Journal Article

Cohort study of cardiovascular safety of different COVID-19 vaccination doses among 46 million adults in England

Whiteley, William N., Khunti, Kamlesh, Sterne, Jonathan A. C., Wood, Angela M., Walker, Venexia, Torabi, Fatemeh, Abbasizanjani, Hoda, Horne, Elsie, Ip, Samantha, Akbari, Ashley, Denholm, Rachel, North, Teri-Louise, Denaxas, Spiros, Keene, Spencer, Sudlow, Cathie, Banerjee, Amitava, Li, Yangfan

2024

Overview

The first dose of COVID-19 vaccines led to an overall reduction in cardiovascular events, and in rare cases, cardiovascular complications. There is less information about the effect of second and booster doses on cardiovascular diseases. Using longitudinal health records from 45.7 million adults in England between December 2020 and January 2022, our study compared the incidence of thrombotic and cardiovascular complications up to 26 weeks after first, second and booster doses of brands and combinations of COVID-19 vaccines used during the UK vaccination program with the incidence before or without the corresponding vaccination. The incidence of common arterial thrombotic events (mainly acute myocardial infarction and ischaemic stroke) was generally lower after each vaccine dose, brand and combination. Similarly, the incidence of common venous thrombotic events, (mainly pulmonary embolism and lower limb deep venous thrombosis) was lower after vaccination. There was a higher incidence of previously reported rare harms after vaccination: vaccine-induced thrombotic thrombocytopenia after first ChAdOx1 vaccination, and myocarditis and pericarditis after first, second and transiently after booster mRNA vaccination (BNT-162b2 and mRNA-1273). These findings support the wide uptake of future COVID-19 vaccination programs. COVID-19 vaccines have been associated with rare cardiovascular and thrombotic complications. Here, the authors use population-based longitudinal electronic health record data from ~46 million adults in England to quantify these outcomes following different vaccine doses and schedules.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 2019-nCoV Vaccine mRNA-1273 - administration & dosage / 2019-nCoV Vaccine mRNA-1273 - adverse effects / 631/326/590 / 631/326/596/4130 / 692/699/75 / 692/700/1538 / 692/700/478/174 / Adolescent / Adult / Adults / Aged / Aged, 80 and over / BNT162 Vaccine - administration & dosage / BNT162 Vaccine - adverse effects / Cardiovascular diseases / Cardiovascular Diseases - epidemiology / Cerebral infarction / ChAdOx1 nCoV-19 - administration & dosage / ChAdOx1 nCoV-19 - adverse effects / Cohort Studies / COVID-19 / COVID-19 - prevention & control / COVID-19 vaccines / COVID-19 Vaccines - administration & dosage / COVID-19 Vaccines - adverse effects / Electronic health records / Electronic medical records / Embolism / England - epidemiology / Female / Heart diseases / Humanities and Social Sciences / Humans / Immunization / Immunization, Secondary - adverse effects / Incidence / Ischemia / Male / Middle Aged / mRNA / multidisciplinary / Myocardial infarction / Myocardial Infarction - epidemiology / Myocardial Infarction - etiology / Myocarditis / Myocarditis - epidemiology / Myocarditis - etiology / Pericarditis / Pulmonary Embolism - epidemiology / Pulmonary Embolism - etiology / Science / Science (multidisciplinary) / Thrombocytopenia / Thromboembolism / Thrombosis / Thrombosis - epidemiology / Thrombosis - etiology / Vaccination - adverse effects / Vaccines / Young Adult