Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
To inform the public and policy makers, we investigated and compared the risk of cerebral venous sinus thrombosis (CVST) after SARS-Cov-2 vaccination or infection using a national cohort of 2,643,699 individuals aged 17 y and above, alive, and resident in Wales on 1 January 2020 followed up through...
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Format: | Article |
Language: | English |
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Taylor & Francis Group
2022-11-01
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Series: | Human Vaccines & Immunotherapeutics |
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Online Access: | http://dx.doi.org/10.1080/21645515.2022.2127572 |
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author | Columbus Ohaeri Daniel Rhys Thomas Jane Salmon Simon Cottrell Jane Lyons Ashley Akbari Ronan A Lyons Fatemeh Torabi Gareth GI Davies Christopher Williams |
author_facet | Columbus Ohaeri Daniel Rhys Thomas Jane Salmon Simon Cottrell Jane Lyons Ashley Akbari Ronan A Lyons Fatemeh Torabi Gareth GI Davies Christopher Williams |
author_sort | Columbus Ohaeri |
collection | DOAJ |
description | To inform the public and policy makers, we investigated and compared the risk of cerebral venous sinus thrombosis (CVST) after SARS-Cov-2 vaccination or infection using a national cohort of 2,643,699 individuals aged 17 y and above, alive, and resident in Wales on 1 January 2020 followed up through multiple linked data sources until 28 March 2021. Exposures were first dose of Oxford-ChAdOx1 or Pfizer-BioNTech vaccine or polymerase chain reaction (PCR)-confirmed SARS-Cov-2 infection. The outcome was an incident record of CVST. Hazard ratios (HR) were calculated using multivariable Cox regression, adjusted for confounders. HR from SARS-Cov-2 infection was compared with that for SARS-Cov-2 vaccination. We identified 910,556 (34.4%) records of first SARS-Cov-2 vaccination and 165,862 (6.3%) of SARS-Cov-2 infection. A total of 1,372 CVST events were recorded during the study period, of which 52 (3.8%) and 48 (3.5%) occurred within 28 d after vaccination and infection, respectively. We observed slight non-significant risk of CVST within 28 d of vaccination [aHR: 1.34, 95% CI: 0.95-1.90], which remained after stratifying by vaccine [BNT162b2, aHR: 1.18 (95% CI: 0.63-2.21); ChAdOx1, aHR: 1.40 (95% CI: 0.95-2.05)]. Three times the number of CVST events is observed within 28 d of a positive SARS-Cov-2 test [aHR: 3.02 (95% CI: 2.17-4.21)]. The risk of CVST following SARS-Cov-2 infection is 2.3 times that following SARS-Cov-2 vaccine. This is important information both for those designing COVID-19 vaccination programs and for individuals making their own informed decisions on the risk-benefit of vaccination. This record-linkage approach will be useful in monitoring the safety of future vaccine programs. |
first_indexed | 2024-03-11T21:40:54Z |
format | Article |
id | doaj.art-af18a6e87e8c4ae297e0b0dced0f1aba |
institution | Directory Open Access Journal |
issn | 2164-5515 2164-554X |
language | English |
last_indexed | 2024-03-11T21:40:54Z |
publishDate | 2022-11-01 |
publisher | Taylor & Francis Group |
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series | Human Vaccines & Immunotherapeutics |
spelling | doaj.art-af18a6e87e8c4ae297e0b0dced0f1aba2023-09-26T13:19:09ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2022-11-0118610.1080/21645515.2022.21275722127572Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health recordsColumbus Ohaeri0Daniel Rhys Thomas1Jane Salmon2Simon Cottrell3Jane Lyons4Ashley AkbariRonan A Lyons5Fatemeh Torabi6Gareth GI Davies7Christopher Williams8Public Health WalesPublic Health WalesPublic Health WalesPublic Health WalesSwansea University Medical School, Swansea UniversitySwansea University Medical School, Swansea UniversitySwansea University Medical School, Swansea UniversitySwansea University Medical School, Swansea UniversityPublic Health WalesTo inform the public and policy makers, we investigated and compared the risk of cerebral venous sinus thrombosis (CVST) after SARS-Cov-2 vaccination or infection using a national cohort of 2,643,699 individuals aged 17 y and above, alive, and resident in Wales on 1 January 2020 followed up through multiple linked data sources until 28 March 2021. Exposures were first dose of Oxford-ChAdOx1 or Pfizer-BioNTech vaccine or polymerase chain reaction (PCR)-confirmed SARS-Cov-2 infection. The outcome was an incident record of CVST. Hazard ratios (HR) were calculated using multivariable Cox regression, adjusted for confounders. HR from SARS-Cov-2 infection was compared with that for SARS-Cov-2 vaccination. We identified 910,556 (34.4%) records of first SARS-Cov-2 vaccination and 165,862 (6.3%) of SARS-Cov-2 infection. A total of 1,372 CVST events were recorded during the study period, of which 52 (3.8%) and 48 (3.5%) occurred within 28 d after vaccination and infection, respectively. We observed slight non-significant risk of CVST within 28 d of vaccination [aHR: 1.34, 95% CI: 0.95-1.90], which remained after stratifying by vaccine [BNT162b2, aHR: 1.18 (95% CI: 0.63-2.21); ChAdOx1, aHR: 1.40 (95% CI: 0.95-2.05)]. Three times the number of CVST events is observed within 28 d of a positive SARS-Cov-2 test [aHR: 3.02 (95% CI: 2.17-4.21)]. The risk of CVST following SARS-Cov-2 infection is 2.3 times that following SARS-Cov-2 vaccine. This is important information both for those designing COVID-19 vaccination programs and for individuals making their own informed decisions on the risk-benefit of vaccination. This record-linkage approach will be useful in monitoring the safety of future vaccine programs.http://dx.doi.org/10.1080/21645515.2022.2127572covid19coronavirusvaccinescerebral venous sinus thrombosiscerebral venous thrombosis |
spellingShingle | Columbus Ohaeri Daniel Rhys Thomas Jane Salmon Simon Cottrell Jane Lyons Ashley Akbari Ronan A Lyons Fatemeh Torabi Gareth GI Davies Christopher Williams Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records Human Vaccines & Immunotherapeutics covid19 coronavirus vaccines cerebral venous sinus thrombosis cerebral venous thrombosis |
title | Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records |
title_full | Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records |
title_fullStr | Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records |
title_full_unstemmed | Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records |
title_short | Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records |
title_sort | comparative risk of cerebral venous sinus thrombosis cvst following covid 19 vaccination or infection a national cohort study using linked electronic health records |
topic | covid19 coronavirus vaccines cerebral venous sinus thrombosis cerebral venous thrombosis |
url | http://dx.doi.org/10.1080/21645515.2022.2127572 |
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