Safety comparison of mRNA, viral vector, and inactivated Covid-19 vaccines: incidence of adverse events following primary and booster doses among medical professionals in Malaysia.

BACKGROUND

This study aimed to examine adverse events following first, second, and booster doses of Covid-19 vaccines in Malaysia.

METHODS

This was a prospective longitudinal cohort study conducted between September 2021 to September 2022. Recipients who received different Covid-19 vaccines (Comirnaty, Vaxzevria, and CoronaVac) completed a self-report questionnaire of adverse events on days 1, 2, 4, and 7 following their primary (first and second) and booster (third) vaccinations.

RESULTS

A total of 1283 respondents had completed the questionnaire survey. The most frequent adverse events among Comirnaty recipients (n = 271) following the first dose were pain (87.4%), fatigue (56.9%), myalgia (37.2%), and fever (17.5%), which further increased to 92.1%, 72.8%, 51·2%, and 48%, respectively, following the booster. The most frequent adverse events following the first dose of Vaxzevria (n = 90) were pain (84.4%), fever (76.7%), headache (58.9%) and myalgia (53.3%). Adverse events were reduced after the second dose of Vaxzevria but sharply increased after the booster. The most common adverse events among CoronaVac recipients (1st dose) were pain at the injection site (69.1%), fatigue (49.1%) and increased hunger (34.5%). However, adverse events subsequently decreased after the second and booster doses. The average number of adverse events was highest for Vaxzevria after the first dose (n = 6) and booster dose (n = 6) and lowest for CoronaVac after the first (n = 3), second (n = 2) and booster doses (n = 2).

CONCLUSION

The incidence of adverse events following the first dose of the Covid-19 vaccine was highest among Vaxzevria recipients. Adverse events following Comirnaty vaccine increased gradually from primary to booster dose, whereas recipients with CoronaVac showed subsequent lesser adverse events following primary and booster doses.