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Bettinger JA, Irvine MA, Shulha HP, Valiquette L, Muller MP, Vanderkooi OG, Kellner JD, Top KA, Sadarangani M, McGeer A, Isenor JE, Marty K, Soe P, De Serres G. 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. Clin Infect Dis 2023; 76:1088-1102. [PMID: 36310514 PMCID: PMC9620384 DOI: 10.1093/cid/ciac852] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 11/27/2022] Open
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.
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Affiliation(s)
- Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | | | - Hennady P Shulha
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Canada
| | | | - Otto G Vanderkooi
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - James D Kellner
- Department of Pediatrics and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Karina A Top
- Canadian Center for Vaccinology, IWK Health and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Allison McGeer
- Sinai Health System and University of Toronto, Toronto, Canada
| | - Jennifer E Isenor
- College of Pharmacy and Canadian Center for Vaccinology, Dalhousie University, Halifax, Canada
| | - Kimberly Marty
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Phyumar Soe
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Gaston De Serres
- CHU de Québec-Université Laval, Quebec City, Canada
- Institut National de Santé Publique du Québec, Quebec City, Canada
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