Zhang Kimball, Terebessy Emilie, Zhu Jingqin, Birken Catherine, Borkhoff Cornelia M, Gershon Andrea, Moraes Theo J, Kendzerska Tetyana, Pakhale Smita, To Teresa
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
ICES, Toronto, Ontario, Canada.
PLOS Glob Public Health. 2024 Jul 31;4(7):e0003363. doi: 10.1371/journal.pgph.0003363. eCollection 2024.
Few studies have examined population-level data of the COVID-19 original and bivalent vaccine on its uptake and potential side effects. We used population-based health administrative data from Jan 2021-Feb 2023 to identify Ontario residents aged 12-35 years old to calculate their rates of COVID-19 vaccine uptake and vaccine-related cardiac events (myocarditis and pericarditis). Multivariable Cox, logistic, and negative binomial regression analyses were used to adjust for covariates. Hazard ratios (HR) were reported with 95% confidence intervals (CI). The study population included 5,012,721 individuals. Comparing to the general population, those with chronic diseases were associated with 13-37% higher rates of vaccine uptake and 1.39-2.27 times higher odds of receiving booster doses. Overall, post-vaccination cardiac event incidence rates ranged from 3-12 per 100,000 persons. Compared to the general population, the incidence rate of cardiac events among those with asthma and allergic diseases was significantly higher, 3.7 events per 100,000 persons. Compared to the general population, those with asthma and/or allergic diseases had significantly higher associated likelihoods of a cardiac event (HR = 1.31, 95% CI: 1.08-1.57). Females, adults, and those with prior COVID-19 infections had decreased odds of cardiac events after 2nd vaccine doses. No significant differences in post-vaccine cardiac events were detected between original and bivalent doses. This Canadian population-based study reported substantially higher rates of vaccine uptake and a very rare incidence of temporally associated post-vaccination cardiac events. While substantially smaller than the benefits of vaccination, our results indicated a continued small risk of cardiac side effects from bivalent COVID-19 vaccines in individuals with comorbidities.
很少有研究考察过新冠原始疫苗和二价疫苗在人群层面上的接种情况及潜在副作用数据。我们利用2021年1月至2023年2月基于人群的健康管理数据，确定安大略省12至35岁的居民，以计算他们的新冠疫苗接种率和疫苗相关心脏事件（心肌炎和心包炎）发生率。采用多变量Cox、逻辑和负二项回归分析来调整协变量。报告风险比（HR）及95%置信区间（CI）。研究人群包括5,012,721人。与普通人群相比，患有慢性病的人群疫苗接种率高13%至37%，接受加强针的几率高1.39至2.27倍。总体而言，接种疫苗后心脏事件发病率为每10万人3至12例。与普通人群相比，哮喘和过敏性疾病患者的心脏事件发病率显著更高，为每10万人3.7例。与普通人群相比，患有哮喘和/或过敏性疾病的人群发生心脏事件的相关可能性显著更高（HR = 1.31，95% CI：1.08 - 1.57）。女性、成年人以及先前感染过新冠的人在接种第二剂疫苗后发生心脏事件的几率降低。原始疫苗和二价疫苗接种后心脏事件无显著差异。这项基于加拿大人群的研究报告称，疫苗接种率大幅提高，且接种疫苗后与时间相关的心脏事件发生率极低。虽然远小于接种疫苗的益处，但我们的结果表明，二价新冠疫苗在合并症患者中仍存在持续的小概率心脏副作用风险。
