TY - JOUR
T1 - Risk of thrombocytopenic, haemorrhagic and thromboembolic disorders following COVID-19 vaccination and positive test
T2 - a self-controlled case series analysis in Wales
AU - Torabi, Fatemeh
AU - Bedston, Stuart
AU - Lowthian, Emily
AU - Akbari, Ashley
AU - Owen, Rhiannon K
AU - Bradley, Declan
AU - Agrawal, Utkarsh
AU - Collins, Peter
AU - Fry, Richard
AU - Griffiths, Lucy J
AU - Beggs, Jillian
AU - Davies, Gareth
AU - Hollinghurst, Joe
AU - Lyons, Jane
AU - Abbasizanjani, Hoda
AU - Cottrell, Simon
AU - Perry, Malorie
AU - Roberts, Richard
AU - Azcoaga-Lorenzo, Amaya
AU - Fagbamigbe, Adeniyi
AU - Shi, Ting
AU - Tang, Ruby S. M.
AU - Robertson, Chris
AU - Hobbs, Richard
AU - de Lusignan, Simon
AU - McCowan, Colin
AU - Gravenor, Michael
AU - Simpson, Colin
AU - Sheikh, Aziz
AU - Lyons, Ronan A.
N1 - Funding: This work was supported by the Medical Research Council [MR/V028367/1]; Health Data Research UK [HDR-9006] which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; and Administrative Data Research UK which is funded by the Economic and Social Research Council [grant ES/S007393/1]. This work was supported by the Wales COVID-19 Evidence Centre, funded by Health and Care Research Wales.
This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation. We also acknowledge the support of the HDR UK BREATHE Hub, funded by the Industrial Strategy Challenge Fund through a grant via Health Data Research UK.
PY - 2022/9/30
Y1 - 2022/9/30
N2 - 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.
AB - 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.
KW - COVID-19 vaccines
KW - SARS-CoV-2 infection
KW - Adverse thrombosis events
KW - Electronic health records
KW - Population study
U2 - 10.1038/s41598-022-20118-6
DO - 10.1038/s41598-022-20118-6
M3 - Article
SN - 2045-2322
VL - 12
JO - Scientific Reports
JF - Scientific Reports
M1 - 16406
ER -
