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Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland

Colin R. Simpson Orcid Logo, Steven Kerr, Srinivasa Vittal Katikireddi Orcid Logo, Colin McCowan, Lewis D. Ritchie, Jiafeng Pan, Sarah J. Stock Orcid Logo, Igor Rudan, Ruby S. M. Tsang Orcid Logo, Simon de Lusignan Orcid Logo, F. D. Richard Hobbs, Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo, Chris Robertson, Aziz Sheikh Orcid Logo

Nature Communications, Volume: 13, Issue: 1

Swansea University Authors: Ashley Akbari Orcid Logo, Ronan Lyons Orcid Logo

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DOI (Published version): 10.1038/s41467-022-32264-6

Abstract

We investigated thrombocytopenic, thromboembolic and hemorrhagic events following a second dose of ChAdOx1 and BNT162b2 using a self-controlled case series analysis. We used a national prospective cohort with 2.0 million(m) adults vaccinated with two doses of ChAdOx or 1.6 m with BNT162b2. The incid...

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Published in: Nature Communications
ISSN: 2041-1723
Published: Springer Science and Business Media LLC 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa60875
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spelling 2022-09-09T15:55:34.7972211 v2 60875 2022-08-23 Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false 2022-08-23 HDAT We investigated thrombocytopenic, thromboembolic and hemorrhagic events following a second dose of ChAdOx1 and BNT162b2 using a self-controlled case series analysis. We used a national prospective cohort with 2.0 million(m) adults vaccinated with two doses of ChAdOx or 1.6 m with BNT162b2. The incidence rate ratio (IRR) for idiopathic thrombocytopenic purpura (ITP) 14–20 days post-ChAdOx1 second dose was 2.14, 95% confidence interval (CI) 0.90–5.08. The incidence of ITP post-second dose ChAdOx1 was 0.59 (0.37–0.89) per 100,000 doses. No evidence of an increased risk of CVST was found for the 0–27 day risk period (IRR 0.83, 95% CI 0.16 to 4.26). However, few (≤5) events arose within this risk period. It is perhaps noteworthy that these events all clustered in the 7–13 day period (IRR 4.06, 95% CI 0.94 to 17.51). No other associations were found for second dose ChAdOx1, or any association for second dose BNT162b2 vaccination. Second dose ChAdOx1 vaccination was associated with increased borderline risks of ITP and CVST events. However, these events were rare thus providing reassurance about the safety of these vaccines. Further analyses including more cases are required to determine more precisely the risk profile for ITP and CVST after a second dose of ChAdOx1 vaccine. Journal Article Nature Communications 13 1 Springer Science and Business Media LLC 2041-1723 15 8 2022 2022-08-15 10.1038/s41467-022-32264-6 Data availability:A data-dictionary covering the datasets used in this study can be found at https://github.com/EAVE-II/EAVE-II-data-dictionary. Patient-level data underlying this article is controlled and cannot be shared publicly due to data protection and confidentiality requirements. Data can be made available to approved researchers for analysis after securing relevant permissions from the data holders via the Public Benefit and Privacy Panel (PBPP). Enquiries regarding data availability should be directed to phs.edris@phs.scot COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University EAVE II is funded by the Medical Research Council (MR/R008345/1) with the support of BREATHE—The Health Data Research Hub for Respiratory Health [MC_PC_19004], which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. 2022-09-09T15:55:34.7972211 2022-08-23T18:58:12.5971902 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Colin R. Simpson 0000-0002-5194-8083 1 Steven Kerr 2 Srinivasa Vittal Katikireddi 0000-0001-6593-9092 3 Colin McCowan 4 Lewis D. Ritchie 5 Jiafeng Pan 6 Sarah J. Stock 0000-0003-4308-856x 7 Igor Rudan 8 Ruby S. M. Tsang 0000-0002-2520-526x 9 Simon de Lusignan 0000-0002-8553-2641 10 F. D. Richard Hobbs 11 Ashley Akbari 0000-0003-0814-0801 12 Ronan Lyons 0000-0001-5225-000X 13 Chris Robertson 14 Aziz Sheikh 0000-0001-7022-3056 15 60875__25106__1adeb17f55994ba793ee934e7ea57828.pdf 60875_VoR.pdf 2022-09-09T15:53:19.6743216 Output 771891 application/pdf Version of Record true © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License true eng http://creativecommons.org/licenses/by/4.0/
title Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
spellingShingle Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
Ashley Akbari
Ronan Lyons
title_short Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
title_full Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
title_fullStr Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
title_full_unstemmed Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
title_sort Second-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland
author_id_str_mv aa1b025ec0243f708bb5eb0a93d6fb52
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Ashley Akbari
Ronan Lyons
author2 Colin R. Simpson
Steven Kerr
Srinivasa Vittal Katikireddi
Colin McCowan
Lewis D. Ritchie
Jiafeng Pan
Sarah J. Stock
Igor Rudan
Ruby S. M. Tsang
Simon de Lusignan
F. D. Richard Hobbs
Ashley Akbari
Ronan Lyons
Chris Robertson
Aziz Sheikh
format Journal article
container_title Nature Communications
container_volume 13
container_issue 1
publishDate 2022
institution Swansea University
issn 2041-1723
doi_str_mv 10.1038/s41467-022-32264-6
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description We investigated thrombocytopenic, thromboembolic and hemorrhagic events following a second dose of ChAdOx1 and BNT162b2 using a self-controlled case series analysis. We used a national prospective cohort with 2.0 million(m) adults vaccinated with two doses of ChAdOx or 1.6 m with BNT162b2. The incidence rate ratio (IRR) for idiopathic thrombocytopenic purpura (ITP) 14–20 days post-ChAdOx1 second dose was 2.14, 95% confidence interval (CI) 0.90–5.08. The incidence of ITP post-second dose ChAdOx1 was 0.59 (0.37–0.89) per 100,000 doses. No evidence of an increased risk of CVST was found for the 0–27 day risk period (IRR 0.83, 95% CI 0.16 to 4.26). However, few (≤5) events arose within this risk period. It is perhaps noteworthy that these events all clustered in the 7–13 day period (IRR 4.06, 95% CI 0.94 to 17.51). No other associations were found for second dose ChAdOx1, or any association for second dose BNT162b2 vaccination. Second dose ChAdOx1 vaccination was associated with increased borderline risks of ITP and CVST events. However, these events were rare thus providing reassurance about the safety of these vaccines. Further analyses including more cases are required to determine more precisely the risk profile for ITP and CVST after a second dose of ChAdOx1 vaccine.
published_date 2022-08-15T04:19:21Z
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