Effectiveness of the original monovalent mRNA COVID-19 vaccination series against hospitalization for COVID-19-associated venous thromboembolism
Author Department
Medicine
Document Type
Article, Peer-reviewed
Publication Date
10-2024
Abstract
Background: COVID-19 is a strong risk factor for venous thromboembolism (VTE). Few studies have evaluated the effectiveness of COVID-19 vaccination in preventing hospitalization for COVID-19 with VTE.
Methods: Adults hospitalized at 21 sites between March 2021 and October 2022 with symptoms of acute respiratory illness were assessed for COVID-19, completion of the original monovalent mRNA COVID-19 vaccination series, and VTE. Prevalence of VTE was compared between unvaccinated and vaccinated patients with COVID-19. Vaccine effectiveness in preventing COVID-19 hospitalization with VTE was calculated using a test negative design. Vaccine effectiveness was also stratified by predominant circulating SARS-CoV-2 variant.
Results: Among 18,811 patients (median age 63 [IQR:50-73], 49% women, 59% non-Hispanic White, 20% non-Hispanic Black, 14% Hispanic, and median of 2 comorbid conditions [IQR:1-3]), 9,792 were admitted with COVID-19 (44% vaccinated) and 9,019 were test-negative controls (73% vaccinated). Among patients with COVID-19, 601 were diagnosed with VTE by hospital day 28, of whom 170 were vaccinated. VTE was more common among unvaccinated than vaccinated COVID-19 patients (7.8% versus 4.0%; p=0.001). Vaccine effectiveness against COVID-19 hospitalization with VTE was 84% (95% CI: 80-87%) overall. Vaccine effectiveness stratified by predominant circulating variant was 88% (73-95%) for alpha, 93% (90-95%) for delta, and 68% (58-76%) for omicron variants.
Conclusions and relevance: Vaccination with the original monovalent mRNA series was associated with a decrease in COVID-19 hospitalization with VTE, though data detailing prior history of VTE and use of anticoagulation were not available. These findings will inform risk-benefit considerations for those considering vaccination.
Keywords: COVID-19; SARS-CoV-2; deep venous thrombosis; pulmonary embolus; vaccine; venous thromboembolism.
Recommended Citation
Hager DN, Zhu Y, Sohn I, Stubblefield WB, Streiff MB, Gaglani M, Steingrub JS, Duggal A, Felzer JR, O'Rourke M, Peltan ID, Mohamed A, Stiller R, Wilson JG, Qadir N, Ginde AA, Zepeski AE, Mallow C, Lauring AS, Johnson NJ, Gibbs KW, Kwon JH, Self WH; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network. Effectiveness of the original monovalent mRNA COVID-19 vaccination series against hospitalization for COVID-19-associated venous thromboembolism. J Infect Dis. 2024 Oct 15:jiae502. doi: 10.1093/infdis/jiae502. Epub ahead of print.
PMID
39405261