Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa, Israel.
Ophthalmology. 2022 Oct;129(10):1087-1095. doi: 10.1016/j.ophtha.2022.05.015. Epub 2022 May 25.
To assess the association between BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine and the risk of active noninfectious uveitis (NIU).
Retrospective, population-based study.
Two million six hundred two thousand five hundred fifty-seven people who received the first vaccine dose between December 20, 2020, and April 30, 2021, and 2 441 719 people who received the second vaccine dose between January 10, 2021, and April 30, 2021.
Events of active NIU were included if they occurred within 21 days after either vaccine dose. Active NIU was defined as newly active or worsening ocular inflammation requiring initiation or increase in local or systemic corticosteroids. Observed cases were compared with the expected number, based on the experience of the population in 2019.
Age- and sex-adjusted standardized incidence ratios (SIRs) and attributable risks after BNT126b2 vaccination.
Overall, 100 and 88 events of active NIU were recorded within 21 days after the first and second vaccine doses, respectively. Using the experience of the population in 2019 as a reference, after the first dose, the estimated age- and sex-adjusted SIR was 1.41 (95% confidence interval [CI], 1.15-1.71) along with a 21-day attributable risk of 1.12 cases per 100 000 vaccinees. After the second dose, the SIR was 1.31 (95% CI, 1.05-1.62), with an estimated attributable risk of 0.86 cases per 100 000 vaccinees. Anterior uveitis was the most common site of inflammation, occurring in 90.96% of eyes, and idiopathic uveitis was the most common cause (56.38%).
This study suggests that the BNT162b2 mRNA COVID-19 vaccine may be associated with an increased risk of active NIU. However, considering the small effect size and study limitations, this study does not provide proof for a cause-and-effect relationship. The small estimated attributable risks suggest that the impact on public health is relatively minor.
评估 BNT162b2 mRNA 冠状病毒病 2019（COVID-19）疫苗与活动性非感染性葡萄膜炎（NIU）风险之间的关联。
回顾性、基于人群的研究。
2625577 人于 2020 年 12 月 20 日至 2021 年 4 月 30 日之间接受第一剂疫苗，2441719 人于 2021 年 1 月 10 日至 2021 年 4 月 30 日之间接受第二剂疫苗。
如果事件发生在任何一剂疫苗接种后 21 天内，则将活动性 NIU 事件包括在内。活动性 NIU 定义为新出现或加重的眼部炎症，需要开始或增加局部或全身皮质类固醇治疗。观察到的病例与基于 2019 年人群经验的预期数量进行了比较。
接种 BNT126b2 后的年龄和性别调整标准化发病率比（SIR）和归因风险。
总体而言，在第一剂和第二剂疫苗接种后 21 天内，分别记录了 100 例和 88 例活动性 NIU 事件。以 2019 年人群的经验为参考，第一剂疫苗后，估计的年龄和性别调整后的 SIR 为 1.41（95%置信区间[CI]，1.15-1.71），21 天归因风险为每 100000 名疫苗接种者 1.12 例。第二剂疫苗后，SIR 为 1.31（95%CI，1.05-1.62），估计归因风险为每 100000 名疫苗接种者 0.86 例。前葡萄膜炎是最常见的炎症部位，占 90.96%的眼睛，特发性葡萄膜炎是最常见的病因（56.38%）。
本研究表明，BNT162b2 mRNA COVID-19 疫苗可能与活动性 NIU 风险增加相关。然而，考虑到效应量小和研究局限性，本研究并未提供因果关系的确凿证据。估计的归因风险较小表明对公共卫生的影响相对较小。
