Mericliler Meric
Hematology, Medical Oncology, and Palliative Care, Virginia Commonwealth University, Richmond, USA.
Hematology, Medical Oncology, and Palliative Care, Massey Cancer Center, Richmond, USA.
Cureus. 2023 Jul 6;15(7):e41460. doi: 10.7759/cureus.41460. eCollection 2023 Jul.
Introduction Autoimmune diseases have been linked to COVID-19 vaccines. An increasing number of cases have reported de novo immune thrombocytopenia (ITP) following mRNA COVID-19 vaccines. This study aims to investigate the incidence of de novo ITP following the mRNA COVID-19 vaccine in comparison to other non-mRNA vaccines and COVID-19. Methods Data were collected from the TriNetX global health research network, which covers over 117 million patients. Four different patient cohorts were included: those who received the mRNA COVID-19 vaccine (between 12/15/2020 - 5/1/2023), the influenza vaccine (between 01/01/2010 - 01/01/2020), tetanus, diphtheria, and pertussis/tetanus and diphtheria (Tdap/Td) vaccines (between 01/01/2010 - 01/01/2020), and those who had COVID-19 (between 01/01/2020 - 05/01/2023). A comparative analysis was conducted to examine the occurrence of de novo ITP within three weeks after receiving mRNA COVID-19 vaccine, non-mRNA vaccines, or upon diagnosis of COVID-19. Additionally, a comparative analysis was performed after 1:1 propensity score matching to balance baseline characteristics (age, sex, and race). Results The overall event rate was 0.07 per 10,000 for the mRNA COVID-19 vaccine, 0.25 per 10,000 for the influenza vaccine, and 0.28 per 10,000 for the Tdap/Td vaccines. Additionally, the incidence of de novo ITP following COVID-19 was 0.30 per 10,000. Those who received the influenza vaccine and Tdap/Td vaccines had higher rates of de novo ITP compared to the mRNA COVID-19 vaccine group, with a relative risk of 3.48 and 3.88, respectively. The occurrence of de novo ITP following COVID-19 was significantly higher compared to that following the mRNA COVID-19 vaccine, with a relative risk of 4.27. Post-propensity score matching analysis produced similar outcomes. Conclusions The findings of this study suggest that the incidence of de novo ITP is significantly lower following mRNA-based COVID-19 vaccines compared to non-mRNA vaccines and COVID-19.
引言 自身免疫性疾病与新冠疫苗有关。越来越多的病例报告称，在接种mRNA新冠疫苗后出现了新发免疫性血小板减少症（ITP）。本研究旨在调查与其他非mRNA疫苗及新冠病毒感染相比，接种mRNA新冠疫苗后新发ITP的发生率。
方法 数据收集自TriNetX全球健康研究网络，该网络覆盖超过1.17亿患者。纳入了四个不同的患者队列：接种mRNA新冠疫苗的患者（2020年12月日至2023年5月1日）、接种流感疫苗的患者（2010年1月1日至2020年1月1日）、接种破伤风、白喉和百日咳/破伤风和白喉（Tdap/Td）疫苗的患者（2010年1月1日至2020年1月1日），以及感染新冠病毒的患者（2020年1月1日至2023年5月1日）。进行了一项比较分析，以检查在接种mRNA新冠疫苗、非mRNA疫苗后三周内或确诊感染新冠病毒后新发ITP的发生情况。此外，在进行1:1倾向评分匹配以平衡基线特征（年龄、性别和种族）后，进行了比较分析。
结果 mRNA新冠疫苗的总体事件发生率为每10000人中有0.07例，流感疫苗为每10000人中有0.25例，Tdap/Td疫苗为每10000人中有0.28例。此外，新冠病毒感染后新发ITP的发生率为每10000人中有0.30例。与mRNA新冠疫苗组相比，接种流感疫苗和Tdap/Td疫苗的患者新发ITP的发生率更高，相对风险分别为3.48和3.88。新冠病毒感染后新发ITP的发生率显著高于接种mRNA新冠疫苗后的发生率，相对风险为4.27。倾向评分匹配分析后得出了类似的结果。
结论 本研究结果表明，与非mRNA疫苗和新冠病毒感染相比，基于mRNA的新冠疫苗接种后新发ITP的发生率显著更低。
