https://orcid.org/0000-0003-0030-8737
![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
ABSTRACT
Background
Adverse events following mRNA COVID-19 vaccines, including herpes zoster (HZ), have been reported. We conducted a cohort study to evaluate the association between mRNA COVID-19 vaccination and subsequent HZ at Kaiser Permanente Southern California (KPSC).
Research design and methods
The vaccinated cohort consisted of KPSC members who received their first dose of mRNA COVID-19 vaccine (mRNA-1273 and BNT162b2) during 12/2020–05/2021 and were matched to unvaccinated individuals on age and sex. Incident HZ cases occurring within 90 days of follow-up were identified by diagnosis codes and antiviral medications. Cox proportional hazards models estimated adjusted hazard ratios (aHR), comparing HZ incidence between the vaccinated and unvaccinated cohorts.
Results
Cohort included 1,052,362 mRNA-1273 recipients, 1,055,461 BNT162b2 recipients, and 1,020,334 comparators. Compared to unvaccinated individuals, aHR for HZ up to 90 days after the second dose of mRNA-1273 and BNT162b2 was 1.14 (1.05–1.24) and 1.12 (1.03–1.22), respectively. In those aged ≥50 years not vaccinated with zoster vaccine, aHR was also increased after the second dose of mRNA-1273 (1.18 [1.06–1.33]) and BNT162b2 (1.15 [1.02–1.29]) vaccine vs. unvaccinated individuals.
Conclusions
Our findings suggest a potential increased risk of HZ after a second dose of mRNA vaccines, potentially driven by the increased risk in individuals aged ≥50 years without history of zoster vaccination.
Acknowledgments
Work was previously presented at the June 2022 Society for Epidemiologic Research (SER) conference in Chicago, IL. The work was conducted while Dr. Lin was affiliated with the Department of Research and Evaluation at Kaiser Permanente Southern California. Currently, Dr. Lin is affiliated with the Dr. Shine Clinic, New Taipei City, Taiwan. The authors thank the patients of Kaiser Permanente for their partnership with us to improve their health. Their information, collected through our EHR systems, leads to findings that help us improve care for our members and can be shared with the larger community.
Declaration of interest
A Florea reports research support from Moderna, GlaxoSmithKline, Pfizer, and Gilead for unrelated studies. JW reports research support from GlaxoSmithKline for unrelated studies. L Qian reports research support from Moderna, GlaxoSmithKline and Dynavax for unrelated studies. LS Sy reports research support from Moderna, GlaxoSmithKline, and Dynavax for unrelated studies. JH Ku reports research support from Moderna and GlaxoSmithKline for unrelated studies. HF Tseng reports research support from Moderna and GlaxoSmithKline for unrelated studies. Remaining authors report there are no competing interests to declare.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Author Contributions
Concept and design, or analysis and interpretation of data: AF, JW, LQ, BL, LSS, ICL, JHK, HFT. Drafting of the manuscript: AF. Critical revision of the manuscript for intellectual content: JW, LQ, BL, LSS, ICL, JHK, HFT. Statistical analysis: JW, LQ. Final approval of the version to be published: AF, JW, LQ, BL, LSS, ICL, JHK, HFT. All authors agree to be accountable for all aspects of the work.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2023.2232451.