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10-1016-j-vaccine-2022-01-026 |
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|a 0264410X (ISSN)
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|a Impact of prior SARS-CoV-2 infection on incidence of hospitalization and adverse events following mRNA SARS-CoV-2 vaccination: A nationwide, retrospective cohort study
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|b Elsevier Ltd
|c 2022
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|a 8
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|z View Fulltext in Publisher
|u https://doi.org/10.1016/j.vaccine.2022.01.026
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|a Background: Previous studies evaluated the SARS-CoV-2 vaccine safety or compared adverse events following vaccination to those from infection. Limited data about the impact of prior infection on post-vaccine adverse events are available. The objective of this study was to evaluate the impact of prior SARS-CoV-2 infection on outcomes shortly after vaccination using a longitudinal design. Methods: Nationwide, multicenter, retrospective cohort study of hospitalization, death, and pre-specified adverse event rates among Veterans who received mRNA vaccines within the Veterans Health Administration between 12/11/2020 and 8/31/2021. Daily incidence rates were compared before and after vaccine doses, stratified by history of microbiologically-confirmed SARS-CoV-2. Results: 3,118,802 patients received a first dose and 2,979,326 a second, including 102,829 with a history of SARS-CoV-2 infection. Daily incident hospitalization rates were unchanged before and after the second dose among patients without previous infection (28.8/100,000 post-dose versus 28.6/100,000 pre-dose, p = 0.92). In previously-infected patients, the hospitalization rate increased above baseline one day following vaccination (158.2/100,000 after dose 2 versus 57.3/100,000 pre-dose, p < 0.001), then returned to baseline. Chart review indicated vaccine side effects, such as fever, constitutional symptoms, weakness, or falls, as the definite (39%) or possible (18%) cause of hospitalization. Affected patients had mean age 75, and 90% had at least one serious comorbidity. Hospitalizations were brief (median 2 days), with rapid return to baseline health. Worse baseline health among previously-infected patients prevented conclusions about mortality risk. Conclusions: Two-dose mRNA vaccine regimens are safe in a population with many comorbidities. Transient increased risks of hospitalization were identified among patients with prior SARS-CoV-2, absolute risk ∼1:1000. Findings support additional study regarding the optimal dosing schedule in this population. Funding: None. © 2022
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|a adult
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|a Adverse events
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|a aged
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|a Aged
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|a Article
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|a clinical trial
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|a cohort analysis
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|a comorbidity
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|a controlled study
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|a coronavirus disease 2019
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|a Covid-19
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|a COVID-19
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|a COVID-19 Vaccines
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|a drug safety
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|a elasomeran
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|a falling
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|a female
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|a fever
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|a hospitalization
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|a hospitalization
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|a Hospitalization
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|a human
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|a Humans
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|a incidence
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|a incidence
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|a Incidence
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|a longitudinal study
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|a major clinical study
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|a male
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|a medical history
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|a medical record review
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|a messenger RNA
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|a microbiological examination
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|a middle aged
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|a mortality
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|a mortality risk
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|a mRNA vaccine
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|a mRNA Vaccines
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|a multicenter study
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|a recombinant vaccine
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|a Retrospective Studies
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|a retrospective study
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|a RNA vaccine
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|a RNA, Messenger
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|a SARS-CoV-2
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|a Severe acute respiratory syndrome coronavirus 2
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|a side effect
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|a Surveillance
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|a tozinameran
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|a Trigger tools
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|a vaccination
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|a Vaccination
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|a Vaccination
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|a Vaccines, Synthetic
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|a veteran
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|a weakness
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|a Branch-Elliman, W.
|e author
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|a Do, N.V.
|e author
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|a Fillmore, N.R.
|e author
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|a La, J.
|e author
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|a Li, L.L.
|e author
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|a Monach, P.A.
|e author
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|a Strymish, J.M.
|e author
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|a Zheng, C.
|e author
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|t Vaccine
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