biomaterials and Bioengineering Laboratory, Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, c/Guillem de Castro 94, 46001 Valencia, Spain
| | - Murtaza M Tambuwala
- Lincoln Medical School, Brayford Pool Campus, University of Lincoln, Lincoln LN6 7TS, UK
| | - Vladimir N Uversky
- Department of Molecular Medicine and USF Health Byrd Alzheimer's Institute, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Elrashdy M Redwan
- Department of Biological Science, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Therapeutic and Protective Proteins Laboratory, Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City for Scientific Research and Technology Applications, New Borg EL-Arab 21934, Egypt
| | - Debmalya Barh
- Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur 721172, India
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
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9
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Buchan SA, Alley S, Seo CY, Johnson C, Kwong JC, Nasreen S, Thampi N, Lu D, Harris TM, Calzavara A, Wilson SE. Myocarditis or Pericarditis Events After BNT162b2 Vaccination in Individuals Aged 12 to 17 Years in Ontario, Canada. JAMA Pediatr 2023; 177:410-418. [PMID: 36848096 PMCID: PMC9972235 DOI: 10.1001/jamapediatrics.2022.6166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Importance The risk of myocarditis or pericarditis after COVID-19 messenger RNA vaccines varies by age and sex, and there is some evidence to suggest increasing risk with shorter intervals between dose 1 and 2 (ie, interdose interval). Objective To estimate the incidence of reported myocarditis or pericarditis after BNT162b2 vaccine among adolescents and to describe the clinical information associated with these events. Design, Setting, and Participants This was a population-based cohort study using passive vaccine safety surveillance data linked to the provincial COVID-19 vaccine registry. Included in the study were all adolescents aged 12 to 17 years in Ontario, Canada, who received 1 or more doses of BNT162b2 vaccine between December 14, 2020, and November 21, 2021, and reported an episode of myocarditis or pericarditis. Data were analyzed from December 15, 2021, to April 22, 2022. Exposure Receipt of BNT162b2 (Comirnaty [Pfizer-BioNTech]) vaccine. Main Outcomes and Measure Reported incidence of myocarditis or pericarditis meeting level 1 to 3 of the Brighton Collaboration case definition per 100 000 doses of BNT162b2 administered by age group (12-15 years vs 16-17 years), sex, dose number, and interdose interval. All clinical information associated with symptoms, health care usage, diagnostic test results, and treatment at the time of the acute event were summarized. Results There were approximately 1.65 million doses of BNT162b2 administered and 77 reports of myocarditis or pericarditis among those aged 12 to 17 years, which met the inclusion criteria during the study period. Of the 77 adolescents (mean [SD] age, 15.0 [1.7] years; 63 male individuals [81.8%]), 51 (66.2%) developed myocarditis or pericarditis after dose 2 of BNT162b2. Overall, 74 individuals (96.1%) with an event were assessed in the emergency department, and 34 (44.2%) were hospitalized (median [IQR] length of stay, 1 [1-2] day). The majority of adolescents (57 [74.0%]) were treated with nonsteroidal anti-inflammatory drugs only, and 11 (14.3%) required no treatment. The highest reported incidence was observed among male adolescents aged 16 to 17 years after dose 2 (15.7 per 100 000; 95% CI, 9.7-23.9). Among those aged 16 to 17 years, the reporting rate was highest in those with a short (ie, ≤30 days) interdose interval (21.3 per 100 000; 95% CI, 11.0-37.2). Conclusions and Relevance Results of this cohort study suggest that there was variation in the reported incidence of myocarditis or pericarditis after BNT162b2 vaccine among adolescent age groups. However, the risk of these events after vaccination remains very rare and should be considered in relation to the benefits of COVID-19 vaccination.
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Affiliation(s)
- Sarah A. Buchan
- Public Health Ontario, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
| | - Sarah Alley
- Public Health Ontario, Toronto, Ontario, Canada
| | - Chi Yon Seo
- Public Health Ontario, Toronto, Ontario, Canada
| | | | - Jeffrey C. Kwong
- Public Health Ontario, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada,Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada,University Health Network, Toronto, Ontario, Canada
| | - Sharifa Nasreen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
| | - Nisha Thampi
- Public Health Ontario, Toronto, Ontario, Canada,Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Diane Lu
- Public Health Ontario, Toronto, Ontario, Canada
| | | | - Andrew Calzavara
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sarah E. Wilson
- Public Health Ontario, Toronto, Ontario, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada,ICES, Toronto, Ontario, Canada
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