Риск миокардита
Dec. 26th, 2021 11:06 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
chuka_lisДля молодых мужчин (моложе 40) после прививки, особенно после 2 дозы, выше, чем после ковида.
При этом, если брать независимо от возраста или пола, то риск миокрадита после прививки будет меньше или сравним с риском после ковида. За счет того, что у пожилых риски миокрадита после болезни выше.
Дополнительных случаев миокардитов случается 1-100 на миллион (привитых или заболевших) человек, в зависимости от возраста, пола, типа вакцины, номера дозы, или ковида.
Between Dec ember 1, 2020, to November 15, 2021 a total of 42,200,614 people were vaccinated with at least one dos e o f ChAdOx1 (n=20,646,456), BNT162b2 (n=20,391,600) or mRNA-1273 (n=1,162,558) in England (Supplementary Table 1). Of thes e, 38,347,981 received two doses o f ei ther ChAdOx1 (n= 20,059,058), BNT162b2 (n=17,294,004 ) or mRNA-1273 (n=1,039,919) and 10,978,507 people received a thi rd dose of ChAdOx1 (n=35,608), BNT162b2 (n=10,599,183) or mRNA-1273 (n=343,716). Amongst people receiving at least one vaccin e dose, 5,185,772 (12.3%) tested positi ve for SARS-CoV-2; 2,834,579 (54 .7%) prior to va ccinat ion, 698,993 (13.5%) after a first vaccin e dose, 1,604,087 (30.9%) after a second vaccine dose an d 48,113 (0.9%) after a third vacc ine dose. Of the 42,200,614 persons included in th e study population, 2,539 (0.006%) were hospitalised or di ed from myocarditis during the study period; 552 (0.001%) of these events occ urred during 1-28 days following any dose of vaccine (Supplementary Table 2). Over the 1-28 days post vaccination, we observed an association with the first dose of ChAdOx1 (IRR 1.27, 95%CI 1.05, 1.55) and BNT162b2 (IRR 1.37, 95%CI 1.12, 1.67), but not mRNA-1273 (IRR 1.80, 95%CI 0.91, 3.58; Table 1 and Extended Figure 1).Following a second dose, the r is k was higher with mRNA-1273 (IRR 13.71, 95%CI 8.46, 22.20) compared to BNT162b2 (IRR 1.60, 95%CI 1.31, 1.97). No association wi th a second dose o f ChAdOx1 was found. An association after a third dose was only observed for BNT162b2 (IRR 2.02, 95%CI 1.40, 2.91). No myocarditis events occurr ed 1-28 days after a third dose in the small number of persons receiving ChAdOx1 or mRNA-1273 vaccine. The risk of myocardit is was increased in th e 1-28 days following a SARS-CoV-2 positive test (IR R 8.40, 95%CI 6.89, 10.25). In males aged less than 40 years, we observed an in creased risk of myocar ditis in the 1-28 days following a first dose of BNT162b2 (IRR 1.66, 95%CI 1.14, 2.41) and mRNA-1273 (IRR 2.34, 95%CI 1.03, 5.34); after a second dose of ChAdOx1 (2.57, 95%CI 1.52, 4.35), BNT162b2 (IRR 3.41, 95% CI 2.44, 4.78) and mRNA-1273 (IRR 16.52, 95%CI 9.10, 30.00); after a third dose of BNT162b2 (IRR 7.60, 95%CI 2.44, 4.78); and following a SARS-CoV-2 positive test (IR R 2.02, 95%CI 1.13, 3.61; Extended Figure 1 and Table 1). In older males, the risk of myocarditi s was increased 1-28 days fo llowing a th ir d dose o f BNT162b2 vaccine (IRR 2. 48, 95%CI 1.46, 4.19) and following a posi tive test (IR R 5.98, 95%CI 2.83, 12.63). In females aged less than 40 y ears, we only obs erved an inc reased risk o f myocardit is in the 1-28 days following a second dose of mRNA-1273 vaccine (IRR 7.55, 95%CI 1.67, 34.12; Figure 1). However, the numbers of events were small. In older females, we found no associatio n between myocarditis and vaccina tio n. Supplementary Table 4 shows IRRs per week following exposure. We estimated the number of excess myocarditis event s per million pers ons in the 1-28 days following each exposure fo r th e mai n analysis and by age and sex (Suppl emental Table 5 and Figure 1). Following the first dose of the ChAdOx1 and BNT162b2 vaccines an additiona l 1 (95%CI 0, 2) and 2 (95%CI 1, 2) myocardit is events per mill ion person s exposed would be anticipate d, respect ively. Foll owing the second dose o f BNT162b2 and mRNA-1273 an additional 2 (95%CI 2, 3) and 36 (95%CI 34, 37) myocarditis even ts would be anticipat ed, respecti vely. Following a third dose of BNT162b2 an additional 2 (95%CI 1, 2) myocarditis events per million pe rsons would be anticipate d. These estimates compare to an additional 30 (95%CI 29, 31) myocarditis e vents pe r million in the 1-28 days fol lowing a SARS-CoV-2 positiv e test. In males aged less than 40 years, we estimated an additiona l 3 (95%CI 1, 5) and 12 (95%CI 1, 13) myocarditis events per mil lion i n the 1-28 days fo llowing a firs t do se of BNT162b2 and mRNA-1273, respective ly; an addi tio nal 14 (95%CI 8, 17), 12 (95%CI 1, 7) and 101 (95%CI 95, 104) myocarditis events fol lowing a second dose of ChAdOx1, BNT162b2 and mRNA-1273, respecti vely; and an addi tional 13 (9 5%CI 7, 15) myocarditis events fo llo wing a third d ose o f BNT162b2 vaccine. This compares wit h 7 (95%CI 2, 11) additional myocardi tis even ts in the 1-28 days following a posi tive SARS-CoV-2 test. In older males, we estimated 3 (95% CI 2, 4) and 73 (95% 71, 75) additional myocarditis e vents per million fol lowing a third dose of BNT162b2 and a positive SARS-CoV-2 test, respectively . In females aged less than 40 years, we estimated an additional 8 (95% CI 4, 9) and 7 (95% CI 6, 8) events per million fol lowing a second dose of mRNA-1273 and a positive SARS-CoV-2 test, respecti vely. In o lder females, we estimated no add itiona l myocard itis ev ents following vaccination, but an additional 39 (95% CI 37, 40) events per million follo wing a positive SARS-CoV-2 test. We report severa l observa tions that may have implications fo r polic y makers and the pub lic. First, we conf irm and ext end our pre vious f indings in more than 42 mil lio n persons that the ris k of hospital izat ion or death fr om myocarditis f ollowing COVID-19 infection is higher than the ris k associated wi th vacc inati on in the o v erall popu lation. Second, the risk of myocarditis is greater following sequen tial doses of mRNA vaccine than sequen tial doses o f th e adenovirus vaccin e. For the f irst time, we observe an i ncrease in myocard itis events fol lo wing a third dose of BNT162b vaccine. Whilst the incidence rate ratios are higher sequen tial ly following each dose of mRNA vaccine, the r isk remains small in the o verall popula tion with an es timated 2 additional cases o f myocardit is per million fo llowing a boost er dose of BNT162b. Third, we report th e risk asso ciated with vac ci nation and infec tion in y ounger pers ons strati fied by sex. Despite more myocard itis events o ccurring in o lder p ersons, th e ris k following COVID-19 vaccination was largely restr icted to younger males aged less than 40 years, where the risks of myocarditis following vac cinati on an d infec tion we re similar. However, t he notable except ion was that in younger males r eceiv i ng a second dose of mRNA-1273 vaccine, the ris k of myocarditis was higher following v accination than infe ction, with an additional 101 events estimated foll owing a second dose of mRNA-1273 vaccine compared to 7 events following a positive SARS-CoV-2 test.
При этом, если брать независимо от возраста или пола, то риск миокрадита после прививки будет меньше или сравним с риском после ковида. За счет того, что у пожилых риски миокрадита после болезни выше.
Дополнительных случаев миокардитов случается 1-100 на миллион (привитых или заболевших) человек, в зависимости от возраста, пола, типа вакцины, номера дозы, или ковида.
Between Dec ember 1, 2020, to November 15, 2021 a total of 42,200,614 people were vaccinated with at least one dos e o f ChAdOx1 (n=20,646,456), BNT162b2 (n=20,391,600) or mRNA-1273 (n=1,162,558) in England (Supplementary Table 1). Of thes e, 38,347,981 received two doses o f ei ther ChAdOx1 (n= 20,059,058), BNT162b2 (n=17,294,004 ) or mRNA-1273 (n=1,039,919) and 10,978,507 people received a thi rd dose of ChAdOx1 (n=35,608), BNT162b2 (n=10,599,183) or mRNA-1273 (n=343,716). Amongst people receiving at least one vaccin e dose, 5,185,772 (12.3%) tested positi ve for SARS-CoV-2; 2,834,579 (54 .7%) prior to va ccinat ion, 698,993 (13.5%) after a first vaccin e dose, 1,604,087 (30.9%) after a second vaccine dose an d 48,113 (0.9%) after a third vacc ine dose. Of the 42,200,614 persons included in th e study population, 2,539 (0.006%) were hospitalised or di ed from myocarditis during the study period; 552 (0.001%) of these events occ urred during 1-28 days following any dose of vaccine (Supplementary Table 2). Over the 1-28 days post vaccination, we observed an association with the first dose of ChAdOx1 (IRR 1.27, 95%CI 1.05, 1.55) and BNT162b2 (IRR 1.37, 95%CI 1.12, 1.67), but not mRNA-1273 (IRR 1.80, 95%CI 0.91, 3.58; Table 1 and Extended Figure 1).Following a second dose, the r is k was higher with mRNA-1273 (IRR 13.71, 95%CI 8.46, 22.20) compared to BNT162b2 (IRR 1.60, 95%CI 1.31, 1.97). No association wi th a second dose o f ChAdOx1 was found. An association after a third dose was only observed for BNT162b2 (IRR 2.02, 95%CI 1.40, 2.91). No myocarditis events occurr ed 1-28 days after a third dose in the small number of persons receiving ChAdOx1 or mRNA-1273 vaccine. The risk of myocardit is was increased in th e 1-28 days following a SARS-CoV-2 positive test (IR R 8.40, 95%CI 6.89, 10.25). In males aged less than 40 years, we observed an in creased risk of myocar ditis in the 1-28 days following a first dose of BNT162b2 (IRR 1.66, 95%CI 1.14, 2.41) and mRNA-1273 (IRR 2.34, 95%CI 1.03, 5.34); after a second dose of ChAdOx1 (2.57, 95%CI 1.52, 4.35), BNT162b2 (IRR 3.41, 95% CI 2.44, 4.78) and mRNA-1273 (IRR 16.52, 95%CI 9.10, 30.00); after a third dose of BNT162b2 (IRR 7.60, 95%CI 2.44, 4.78); and following a SARS-CoV-2 positive test (IR R 2.02, 95%CI 1.13, 3.61; Extended Figure 1 and Table 1). In older males, the risk of myocarditi s was increased 1-28 days fo llowing a th ir d dose o f BNT162b2 vaccine (IRR 2. 48, 95%CI 1.46, 4.19) and following a posi tive test (IR R 5.98, 95%CI 2.83, 12.63). In females aged less than 40 y ears, we only obs erved an inc reased risk o f myocardit is in the 1-28 days following a second dose of mRNA-1273 vaccine (IRR 7.55, 95%CI 1.67, 34.12; Figure 1). However, the numbers of events were small. In older females, we found no associatio n between myocarditis and vaccina tio n. Supplementary Table 4 shows IRRs per week following exposure. We estimated the number of excess myocarditis event s per million pers ons in the 1-28 days following each exposure fo r th e mai n analysis and by age and sex (Suppl emental Table 5 and Figure 1). Following the first dose of the ChAdOx1 and BNT162b2 vaccines an additiona l 1 (95%CI 0, 2) and 2 (95%CI 1, 2) myocardit is events per mill ion person s exposed would be anticipate d, respect ively. Foll owing the second dose o f BNT162b2 and mRNA-1273 an additional 2 (95%CI 2, 3) and 36 (95%CI 34, 37) myocarditis even ts would be anticipat ed, respecti vely. Following a third dose of BNT162b2 an additional 2 (95%CI 1, 2) myocarditis events per million pe rsons would be anticipate d. These estimates compare to an additional 30 (95%CI 29, 31) myocarditis e vents pe r million in the 1-28 days fol lowing a SARS-CoV-2 positiv e test. In males aged less than 40 years, we estimated an additiona l 3 (95%CI 1, 5) and 12 (95%CI 1, 13) myocarditis events per mil lion i n the 1-28 days fo llowing a firs t do se of BNT162b2 and mRNA-1273, respective ly; an addi tio nal 14 (95%CI 8, 17), 12 (95%CI 1, 7) and 101 (95%CI 95, 104) myocarditis events fol lowing a second dose of ChAdOx1, BNT162b2 and mRNA-1273, respecti vely; and an addi tional 13 (9 5%CI 7, 15) myocarditis events fo llo wing a third d ose o f BNT162b2 vaccine. This compares wit h 7 (95%CI 2, 11) additional myocardi tis even ts in the 1-28 days following a posi tive SARS-CoV-2 test. In older males, we estimated 3 (95% CI 2, 4) and 73 (95% 71, 75) additional myocarditis e vents per million fol lowing a third dose of BNT162b2 and a positive SARS-CoV-2 test, respectively . In females aged less than 40 years, we estimated an additional 8 (95% CI 4, 9) and 7 (95% CI 6, 8) events per million fol lowing a second dose of mRNA-1273 and a positive SARS-CoV-2 test, respecti vely. In o lder females, we estimated no add itiona l myocard itis ev ents following vaccination, but an additional 39 (95% CI 37, 40) events per million follo wing a positive SARS-CoV-2 test. We report severa l observa tions that may have implications fo r polic y makers and the pub lic. First, we conf irm and ext end our pre vious f indings in more than 42 mil lio n persons that the ris k of hospital izat ion or death fr om myocarditis f ollowing COVID-19 infection is higher than the ris k associated wi th vacc inati on in the o v erall popu lation. Second, the risk of myocarditis is greater following sequen tial doses of mRNA vaccine than sequen tial doses o f th e adenovirus vaccin e. For the f irst time, we observe an i ncrease in myocard itis events fol lo wing a third dose of BNT162b vaccine. Whilst the incidence rate ratios are higher sequen tial ly following each dose of mRNA vaccine, the r isk remains small in the o verall popula tion with an es timated 2 additional cases o f myocardit is per million fo llowing a boost er dose of BNT162b. Third, we report th e risk asso ciated with vac ci nation and infec tion in y ounger pers ons strati fied by sex. Despite more myocard itis events o ccurring in o lder p ersons, th e ris k following COVID-19 vaccination was largely restr icted to younger males aged less than 40 years, where the risks of myocarditis following vac cinati on an d infec tion we re similar. However, t he notable except ion was that in younger males r eceiv i ng a second dose of mRNA-1273 vaccine, the ris k of myocarditis was higher following v accination than infe ction, with an additional 101 events estimated foll owing a second dose of mRNA-1273 vaccine compared to 7 events following a positive SARS-CoV-2 test.
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