研究揭示了COVID-19疫苗接种后出现罕见血液凝固病症的风险

 

概要

 

《英国医学杂志》发表的一项研究进一步揭示了在接种新冠疫苗后发生一种非常罕见的凝血病症的风险，这种病症被称为血栓形成伴血小板减少综合征(TTS)。健康数据证明了在接种第一剂阿斯利康或强生、辉瑞疫苗后，TTS的风险略有增加。

研究调查了来自五个欧洲国家和美国超过1000万的成年人（这些人在2020年12月到2021年年中之间至少接种了一剂新冠疫苗，如阿斯利康、辉瑞、莫德纳或强生）的常规健康数据。按年龄和性别，并考虑了一系列其他潜在影响因素，例如既往病症和药物使用情况，研究人员对参与者进行了匹配对比分析。然后，研究人员比较了在接种腺病毒疫苗（阿斯利康或强生）和mRNA疫苗（辉瑞或莫德纳）28天内的受试者血栓形成率和血栓形成伴血小板减少症的发生率。

分析显示，接种首剂辉瑞疫苗后出现520例TTS。与辉瑞相比，首次接种阿斯利康疫苗后TTS的风险增加了30%，首次强生接种疫苗后观察到静脉TTS的风险也呈现增加趋势。

研究人员表示这是首次对基于腺病毒的COVID-19疫苗与基于mRNA的COVID-19疫苗进行比较安全性的跨国分析，强调TTS非常罕见，表示政府人员在计划推广进一步的免疫接种活动和未来的疫苗开发时，应该考虑这些腺病毒疫苗接种后观察到的风险。

 

Study sheds new light on the risk of rare blood-clotting condition after covid-19 vaccination

 

A study published by The BMJ today sheds further light on the risk of developing a very rare blood-clotting condition known as thrombosis with thrombocytopenia syndrome (TTS) after vaccination against the covid-19 virus.

 

Based on health data from five European countries and the US, it shows a small increased risk of TTS after a first dose of the Oxford-AstraZeneca vaccine, and a trend towards an increased risk after the Janssen/Johnson & Johnson vaccine, compared with the Pfizer-BioNTech vaccine.

 

The researchers stress that this syndrome is very rare, but say these observed risks "should be considered when planning further immunization campaigns and future vaccine development."

 

TTS occurs when a person has blood clots (thrombosis) as well as low blood platelet counts (thrombocytopenia). It's very rare and different from general clotting conditions like deep vein thrombosis (DVT) or lung clots (pulmonary embolism).

 

TTS is currently being investigated as a rare side effect of adenovirus based covid-19 vaccines, which use a weakened virus to trigger an immune response against coronavirus, but no clear evidence exists on the comparative safety of different types of vaccines.

 

To address this knowledge gap, an international team of researchers set out to compare the risk of TTS or thromboembolic events associated with use of adenovirus based covid-19 vaccines with mRNA based covid-19 vaccines.

 

Their findings are based on routinely collected health data for over 10 million adults in France, Germany, the Netherlands, Spain, the UK, and the US who received at least one dose of a covid-19 vaccine (Oxford-AstraZeneca, Pfizer-BioNTech, Moderna or Janssen/Johnson & Johnson) from December 2020 to mid-2021.

 

To minimize possible error, participants were matched by age and sex and a range of other potentially influential factors such as pre-existing conditions and medication use were taken into account.

 

The researchers then compared rates of thrombosis and of thrombosis with thrombocytopenia between the adenovirus vaccines (Oxford-AstraZeneca or Janssen/Johnson & Johnson) and the mRNA vaccines (Pfizer-BioNTech or Moderna) within 28 days after vaccination.

 

Overall, 1.3 million first dose Oxford-AstraZeneca recipients were matched to 2.1 million Pfizer-BioNTech recipients from Germany and the UK.

 

An additional, 762,517 people receiving Janssen/Johnson & Johnson were matched to 2.8 million receiving Pfizer-BioNTech in Germany, Spain, and the US, and all 628,164 Janssen/Johnson & Johnson recipients from the US were matched to 2.2 million Moderna recipients.

 

Source:

News-Medical

Published on Octobre 27 2022

 

 

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