Thrombosis and thrombocytopenia after vaccination against and infection with SARS-CoV-2 in the United Kingdom

Edward Burn, Xintong Li, Antonella Delmestri, Nathan Jones, Talita Duarte-Salles, Carlen Reyes, Eugenia Martinez-Hernandez, Edelmira Marti, Katia M. C. Verhamme, Peter R. Rijnbeek, Victoria Y. Strauss and Daniel Prieto-Alhambra ()
Additional contact information
Edward Burn: Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
Xintong Li: University of Oxford
Antonella Delmestri: University of Oxford
Nathan Jones: University of Oxford
Talita Duarte-Salles: Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
Carlen Reyes: Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol)
Eugenia Martinez-Hernandez: Hospital Clinic and University of Barcelona
Edelmira Marti: Hospital Clínico Universitario de Valencia
Katia M. C. Verhamme: Erasmus University Medical Center
Peter R. Rijnbeek: Erasmus University Medical Center
Victoria Y. Strauss: University of Oxford
Daniel Prieto-Alhambra: University of Oxford

Nature Communications, 2022, vol. 13, issue 1, 1-10

Abstract: Abstract Population-based studies can provide important evidence on the safety of COVID-19 vaccines. Using data from the United Kingdom, here we compare observed rates of thrombosis and thrombocytopenia following vaccination against SARS-CoV-2 and infection with SARS-CoV-2 with background (expected) rates in the general population. First and second dose cohorts for ChAdOx1 or BNT162b2 between 8 December 2020 and 2 May 2021 in the United Kingdom were identified. A further cohort consisted of people with no prior COVID-19 vaccination who were infected with SARS-Cov-2 identified by a first positive PCR test between 1 September 2020 and 2 May 2021. The fourth general population cohort for background rates included those people in the database as of 1 January 2017. In total, we included 3,768,517 ChAdOx1 and 1,832,841 BNT162b2 vaccinees, 401,691 people infected with SARS-CoV-2, and 9,414,403 people from the general population. An increased risk of venous thromboembolism was seen after first dose of ChAdOx1 (standardized incidence ratio: 1.12 [95% CI: 1.05 to 1.20]), BNT162b2 (1.12 [1.03 to 1.21]), and positive PCR test (7.27 [6.86 to 7.72]). Rates of cerebral venous sinus thrombosis were higher than otherwise expected after first dose of ChAdOx1 (4.14 [2.54 to 6.76]) and a SARS-CoV-2 PCR positive test (3.74 [1.56 to 8.98]). Rates of arterial thromboembolism after vaccination were no higher than expected but were increased after a SARS-CoV-2 PCR positive test (1.39 [1.21 to 1.61]). Rates of venous thromboembolism with thrombocytopenia were higher than expected after a SARS-CoV-2 PCR positive test (5.76 [3.19 to 10.40]).

Date: 2022
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DOI: 10.1038/s41467-022-34668-w

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