Hawken Steven, Wilson Lindsay A, Wilson Kumanan
Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.
School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Cres., Ottawa, ON K1G 5Z3, Canada.
Vaccines (Basel). 2024 Sep 14;12(9):1052. doi: 10.3390/vaccines12091052.
In Canada, vaccine safety studies are often conducted at the provincial/territorial level where the primary data on vaccination reside. Combining health services data from multiple jurisdictions using a pooled data analytic approach would reduce the amount of time needed to detect vaccine safety signals. To determine the difference in the time it would take to identify safety signals using different proportions of the Canadian population, we conducted power and sample size calculations for a hypothetical self-controlled case series-based surveillance analysis. We used scenarios modeled after the real-world examples of myocarditis and vaccine-induced immune thrombotic thrombocytopenia (VITT) following COVID-19 vaccination as our base cases. Our calculations demonstrated that in the case of a myocarditis-type event, a pooled analysis would reduce the time needed to detect a safety signal by over 60% compared to using Ontario data alone. In the case of a VITT-type event, a pooled analysis could detect a safety signal 49 days sooner than using Ontario data alone, potentially averting as many as 30 events. Our analysis demonstrates that there is substantial value in using pan-Canadian health services data to evaluate the safety of vaccines. Efforts should be made to develop a pan-Canadian vaccine data source to allow for an earlier evaluation of suspected adverse events following immunization.
在加拿大,疫苗安全性研究通常在省级/地区级开展,这些地方保存着疫苗接种的原始数据。采用汇总数据分析方法整合多个司法管辖区的卫生服务数据,将减少发现疫苗安全信号所需的时间。为了确定使用不同比例的加拿大人口来识别安全信号所需时间的差异,我们针对基于自我对照病例系列的假设性监测分析进行了效能和样本量计算。我们以新冠疫苗接种后心肌炎和疫苗诱导的免疫性血栓性血小板减少症(VITT)的实际案例为蓝本构建情景作为我们的基础案例。我们的计算表明,对于心肌炎类型的事件,与仅使用安大略省的数据相比,汇总分析将把发现安全信号所需的时间减少60%以上。对于VITT类型的事件,汇总分析可比仅使用安大略省的数据提前49天发现安全信号,可能避免多达30起事件。我们的分析表明,利用全加拿大的卫生服务数据评估疫苗安全性具有重大价值。应努力开发一个全加拿大的疫苗数据源,以便更早地评估免疫接种后的疑似不良事件。