Thrombocytopenia and venous thromboembolic events after BNT162b2, CoronaVac, ChAdOx1 vaccines and SARS-CoV-2 infection: a self-controlled case series study
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Published:2023-11-22
Issue:1
Volume:13
Page:
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ISSN:2045-2322
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Container-title:Scientific Reports
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language:en
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Short-container-title:Sci Rep
Author:
Ab Rahman NorazidaORCID, Lim Ming TsueyORCID, Lee Fei YeeORCID, Wo Wee Kee, Yeoh Hee Sheong, Peariasamy Kalaiarasu M.ORCID, Sivasampu SheaminiORCID, Ramli Azuana, Lee Sing Chet, Choo Sim Mei, Appanan Maheshwara Rao, King Teck Long, Yen Chia How, Anak Jam Emelyne Bani, Mahmud Fatihah, Mohamad Nor Fariz Safhan, Badrul Hisham Muhammad Hazrul, Saharudin Siti Nurhafizah, Ayub Nor Aliya, Sevalingam Raj Kumar, Bahari Rashidah, Ibrahim Nor Nadziroh, Mohd Noor Nurain, Mohamed Nor Lisa, Zainal Abidin Nurul Huda, Wong Hin Seng, Ghazali Siti Nur Akmal, Rozkhaidi Nurul Afifah, Shaduqi Norzubaidatulhikmah, Hossain Hanisah, Lay Jeannette Jieni, Mohamad Nazri Nor Azizah,
Abstract
AbstractThis study assessed the association between COVID-19 vaccines, SARS-CoV-2 infection and the risk of thrombocytopenia and venous thromboembolism (VTE). This self-controlled case series study used hospital records between 1st February 2021 and 28th February 2022 linked to the national immunisation registry and COVID-19 surveillance data in Malaysia. Conditional Poisson regression was used to estimate incidence rate ratios (IRR) of events in the risk period (day 1–21 post-exposure) relative to control period with the corresponding 95% confidence interval (CI) adjusted for calendar period. We found no significant increased risk of thrombocytopenia in 1–21 days following BNT162b2, CoronaVac and ChAdOx1 vaccines while the risk was increased following SARS-CoV-2 infection (IRR 15.52, 95% CI 13.38–18.00). Similarly, vaccination with BNT162b2, CoronaVac, or ChAdOx1 was not associated with an increased risk of VTE during the 1–21 days risk period. SARS-CoV-2 infection was associated with increased risk of VTE (IRR 39.84, 95% CI 27.45–32.44). Our findings showed low event rates of thrombocytopenia and VTE following booster vaccination with comparable safety profiles between those who received homologous and heterologous booster combinations. Our findings showed the risk of thrombocytopenia and VTE was not increased after COVID-19 vaccination while the risks were substantially higher after SARS-CoV-2 infection.
Funder
Kementerian Kesihatan Malaysia
Publisher
Springer Science and Business Media LLC
Subject
Multidisciplinary
Reference43 articles.
1. Polack, F. P. et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N. Engl. J. Med. 383(27), 2603–2615 (2020). 2. Voysey, M. et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet 397(10269), 99–111 (2021). 3. Suah, J. L. et al. PICK-ing Malaysia’s epidemic apart: Effectiveness of a diverse COVID-19 vaccine portfolio. Vaccines (Basel) 9(12), 1381 (2021). 4. European Medicines Agency. COVID-19 Vaccine AstraZeneca: Benefits still outweigh the risks despite possible link to rare blood clots with low platelets 2021 [1 June 2022]. Available from: https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-benefits-still-outweigh-risks-despite-possible-link-rare-blood-clots. 5. Pottegård, A. et al. Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: Population based cohort study. bmj 373, n1114 (2021).
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