Real-world evidence from over one million COVID-19 vaccinations is consistent with reactivation of the varicella-zoster virus.
Real-world evidence from over one million COVID-19 vaccinations is consistent with reactivation of the varicella-zoster virus.
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DOI：
10.1111/jdv.18184
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发表时间：
2022-08
影响因子：
9.2
通讯作者：
Preissner, S.
中科院分区：
文献类型：
--
作者：
Hertel, M.;Heiland, M.;Nahles, S.;von Laffert, M.;Mura, C.;Bourne, P. E.;Preissner, R.;Preissner, S.
水痘带状疱疹病毒（VZV）的重新激活，导致人类带状疱疹（HZ，同义词：带状疱疹），可能是疫苗的罕见不良反应。最近，出现了COVID-19疫苗接种后的病例报告。本研究的目的是基于真实的世界数据，评估在大型队列中接种COVID-19疫苗后是否发现HZ频率增加。作为一种假设，假设接种COVID-19疫苗的受试者（队列I）的HZ发生率显著高于未接种疫苗的受试者（队列II）。从TriNetX数据库中检索初始队列1 095 086例接种疫苗和16 966 018例未接种疫苗的患者，并在年龄和性别上进行匹配，以减轻混杂偏倚。匹配后，每个队列占1 095 086例患者。对于接种组（队列I），2204例受试者在COVID-19疫苗接种后60天内发生HZ，而在队列II中，1223例患者在因任何其他原因（即未接种疫苗）就诊后60天内被诊断为HZ。队列I和队列II发生带状疱疹的风险分别为0.20%和0.11%。差异具有统计学高度显著性（P < 0.0001;对数秩检验）。风险比和比值比分别为1.802（95%置信区间[CI] = 1.680; 1.932）和1.804（95% CI = 1.682; 1.934）。与该假设一致，COVID-19疫苗接种后，在统计学上可检测到较高的HZ发生率。因此，HZ的爆发可能是COVID-19疫苗的罕见药物不良反应。尽管VZV再活化的分子基础仍然不清楚，但VZV特异性T细胞介导的免疫的暂时性损害可能在接种后HZ发病机制中发挥机制作用。请注意，VZV再激活是感染和其他疫苗的公认现象（即该不良事件不是COVID-19特异性的）。
Reactivation of the varicella‐zoster virus (VZV), which causes herpes zoster (HZ, synonym: shingles) in humans, can be a rare adverse reaction to vaccines. Recently, reports of cases after COVID‐19 vaccination have arisen. The aim of this study was to assess whether the frequency of HZ is found to increase after COVID‐19 vaccination in a large cohort, based on real‐world data. As a hypothesis, the incidence of HZ was assumed to be significantly higher in subjects who received a COVID‐19 vaccine (Cohort I) vs. unvaccinated individuals (Cohort II). The initial cohorts of 1 095 086 vaccinated and 16 966 018 unvaccinated patients were retrieved from the TriNetX database and were matched on age and gender in order to mitigate confounder bias. After matching, each cohort accounted for 1 095 086 patients. For the vaccinated group (Cohort I), 2204 subjects developed HZ within 60 days of COVID‐19 vaccination, while among Cohort II, 1223 patients were diagnosed with HZ within 60 days after having visited the clinic for any other reason (i.e. not vaccination). The risk of developing shingles was calculated as 0.20% and 0.11% for cohort I and cohort II, respectively. The difference was statistically highly significant (P < 0.0001; log‐rank test). The risk ratio and odds ratio were 1.802 (95% confidence interval [CI] = 1.680; 1.932) and 1.804 (95% CI = 1.682; 1.934). Consistent with the hypothesis, a higher incidence of HZ was statistically detectable post‐COVID‐19 vaccine. Accordingly, the eruption of HZ may be a rare adverse drug reaction to COVID‐19 vaccines. Even though the molecular basis of VZV reactivation remains murky, temporary compromising of VZV‐specific T‐cell‐mediated immunity may play a mechanistic role in post‐vaccination pathogenesis of HZ. Note that VZV reactivation is a well‐established phenomenon both with infections and with other vaccines (i.e. this adverse event is not COVID‐19‐specific).
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DOI：
10.1056/nejmcp1302674
发表时间：
2013-07-18
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen JI
通讯作者：
Cohen JI
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DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
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C4591001 Clinical Trial Group
DOI：
10.1056/nejmoa2104840
发表时间：
2021-06-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Greinacher A;Thiele T;Warkentin TE;Weisser K;Kyrle PA;Eichinger S
通讯作者：
Eichinger S
DOI：
10.1056/nejmoa2105290
发表时间：
2021-12-16
期刊：
The New England journal of medicine
影响因子：
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作者：
Falsey AR;Sobieszczyk ME;Hirsch I;Sproule S;Robb ML;Corey L;Neuzil KM;Hahn W;Hunt J;Mulligan MJ;McEvoy C;DeJesus E;Hassman M;Little SJ;Pahud BA;Durbin A;Pickrell P;Daar ES;Bush L;Solis J;Carr QO;Oyedele T;Buchbinder S;Cowden J;Vargas SL;Guerreros Benavides A;Call R;Keefer MC;Kirkpatrick BD;Pullman J;Tong T;Brewinski Isaacs M;Benkeser D;Janes HE;Nason MC;Green JA;Kelly EJ;Maaske J;Mueller N;Shoemaker K;Takas T;Marshall RP;Pangalos MN;Villafana T;Gonzalez-Lopez A;AstraZeneca AZD1222 Clinical Study Group
通讯作者：
AstraZeneca AZD1222 Clinical Study Group
影响因子：
3.6
作者：
Dursun, Recep;Temiz, Selami Aykut
通讯作者：
Temiz, Selami Aykut