{"id":25737,"date":"2024-05-19T04:02:00","date_gmt":"2024-05-18T20:02:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25737"},"modified":"2024-05-19T05:47:00","modified_gmt":"2024-05-18T21:47:00","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%be%8e%e5%9b%bd%e8%80%81%e5%b9%b4%e4%ba%ba%e6%8e%a5%e7%a7%8d%e6%96%b0%e5%86%a0%e7%97%85%e6%af%92%e4%b8%a4%e4%bb%b7%e7%96%ab%e8%8b%97%e5%90%8e","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25737","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u7f8e\u56fd\u8001\u5e74\u4eba\u63a5\u79cd\u65b0\u51a0\u75c5\u6bd2\u4e24\u4ef7\u75ab\u82d7\u540e\u7684\u5352\u4e2d\u98ce\u9669"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

March 19, 2024<\/p>\n\n\n\n

Stroke Risk After COVID-19 Bivalent Vaccination Among US Older Adults<\/h1>\n\n\n\n

Yun\u00a0Lu,\u00a0Kathryn\u00a0Matuska,\u00a0Gita\u00a0Nadimpalli,\u00a0et al<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>2024;331(11):938-950. doi:10.1001\/jama.2024.1059<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Among adults aged 65 years or older, is the risk of stroke elevated in a time period immediately after administration of either brand of a COVID-19 bivalent vaccine compared with a later time period?<\/p>\n\n\n\n

Findings<\/strong>  In this self-controlled case series that included 11\u202f001 Medicare beneficiaries who experienced stroke after administration of either brand of the COVID-19 bivalent vaccine, the risk of stroke was not significantly elevated during the 1- to 21-day or 22- to 42-day risk window after vaccination compared with the 43- to 90-day control window.<\/p>\n\n\n\n

Meaning<\/strong>  In this self-controlled case series among Medicare beneficiaries aged 65 years or older, the primary analysis showed no evidence of a significantly elevated stroke risk during the days immediately after administration of either brand of the COVID-19 bivalent vaccine.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  In January 2023, the US Centers for Disease Control and Prevention and the US Food and Drug Administration noted a safety concern for ischemic stroke among adults aged 65 years or older who received the Pfizer-BioNTech BNT162b2; WT\/OMI BA.4\/BA.5 COVID-19 bivalent vaccine.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate stroke risk after administration of (1) either brand of the COVID-19 bivalent vaccine, (2) either brand of the COVID-19 bivalent plus a high-dose or adjuvanted influenza vaccine on the same day (concomitant administration), and (3) a high-dose or adjuvanted influenza vaccine.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Self-controlled case series including 11\u202f001 Medicare beneficiaries aged 65 years or older who experienced stroke after receiving either brand of the COVID-19 bivalent vaccine (among 5\u202f397\u202f278 vaccinated individuals). The study period was August 31, 2022, through February 4, 2023.<\/p>\n\n\n\n

Exposures<\/strong>  Receipt of (1) either brand of the COVID-19 bivalent vaccine (primary) or (2) a high-dose or adjuvanted influenza vaccine (secondary).<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Stroke risk (nonhemorrhagic stroke, transient ischemic attack, combined outcome of nonhemorrhagic stroke or transient ischemic attack, or hemorrhagic stroke) during the 1- to 21-day or 22- to 42-day risk window after vaccination vs the 43- to 90-day control window.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0There were 5\u202f397\u202f278 Medicare beneficiaries who received either brand of the COVID-19 bivalent vaccine (median age, 74 years [IQR, 70-80 years]; 56% were women). Among the 11\u202f001 beneficiaries who experienced stroke after receiving either brand of the COVID-19 bivalent vaccine, there were no statistically significant associations between either brand of the COVID-19 bivalent vaccine and the outcomes of nonhemorrhagic stroke, transient ischemic attack, nonhemorrhagic stroke or transient ischemic attack, or hemorrhagic stroke during the 1- to 21-day or 22- to 42-day risk window vs the 43- to 90-day control window (incidence rate ratio [IRR] range, 0.72-1.12). Among the 4596 beneficiaries who experienced stroke after concomitant administration of either brand of the COVID-19 bivalent vaccine plus a high-dose or adjuvanted influenza vaccine, there was a statistically significant association between vaccination and nonhemorrhagic stroke during the 22- to 42-day risk window for the Pfizer-BioNTech BNT162b2; WT\/OMI BA.4\/BA.5 COVID-19 bivalent vaccine (IRR, 1.20 [95% CI, 1.01-1.42]; risk difference\/100\u202f000 doses, 3.13 [95% CI, 0.05-6.22]) and a statistically significant association between vaccination and transient ischemic attack during the 1- to 21-day risk window for the Moderna mRNA-1273.222 COVID-19 bivalent vaccine (IRR, 1.35 [95% CI, 1.06-1.74]; risk difference\/100\u202f000 doses, 3.33 [95% CI, 0.46-6.20]). Among the 21\u202f345 beneficiaries who experienced stroke after administration of a high-dose or adjuvanted influenza vaccine, there was a statistically significant association between vaccination and nonhemorrhagic stroke during the 22- to 42-day risk window (IRR, 1.09 [95% CI, 1.02-1.17]; risk difference\/100\u202f000 doses, 1.65 [95% CI, 0.43-2.87]).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Among Medicare beneficiaries aged 65 years or older who experienced stroke after receiving either brand of the COVID-19 bivalent vaccine, there was no evidence of a significantly elevated risk for stroke during the days immediately after vaccination.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  March 19, 2024 S […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25737"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25737"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25737\/revisions"}],"predecessor-version":[{"id":25738,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25737\/revisions\/25738"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25737"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25737"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25737"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}