UNASSIGNED: To investigate the risk of uveitis recurrence after COVID-19 vaccination in a cohort of individuals with a history of uveitis.
UNASSIGNED: This retrospective population-based cohort study included individuals diagnosed with uveitis between January 1, 2015, and February 25, 2021, in South Korea. After excluding individuals without COVID-19 vaccination or with SARS-CoV-2 infection, individuals with a history of uveitis who had received at least 1 dose of a messenger RNA (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) or adenovirus vector-based (ChAdOx1 [AstraZeneca] or Ad26.COV2.S [Janssen]) COVID-19 vaccine were included. Data were analyzed from February 26, 2021, to December 31, 2022.
UNASSIGNED: Demographic and clinical data, along with vaccination details, were retrieved from the Korean National Health Insurance Service and Korea Disease Control and Prevention Agency databases.
UNASSIGNED: Outcomes of interest were incidence and risk of postvaccination uveitis in association with different COVID-19 vaccines and periods before and after COVID-19 vaccination. Uveitis was categorized by onset (early, within 30 days, or delayed) and type (anterior or nonanterior). Hazard ratios (HRs) with 95% CIs were calculated to evaluate the risk of uveitis following COVID-19 vaccination, stratified according to vaccine type and vaccination period.
UNASSIGNED: Of 543 737 individuals with history of uveitis, 473 934 individuals (mean [SD] age, 58.9 [17.4] years; 243 127 [51.3] female) had documented COVID-19 vaccination and were included in analysis. The cumulative incidence of postvaccination uveitis was 8.6% at 3 months, 12.5% at 6 months, and 16.8% at 1 year, predominantly of the anterior type. Variations in the risk of postvaccination uveitis were observed across different vaccines and intervaccination periods. The risk of early postvaccination uveitis was increased for individuals receiving the BNT162b2 (HR, 1.68; 95% CI, 1.52-1.86), mRNA-1273 (HR, 1.51; 95% CI, 1.21-1.89), ChAdOx1 (HR, 1.60; 95% CI, 1.43-1.79), and Ad26.COV2.S (HR, 2.07; 95% CI, 1.40-3.07) vaccines. The risk of uveitis was higher particularly between the first and second vaccination doses (HR, 1.64; 95% CI, 1.55-1.73).
UNASSIGNED: These findings suggest that there was an elevated risk of uveitis following COVID-19 vaccination, with the vaccine type and period mediating this risk. For individuals with a history of uveitis, clinicians should consider the potential risk of uveitis recurrence in vaccination strategies and clinical monitoring.
■调查有葡萄膜炎病史的人群在接种COVID-19疫苗后葡萄膜炎复发的风险。
这项基于人群的回顾性队列研究包括2015年1月1日至2021年2月25日在韩国诊断为葡萄膜炎的个体。在排除未接种COVID-19疫苗或SARS-CoV-2感染的个体后,有葡萄膜炎病史的个体接受过至少1剂信使RNA(BNT162b2[Pfizer-BioNTech]或mRNA-1273[Moderna])或腺病毒载体(ChAdOx1[AstraZeneca]或Ad26.COV2.S[Janssen])包括COVID-19疫苗。数据从2021年2月26日至2022年12月31日进行了分析。
■人口统计学和临床数据,以及疫苗接种细节,从韩国国家健康保险局和韩国疾病控制和预防局的数据库中检索。
■感兴趣的结果是与不同COVID-19疫苗以及COVID-19疫苗接种前后的疫苗接种后葡萄膜炎的发生率和风险。葡萄膜炎按发病分类(早期,30天内,或延迟)和类型(前或非前)。计算95%CI的危险比(HR)以评估COVID-19疫苗接种后葡萄膜炎的风险,根据疫苗类型和疫苗接种期进行分层。
■在有葡萄膜炎病史的543737人中,473934人(平均[SD]年龄,58.9[17.4]年;243127[51.3]女性)记录了COVID-19疫苗接种并纳入分析。3个月时接种后葡萄膜炎的累积发生率为8.6%,6个月时为12.5%,一年为16.8%,主要为前牙型。在不同的疫苗和接种间期观察到疫苗接种后葡萄膜炎风险的变化。接受BNT162b2的个体接种疫苗后早期葡萄膜炎的风险增加(HR,1.68;95%CI,1.52-1.86),mRNA-1273(HR,1.51;95%CI,1.21-1.89),ChAdOx1(HR,1.60;95%CI,1.43-1.79),Ad26COV2.S(HR,2.07;95%CI,1.40-3.07)疫苗。葡萄膜炎的风险较高,特别是在第一次和第二次疫苗接种剂量之间(HR,1.64;95%CI,1.55-1.73)。
这些研究结果表明,接种COVID-19疫苗后葡萄膜炎的风险增加,疫苗类型和时期介导了这种风险。对于有葡萄膜炎病史的人,临床医师应在疫苗接种策略和临床监测中考虑葡萄膜炎复发的潜在风险.