Journal
NATURE MEDICINE
Volume 27, Issue 7, Pages 1290-+Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41591-021-01408-4
Keywords
-
Funding
- Medical Research Council [MC_PC_19075]
- BREATHE: the Health Data Research Hub for Respiratory Health through the UK Research and Innovation Industrial Strategy Challenge Fund [MC_PC_19004]
- Public Health Scotland
- Community Health and Social Care Directorate of the Scottish Government
- National Institute for Health Research (NIHR) School for Primary Care Research
- NIHR Collaboration for Leadership in Applied Health Research and Care Oxford
- NIHR Oxford BREATHE Centre
Ask authors/readers for more resources
Analysis of data from the EAVE II cohort in Scotland has shown that a first dose of the ChAdOx1 nCoV-19 vaccine may be associated with increased risks of idiopathic thrombocytopenic purpura, arterial thromboembolic events, and hemorrhagic events. However, there were no positive associations found between the BNT162b2 vaccine and these adverse events.
New data from the EAVE II cohort in Scotland suggests that a first dose of the ChAdOx1 nCoV-19 vaccine might be associated with a small increase in the risk of idiopathic thrombocytopenic purpura between 0 and 27 d after vaccination. Reports of ChAdOx1 vaccine-associated thrombocytopenia and vascular adverse events have led to some countries restricting its use. Using a national prospective cohort, we estimated associations between exposure to first-dose ChAdOx1 or BNT162b2 vaccination and hematological and vascular adverse events using a nested incident-matched case-control study and a confirmatory self-controlled case series (SCCS) analysis. An association was found between ChAdOx1 vaccination and idiopathic thrombocytopenic purpura (ITP) (0-27 d after vaccination; adjusted rate ratio (aRR) = 5.77, 95% confidence interval (CI), 2.41-13.83), with an estimated incidence of 1.13 (0.62-1.63) cases per 100,000 doses. An SCCS analysis confirmed that this was unlikely due to bias (RR = 1.98 (1.29-3.02)). There was also an increased risk for arterial thromboembolic events (aRR = 1.22, 1.12-1.34) 0-27 d after vaccination, with an SCCS RR of 0.97 (0.93-1.02). For hemorrhagic events 0-27 d after vaccination, the aRR was 1.48 (1.12-1.96), with an SCCS RR of 0.95 (0.82-1.11). A first dose of ChAdOx1 was found to be associated with small increased risks of ITP, with suggestive evidence of an increased risk of arterial thromboembolic and hemorrhagic events. The attenuation of effect found in the SCCS analysis means that there is the potential for overestimation of the reported results, which might indicate the presence of some residual confounding or confounding by indication. Public health authorities should inform their jurisdictions of these relatively small increased risks associated with ChAdOx1. No positive associations were seen between BNT162b2 and thrombocytopenic, thromboembolic and hemorrhagic events.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available