Risk of carditis among adolescents after extending the interdose intervals of BNT162b2

Abstract

Previous studies indicate an increased carditis risk among adolescents following the two-dose messenger RNA COVID-19 vaccine. Several jurisdictions have extended the interdose interval between the first and second doses to reduce the risk. However, the effectiveness of such an extension policy remains inconclusive. Using the territory-wide vaccine record-linked electronic health records in Hong Kong, we conducted a nested case-control study from February 23, 2021 to August 15, 2022. Adolescents aged between 12 and 17 who received two-dose BNT162b2 were included for comparing risks between standard interdose interval (21-27 days) versus extended interdose interval ( ≥ 56 days). The carditis cumulative incidence within 28 days following the second dose was calculated. The adjusted odds ratio was estimated from multivariable conditional logistic regression. We identified 49 adolescents with newly diagnosed carditis within 28 days following the second dose. The crude cumulative incidence is 37.41 [95% confidence interval (CI): 27.68-49.46] per million vaccinated adolescents. Compared to the standard interdose interval group, adolescents with an extended interval had a significantly lower risk of carditis [adjusted odds ratio (aOR) 0.34 (95% CI: 0.16-0.73)]. Sensitivity analysis of carditis occurring within 14 days following the second dose yielded a similar estimate [aOR 0.30 (95% CI: 0.13-0.73)]. Extending the interdose interval of the BNT162b2 vaccine from 21 to 27 days to 56 days or longer is associated with 66% lower risk of incident carditis among adolescents. Our findings contribute towards an evidence-based vaccination strategy for a vulnerable population and potentially informs product label updates.

Publication DOI: https://doi.org/10.1038/s41541-023-00789-6
Divisions: College of Health & Life Sciences > Aston Pharmacy School
College of Health & Life Sciences
Funding Information: This work was supported by the Food and Health Bureau of the Government of the Hong Kong Special Administrative Region (Ref: COVID19F01). Publication was made possible in part by support from the HKU Libraries Open Access Author Fund sponsored by the HKU
Additional Information: © 2024. The Author(s). CC BY
Publication ISSN: 2059-0105
Last Modified: 17 Dec 2024 08:25
Date Deposited: 08 Jul 2024 12:38
Full Text Link:
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://www.nat ... 541-023-00789-6 (Publisher URL)
PURE Output Type: Article
Published Date: 2024-02-14
Accepted Date: 2023-12-01
Authors: Fan, Min
Peng, Kuan
Zhang, Yin
Lai, Francisco Tsz Tsun
Chui, Celine Sze Ling
Wan, Eric Yuk Fai
Wong, Carlos King Ho
Chan, Esther Wai Yin
Li, Xue
Wong, Ian Chi Kei (ORCID Profile 0000-0001-8242-0014)

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