tetano
Editor, Senior Moderator
Vaccine
. 2022 Nov 1;S0264-410X(22)01342-1.
doi: 10.1016/j.vaccine.2022.10.073. Online ahead of print.
Association between history of SARS-CoV-2 infection and severe systemic adverse events after mRNA COVID-19 vaccination among U.S. adults
Lindsay K Tompkins[SUP] 1 [/SUP], James Baggs[SUP] 2 [/SUP], Tanya R Myers[SUP] 2 [/SUP], Julianne M Gee[SUP] 2 [/SUP], Paige L Marquez[SUP] 2 [/SUP], Sharon B Kennedy[SUP] 3 [/SUP], David Peake[SUP] 3 [/SUP], Dhruv Dua[SUP] 3 [/SUP], Anne M Hause[SUP] 2 [/SUP], Penelope Strid[SUP] 2 [/SUP], Winston Abara[SUP] 2 [/SUP], Rebecca Rossetti[SUP] 2 [/SUP], Tom T Shimabukuro[SUP] 2 [/SUP], David K Shay[SUP] 2 [/SUP]
Affiliations
Abstract
Background: Risk of experiencing a systemic adverse event (AE) after mRNA coronavirus disease 2019 (COVID-19) vaccination may be greater among persons with a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; data on serious events are limited. We assessed if adults reporting systemic AEs resulting in emergency department visits or hospitalizations during days 0-7 after mRNA COVID-19 vaccine dose 1 were more likely to have a history of prior SARS-CoV-2 infection compared with persons who reported no or non-severe systemic AEs.
Methods: We conducted a nested case-control study using v-safe surveillance data. Participants were ≥ 18 years and received dose 1 during December 14, 2020─May 9, 2021. Cases reported severe systemic AEs 0-7 days after vaccination. Three controls were frequency matched per case by age, vaccination date, and days since vaccination. Follow-up surveys collected SARS-CoV-2 histories.
Results: Follow-up survey response rates were 38.6 % (potential cases) and 56.8 % (potential controls). In multivariable analyses including 3,862 case-patients and 11,586 controls, the odds of experiencing a severe systemic AE were 2.4 (Moderna, mRNA-1273; 95 % confidence interval [CI]: 1.89, 3.09) and 1.5 (Pfizer-BioNTech, BNT162b2; 95 % CI: 1.17, 2.02) times higher among participants with pre-vaccination SARS-CoV-2 histories compared with those without. Medical attention of any kind for symptoms during days 0-7 following dose 2 was not common among case-patients or controls.
Conclusions: History of SARS-CoV-2 infection was significantly associated with severe systemic AEs following dose 1 of mRNA COVID-19 vaccine; the effect varied by vaccine received. Most participants who experienced severe systemic AEs following dose 1 did not require medical attention of any kind for symptoms following dose 2. Vaccine providers can use these findings to counsel patients who had pre-vaccination SARS-CoV-2 infection histories, experienced severe systemic AEs following dose 1, and are considering not receiving additional mRNA COVID-19 vaccine doses.
Keywords: 2019-nCoV Vaccine mRNA-1273; BNT162 vaccine; Nested case-control studies; Vaccine safety; mRNA vaccines.
. 2022 Nov 1;S0264-410X(22)01342-1.
doi: 10.1016/j.vaccine.2022.10.073. Online ahead of print.
Association between history of SARS-CoV-2 infection and severe systemic adverse events after mRNA COVID-19 vaccination among U.S. adults
Lindsay K Tompkins[SUP] 1 [/SUP], James Baggs[SUP] 2 [/SUP], Tanya R Myers[SUP] 2 [/SUP], Julianne M Gee[SUP] 2 [/SUP], Paige L Marquez[SUP] 2 [/SUP], Sharon B Kennedy[SUP] 3 [/SUP], David Peake[SUP] 3 [/SUP], Dhruv Dua[SUP] 3 [/SUP], Anne M Hause[SUP] 2 [/SUP], Penelope Strid[SUP] 2 [/SUP], Winston Abara[SUP] 2 [/SUP], Rebecca Rossetti[SUP] 2 [/SUP], Tom T Shimabukuro[SUP] 2 [/SUP], David K Shay[SUP] 2 [/SUP]
Affiliations
- PMID: 36372665
- DOI: 10.1016/j.vaccine.2022.10.073
Abstract
Background: Risk of experiencing a systemic adverse event (AE) after mRNA coronavirus disease 2019 (COVID-19) vaccination may be greater among persons with a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; data on serious events are limited. We assessed if adults reporting systemic AEs resulting in emergency department visits or hospitalizations during days 0-7 after mRNA COVID-19 vaccine dose 1 were more likely to have a history of prior SARS-CoV-2 infection compared with persons who reported no or non-severe systemic AEs.
Methods: We conducted a nested case-control study using v-safe surveillance data. Participants were ≥ 18 years and received dose 1 during December 14, 2020─May 9, 2021. Cases reported severe systemic AEs 0-7 days after vaccination. Three controls were frequency matched per case by age, vaccination date, and days since vaccination. Follow-up surveys collected SARS-CoV-2 histories.
Results: Follow-up survey response rates were 38.6 % (potential cases) and 56.8 % (potential controls). In multivariable analyses including 3,862 case-patients and 11,586 controls, the odds of experiencing a severe systemic AE were 2.4 (Moderna, mRNA-1273; 95 % confidence interval [CI]: 1.89, 3.09) and 1.5 (Pfizer-BioNTech, BNT162b2; 95 % CI: 1.17, 2.02) times higher among participants with pre-vaccination SARS-CoV-2 histories compared with those without. Medical attention of any kind for symptoms during days 0-7 following dose 2 was not common among case-patients or controls.
Conclusions: History of SARS-CoV-2 infection was significantly associated with severe systemic AEs following dose 1 of mRNA COVID-19 vaccine; the effect varied by vaccine received. Most participants who experienced severe systemic AEs following dose 1 did not require medical attention of any kind for symptoms following dose 2. Vaccine providers can use these findings to counsel patients who had pre-vaccination SARS-CoV-2 infection histories, experienced severe systemic AEs following dose 1, and are considering not receiving additional mRNA COVID-19 vaccine doses.
Keywords: 2019-nCoV Vaccine mRNA-1273; BNT162 vaccine; Nested case-control studies; Vaccine safety; mRNA vaccines.