Adverse events following first and second dose COVID-19 vaccination in England, October 2020 to September 2021 : a national vaccine surveillance platform self-controlled case series study

Tsang, Ruby SM and Joy, Mark and Byford, Rachel and Robertson, Chris and Anand, Sneha N and Hinton, William and Mayor, Nikhil and Kar, Debasish and Williams, John and Victor, William and Akbari, Ashley and Bradley, Declan T and Murphy, Siobhan and O’Reilly, Dermot and Owen, Rhiannon K and Chuter, Antony and Beggs, Jillian and Howsam, Gary and Sheikh, Aziz and Hobbs, FD Richard and de Lusignan, Simon (2023) Adverse events following first and second dose COVID-19 vaccination in England, October 2020 to September 2021 : a national vaccine surveillance platform self-controlled case series study. Eurosurveillance, 28 (3). ISSN 1560-7917 (https://doi.org/10.2807/1560-7917.es.2023.28.3.220...)

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Abstract

Background Post-authorisation vaccine safety surveillance is well established for reporting common adverse events of interest (AEIs) following influenza vaccines, but not for COVID-19 vaccines. Aim To estimate the incidence of AEIs presenting to primary care following COVID-19 vaccination in England, and report safety profile differences between vaccine brands. Methods We used a self-controlled case series design to estimate relative incidence (RI) of AEIs reported to the national sentinel network, the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub. We compared AEIs (overall and by clinical category) 7 days pre- and post-vaccination to background levels between 1 October 2020 and 12 September 2021. Results Within 7,952,861 records, 781,200 individuals (9.82%) presented to general practice with 1,482,273 AEIs, 4.85% within 7 days post-vaccination. Overall, medically attended AEIs decreased post-vaccination against background levels. There was a 3–7% decrease in incidence within 7 days after both doses of Comirnaty (RI: 0.93; 95% CI: 0.91–0.94 and RI: 0.96; 95% CI: 0.94–0.98, respectively) and Vaxzevria (RI: 0.97; 95% CI: 0.95–0.98). A 20% increase was observed after one dose of Spikevax (RI: 1.20; 95% CI: 1.00–1.44). Fewer AEIs were reported as age increased. Types of AEIs, e.g. increased neurological and psychiatric conditions, varied between brands following two doses of Comirnaty (RI: 1.41; 95% CI: 1.28–1.56) and Vaxzevria (RI: 1.07; 95% CI: 0.97–1.78). Conclusion COVID-19 vaccines are associated with a small decrease in medically attended AEI incidence. Sentinel networks could routinely report common AEI rates, contributing to reporting vaccine safety.

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