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Risk of thyroid dysfunction associated with mRNA and inactivated COVID-19 vaccines: a population-based study of 2.3 million vaccine recipients.
Wong, Carlos King Ho; Lui, David Tak Wai; Xiong, Xi; Chui, Celine Sze Ling; Lai, Francisco Tsz Tsun; Li, Xue; Wan, Eric Yuk Fai; Cheung, Ching Lung; Lee, Chi Ho; Woo, Yu Cho; Au, Ivan Chi Ho; Chung, Matthew Shing Hin; Cheng, Franco Wing Tak; Tan, Kathryn Choon Beng; Wong, Ian Chi Kei.
  • Wong CKH; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Lui DTW; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Xiong X; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China.
  • Chui CSL; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Lai FTT; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Li X; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China.
  • Wan EYF; School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Cheung CL; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Lee CH; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Woo YC; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China.
  • Au ICH; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Chung MSH; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong SAR, China.
  • Cheng FWT; Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Tan KCB; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
  • Wong ICK; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
BMC Med ; 20(1): 339, 2022 10 14.
Article in English | MEDLINE | ID: covidwho-2064795
ABSTRACT

BACKGROUND:

In view of accumulating case reports of thyroid dysfunction following COVID-19 vaccination, we evaluated the risks of incident thyroid dysfunction following inactivated (CoronaVac) and mRNA (BNT162b2) COVID-19 vaccines using a population-based dataset.

METHODS:

We identified people who received COVID-19 vaccination between 23 February and 30 September 2021 from a population-based electronic health database in Hong Kong, linked to vaccination records. Thyroid dysfunction encompassed anti-thyroid drug (ATD)/levothyroxine (LT4) initiation, biochemical picture of hyperthyroidism/hypothyroidism, incident Graves' disease (GD), and thyroiditis. A self-controlled case series design was used to estimate the incidence rate ratio (IRR) of thyroid dysfunction in a 56-day post-vaccination period compared to the baseline period (non-exposure period) using conditional Poisson regression.

RESULTS:

A total of 2,288,239 people received at least one dose of COVID-19 vaccination (57.8% BNT162b2 recipients and 42.2% CoronaVac recipients). 94.3% of BNT162b2 recipients and 92.2% of CoronaVac recipients received the second dose. Following the first dose of COVID-19 vaccination, there was no increase in the risks of ATD initiation (BNT162b2 IRR 0.864, 95% CI 0.670-1.114; CoronaVac IRR 0.707, 95% CI 0.549-0.912), LT4 initiation (BNT162b2 IRR 0.911, 95% CI 0.716-1.159; CoronaVac IRR 0.778, 95% CI 0.618-0.981), biochemical picture of hyperthyroidism (BNT162b2 IRR 0.872, 95% CI 0.744-1.023; CoronaVac IRR 0.830, 95% CI 0.713-0.967) or hypothyroidism (BNT162b2 IRR 1.002, 95% CI 0.838-1.199; CoronaVac IRR 0.963, 95% CI 0.807-1.149), GD, and thyroiditis. Similarly, following the second dose of COVID-19 vaccination, there was no increase in the risks of ATD initiation (BNT162b2 IRR 0.972, 95% CI 0.770-1.227; CoronaVac IRR 0.879, 95%CI 0.693-1.116), LT4 initiation (BNT162b2 IRR 1.019, 95% CI 0.833-1.246; CoronaVac IRR 0.768, 95% CI 0.613-0.962), hyperthyroidism (BNT162b2 IRR 1.039, 95% CI 0.899-1.201; CoronaVac IRR 0.911, 95% CI 0.786-1.055), hypothyroidism (BNT162b2 IRR 0.935, 95% CI 0.794-1.102; CoronaVac IRR 0.945, 95% CI 0.799-1.119), GD, and thyroiditis. Age- and sex-specific subgroup and sensitivity analyses showed consistent neutral associations between thyroid dysfunction and both types of COVID-19 vaccines.

CONCLUSIONS:

Our population-based study showed no evidence of vaccine-related increase in incident hyperthyroidism or hypothyroidism with both BNT162b2 and CoronaVac.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 / Hyperthyroidism / Hypothyroidism Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Male Language: English Journal: BMC Med Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: S12916-022-02548-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 / Hyperthyroidism / Hypothyroidism Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Female / Humans / Male Language: English Journal: BMC Med Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: S12916-022-02548-1