Risk of thrombocytopenic, haemorrhagic and thromboembolic disorders following COVID-19 vaccination and positive test: a self-controlled case series analysis in Wales

Fatemeh Torabi*, Stuart Bedston, Emily Lowthian, Ashley Akbari, Rhiannon K Owen, Declan Bradley, Utkarsh Agrawal, Peter Collins, Richard Fry, Lucy J Griffiths, Jillian Beggs, Gareth Davies, Joe Hollinghurst, Jane Lyons, Hoda Abbasizanjani, Simon Cottrell, Malorie Perry, Richard Roberts, Amaya Azcoaga-Lorenzo, Adeniyi FagbamigbeTing Shi, Ruby S. M. Tang, Chris Robertson, Richard Hobbs, Simon de Lusignan, Colin McCowan, Michael Gravenor, Colin Simpson, Aziz Sheikh, Ronan A. Lyons

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)
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Abstract

There is a need for better understanding of the risk of thrombocytopenic, haemorrhagic, thromboembolic disorders following first, second and booster vaccination doses and testing positive for SARS-CoV-2. Self-controlled cases series analysis of 2.1 million linked patient records in Wales between 7th December 2020 and 31st December 2021. Outcomes were the first diagnosis of thrombocytopenic, haemorrhagic and thromboembolic events in primary or secondary care datasets, exposure was defined as 0–28 days post-vaccination or a positive reverse transcription polymerase chain reaction test for SARS-CoV-2. 36,136 individuals experienced either a thrombocytopenic, haemorrhagic or thromboembolic event during the study period. Relative to baseline, our observations show greater risk of outcomes in the periods post-first dose of BNT162b2 for haemorrhagic (IRR 1.47, 95%CI: 1.04–2.08) and idiopathic thrombocytopenic purpura (IRR 2.80, 95%CI: 1.21–6.49) events; post-second dose of ChAdOx1 for arterial thrombosis (IRR 1.14, 95%CI: 1.01–1.29); post-booster greater risk of venous thromboembolic (VTE) (IRR-Moderna 3.62, 95%CI: 0.99–13.17) (IRR-BNT162b2 1.39, 95%CI: 1.04–1.87) and arterial thrombosis (IRR-Moderna 3.14, 95%CI: 1.14–8.64) (IRR-BNT162b2 1.34, 95%CI: 1.15–1.58). Similarly, post SARS-CoV-2 infection the risk was increased for haemorrhagic (IRR 1.49, 95%CI: 1.15–1.92), VTE (IRR 5.63, 95%CI: 4.91, 6.4), arterial thrombosis (IRR 2.46, 95%CI: 2.22–2.71). We found that there was a measurable risk of thrombocytopenic, haemorrhagic, thromboembolic events after COVID-19 vaccination and infection. 
Original languageEnglish
Article number16406
JournalScientific Reports
Volume12
DOIs
Publication statusPublished - 30 Sept 2022

Keywords

  • COVID-19 vaccines
  • SARS-CoV-2 infection
  • Adverse thrombosis events
  • Electronic health records
  • Population study

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