Glaucoma cases reported post-COVID-19 vaccination : A VAERS database analysis

Abstract

ABSTRACTObjectiveTo evaluate glaucoma cases reported post-COVID-19 vaccination and describe the clinical presentations in these cases.DesignAn analysis of the Centers for Disease Control and Prevention (CDC) Vaccine Adverse Event Reporting System (VAERS) databaseParticipantsThe study includes 161 individuals who were reported for glaucoma after administration of COVID-19 vaccines [BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna) and Ad26.COV2.S (Janssen)] between December 2020 and April 2022.Main Outcome MeasuresEstimated crude reporting rate of glaucoma, clinical presentations, onset duration and associated risk factors.ResultsA total of 2,061,557,270 doses of COVID-19 vaccines were administered during the study timeframe. During this period, 161 glaucoma cases were reported with an estimated crude reporting rate (per million doses) of 0.09, 0.06 and 0.07 for BNT162b2, mRNA-1273 and Ad26.COV2.S, respectively. The majority of patients (n=130, 80.7%) received BNT162b2, vaccine, while 27 patients (16.8%) received mRNA-1273 and four patients (2.5%) received rAd26.COV2.S vaccines. The mean age of patients in the cohort was 60.41±17.56 years and 67.7% (n=109) were women. More than half (56.6%) were reported within the first week after vaccination. The glaucoma onset interval was significantly shorter in patients who received BNT162b2 and rAd26.COV2.S vaccines compared to mRNA-1273 (p=0.013). A higher risk of glaucoma incidence was observed in the short term in patients who received BNT162b2 vaccines compared to mRNA-1273 (p=0.05). In patients vaccinated with mRNA-1273, a significantly higher frequency of glaucoma cases was reported in older patients (p=0.047) compared to younger age groups.ConclusionsThe CDC-VAERS data suggest an extremely low safety concern for glaucoma on receiving BNT162b2, mRNA-1273, or Ad26.COV2.S vaccines. The onset interval of adverse events was shorter in patients who received BNT162b2 and rAd26.COV2.S vaccines compared to mRNA-1273. The glaucoma cases after mRNA-1273 vaccination were more commonly reported in older patients. These findings are subject to the limitations of passive reporting systems, under reporting and presumptive case definition, and should be considered preliminary without the medical record analysis for establishing a definitive diagnosis.