PDF(Pubmed)
Abstract：
Introduction Autoimmune diseases have been linked to COVID-19 vaccines. An increasing number of cases have reported de novo immune thrombocytopenia (ITP) following mRNA COVID-19 vaccines. This study aims to investigate the incidence of de novo ITP following the mRNA COVID-19 vaccine in comparison to other non-mRNA vaccines and COVID-19. Methods Data were collected from the TriNetX global health research network, which covers over 117 million patients. Four different patient cohorts were included: those who received the mRNA COVID-19 vaccine (between 12/15/2020 - 5/1/2023), the influenza vaccine (between 01/01/2010 - 01/01/2020), tetanus, diphtheria, and pertussis/tetanus and diphtheria (Tdap/Td) vaccines (between 01/01/2010 - 01/01/2020), and those who had COVID-19 (between 01/01/2020 - 05/01/2023). A comparative analysis was conducted to examine the occurrence of de novo ITP within three weeks after receiving mRNA COVID-19 vaccine, non-mRNA vaccines, or upon diagnosis of COVID-19. Additionally, a comparative analysis was performed after 1:1 propensity score matching to balance baseline characteristics (age, sex, and race). Results The overall event rate was 0.07 per 10,000 for the mRNA COVID-19 vaccine, 0.25 per 10,000 for the influenza vaccine, and 0.28 per 10,000 for the Tdap/Td vaccines. Additionally, the incidence of de novo ITP following COVID-19 was 0.30 per 10,000. Those who received the influenza vaccine and Tdap/Td vaccines had higher rates of de novo ITP compared to the mRNA COVID-19 vaccine group, with a relative risk of 3.48 and 3.88, respectively. The occurrence of de novo ITP following COVID-19 was significantly higher compared to that following the mRNA COVID-19 vaccine, with a relative risk of 4.27. Post-propensity score matching analysis produced similar outcomes. Conclusions The findings of this study suggest that the incidence of de novo ITP is significantly lower following mRNA-based COVID-19 vaccines compared to non-mRNA vaccines and COVID-19.
摘要：
引言自身免疫性疾病与COVID-19疫苗有关。越来越多的病例报道了在mRNACOVID-19疫苗接种后的新发免疫性血小板减少症（ITP）。这项研究旨在调查与其他非mRNA疫苗和COVID-19相比，mRNACOVID-19疫苗后从头ITP的发生率。方法数据来自TriNetX全球健康研究网络，覆盖了超过1.17亿患者。包括四个不同的患者队列：接受mRNACOVID-19疫苗的患者（在2020年12月15日至2023年5月1日之间），流感疫苗（2010年01月01日至2020年01月01日），破伤风,白喉,百日咳/破伤风和白喉（Tdap/Td）疫苗（2010年1月1日至2020年1月1日），以及患有COVID-19的人（2020年1月1日至2023年5月1日）。进行了比较分析，以检查在接受mRNACOVID-19疫苗后三周内从头ITP的发生情况，非mRNA疫苗，或在诊断为COVID-19时。此外,在1：1倾向评分与平衡基线特征(年龄，性别,和种族）。结果COVID-19mRNA疫苗的总事件率为0.07/10,000，流感疫苗每10,000人中有0.25人，Tdap/Td疫苗为0.28/10,000。此外,COVID-19后从头ITP的发生率为0.30/10,000。与COVID-19mRNA疫苗组相比，接种流感疫苗和Tdap/Td疫苗的患者从头ITP发生率更高，相对风险分别为3.48和3.88。与COVID-19mRNA疫苗接种后相比，COVID-19后从头ITP的发生率明显更高，相对风险为4.27。后倾向得分匹配分析产生了相似的结果。结论这项研究的结果表明，与非mRNA疫苗和COVID-19相比，使用基于mRNA的COVID-19疫苗后，从头ITP的发病率显着降低。
