Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan.
Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan; Department of Legal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Leg Med (Tokyo). 2022 Nov;59:102134. doi: 10.1016/j.legalmed.2022.102134. Epub 2022 Aug 20.
COVID-19 vaccines have been used across Japan since 17 February 2021, and as of 17 April 2022, 1690 deaths potentially caused by vaccine-related adverse effects have been reported to the Ministry of Health, Labour and Welfare. However, the causal relationship between vaccination and death could not be fully evaluated because of a lack of sufficient information.
Autopsy cases in which deaths occurred within seven days after COVID-19 vaccination in Tokyo Metropolis and were handled by medical examiners were selected (n = 54). Age, sex, vaccine-related information, cause of death, and possible causal relationship between vaccination and death were examined.
The mean age of the deceased individuals was 68.1 years, and the study sample consisted of 34 males (63.9%) and 20 females (37.0%). Thirty-seven and six individuals received Comirnaty and Spikevax, respectively (68.5% and 11.1% respectively). The manner of death included natural (n = 43), non-natural (n = 8), and undetermined (n = 3). The most frequent cause of death was ischemic heart disease (n = 16). Regarding causal relationships, 46 cases (85.2%) did not show a causal relationship to vaccination, except for myocarditis (n = 3), thrombosis-related death (n = 4), and others (n = 1).
Although many cases of deaths after COVID-19 vaccination in this study showed no definite causal relationship between the vaccination and deaths, some cases showed possible adverse events such as myocarditis. Autopsies are essential for detecting vaccine-related deaths, and the Japanese death investigation system needs to be reinforced from this viewpoint.
自 2021 年 2 月 17 日起，日本开始使用 COVID-19 疫苗，截至 2022 年 4 月 17 日，厚生劳动省已报告 1690 例可能与疫苗不良反应相关的死亡病例。然而，由于缺乏足够的信息，无法充分评估接种疫苗与死亡之间的因果关系。
选择在东京都接种 COVID-19 疫苗后 7 天内死亡并由法医处理的尸检病例（n=54）。检查年龄、性别、与疫苗相关的信息、死亡原因以及接种疫苗与死亡之间可能的因果关系。
死者的平均年龄为 68.1 岁，研究样本包括 34 名男性（63.9%）和 20 名女性（37.0%）。分别有 37 人和 6 人接种了 Comirnaty 和 Spikevax（分别占 68.5%和 11.1%）。死亡方式包括自然死亡（n=43）、非自然死亡（n=8）和死因不明（n=3）。最常见的死亡原因是缺血性心脏病（n=16）。关于因果关系，除心肌炎（n=3）、血栓相关死亡（n=4）和其他（n=1）外，46 例（85.2%）病例与疫苗接种无明确因果关系。
尽管本研究中许多 COVID-19 疫苗接种后死亡病例与疫苗接种之间无明确因果关系，但有些病例显示出可能的不良事件，如心肌炎。尸检对于检测与疫苗相关的死亡至关重要，从这一角度来看，日本的死亡调查系统需要得到加强。
