Multimorbidity and adverse events of special interest associated with Covid-19 vaccines in Hong Kong

• Published in: Nature communications Vol. 13; no. 1; pp. 411 - 8
• Main Authors: Lai, Francisco Tsz Tsun, Huang, Lei, Chui, Celine Sze Ling, Wan, Eric Yuk Fai, Li, Xue, Wong, Carlos King Ho, Chan, Edward Wai Wa, Ma, Tiantian, Lum, Dawn Hei, Leung, Janice Ching Nam, Luo, Hao, Chan, Esther Wai Yin, Wong, Ian Chi Kei
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 20.01.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/326/590; 631/326/596/4130; 692/308/409; 692/700/478/174; Adverse events; Aged; Chronic conditions; Chronic illnesses; Comorbidity; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - immunology; COVID-19 - virology; COVID-19 vaccines; COVID-19 Vaccines - administration & dosage; COVID-19 Vaccines - adverse effects; COVID-19 Vaccines - immunology; Databases, Factual - statistics & numerical data; Electronic health records; Electronic medical records; Epidemics - prevention & control; Female; Health care; Hong Kong - epidemiology; Humanities and Social Sciences; Humans; Immunization; Male; Middle Aged; multidisciplinary; Multimorbidity; Patients; Public health; Public Health - statistics & numerical data; Retrospective Studies; Risk; Risk Factors; SARS-CoV-2 - immunology; SARS-CoV-2 - physiology; Science; Science (multidisciplinary); Vaccination - adverse effects; Vaccination - statistics & numerical data; Vaccines; Hong Kong; Hong Kong China; China
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-022-28068-3

Prior research using electronic health records for Covid-19 vaccine safety monitoring typically focuses on specific disease groups and excludes individuals with multimorbidity, defined as ≥2 chronic conditions. We examine the potential additional risk of adverse events 28 days after the first dose of CoronaVac or Comirnaty imposed by multimorbidity. Using a territory-wide public healthcare database with population-based vaccination records in Hong Kong, we analyze a retrospective cohort of patients with chronic conditions. Thirty adverse events of special interest according to the World Health Organization are examined. In total, 883,416 patients are included and 2,807 (0.3%) develop adverse events. Results suggest vaccinated patients have lower risks of adverse events than unvaccinated individuals, multimorbidity is associated with increased risks regardless of vaccination, and the association of vaccination with adverse events is not modified by multimorbidity. To conclude, we find no evidence that multimorbidity imposes extra risks of adverse events following Covid-19 vaccination. Adverse events resulting from COVID-19 vaccination are a public health concern and it is not known whether pre-existing conditions may impose an increased risk. Here, using electronic health records from Hong Kong, the authors show that adverse events are rare for all groups, and there is no evidence of risk modification due to multimorbidity.