Adverse events following immunization with mRNA and viral vector vaccines in individuals with previous severe acute respiratory syndrome coronavirus 2 infection from the Canadian National Vaccine Safety Network

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DOI

https://doi.org/10.1093/cid/ciac852

Language of the publication
English
Date
2022-10-31
Type
Article
Author(s)
  • Bettinger, Julie A.
  • Shulha, Hennady P.
  • Valiquette, Louis
  • Muller, Matthew P.
  • Vanderkooi, Otto G.
  • Kellner, James D.
  • Top, Karina A.
  • Sadarangani, Manish
  • McGeer, Allison
  • Isenor, Jennifer E.
  • Marty, Kimberly
  • Soe, Phyumar
  • De Serres, Gaston
  • Canadian Immunization Research Network
  • Irvine, Michael A.
Publisher
Oxford University Press on behalf of Infectious Diseases Society of America

Abstract

Background
Adults previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) develop short-term immunity and may have increased reactogenicity to coronavirus disease 2019 (COVID-19) vaccines. This prospective, multicenter, active-surveillance cohort study examined the short-term safety of COVID-19 vaccines in adults with a prior history of SARS-CoV-2.

Methods
Canadian adults vaccinated between 22 December 2020 and 27 November 2021 were sent an electronic questionnaire 7 days post–dose 1, dose 2, and dose 3 vaccination. The main outcome was health events occurring in the first 7 days after each vaccination that prevented daily activities, resulted in work absenteeism, or required a medical consultation, including hospitalization.

Results
Among 684 998 vaccinated individuals, 2.6% (18 127/684 998) reported a prior history of SARS-CoV-2 infection a median of 4 (interquartile range: 2–6) months previously. After dose 1, individuals with moderate (bedridden) to severe (hospitalized) COVID-19 who received BNT162b2, mRNA-1273, or ChAdox1-S vaccines had higher odds of a health event preventing daily activities, resulting in work absenteeism or requiring medical consultation (adjusted odds ratio [95% confidence interval]: 3.96 [3.67–4.28] for BNT162b2, 5.01 [4.57–5.50] for mRNA-1273, and 1.84 [1.54–2.20] for ChAdox1-S compared with no infection). Following dose 2 and 3, the greater risk associated with previous infection was also present but was attenuated compared with dose 1. For all doses, the association was lower or absent after mild or asymptomatic infection.

Conclusions
Adults with moderate or severe previous SARS-CoV-2 infection were more likely to have a health event sufficient to impact routine activities or require medical assessment in the week following each vaccine dose.

Subject

  • Health,
  • Coronavirus diseases,
  • Immunization,
  • Epidemiology

Rights

Pagination

1088-1102

Peer review

Yes

Identifiers

PubMed ID
36310514
ISSN
1537-6591

Article

Journal title
Clinical Infectious Diseases
Journal volume
76
Journal issue
6

Sponsors

This work was supported by the COVID-19 Vaccine Readiness funding from the Canadian Institutes of Health Research and the Public Health Agency of Canada CANVAS grant number CVV-450980 and the Public Health Agency of Canada, through the Vaccine Surveillance Reference Group and the COVID-19 Immunity Task Force (reported by M. A. I., J. E. I., G. D. S., M. S., J. A. B., J. D. K., O. G. V., K. A. T., K. M., L. V., M. P. M., and P. S.). G. D. S. reports support from the Ministère de la Santé et des Services Sociaux du Quebec. M. S. is supported via salary awards from the BC Children's Hospital Foundation and the Michael Smith Foundation for Health Research.

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Communicable diseases

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