Effectiveness of the original monovalent mRNA COVID-19 vaccination series against hospitalization for COVID-19-associated venous thromboembolism

David N Hager; Yuwei Zhu; Ine Sohn; William B Stubblefield; Michael B Streiff; Manjusha Gaglani; Jay S Steingrub; Abhijit Duggal; Jamie R Felzer; Mary O'Rourke; Ithan D Peltan; Amira Mohamed; Robin Stiller; Jennifer G Wilson; Nida Qadir; Adit A Ginde; Anne E Zepeski; Christopher Mallow; Adam S Lauring; Nicholas J Johnson; Kevin W Gibbs; Jennie H Kwon; Wesley H Self; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network

doi:10.1093/infdis/jiae502

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Effectiveness of the original monovalent mRNA COVID-19 vaccination series against hospitalization for COVID-19-associated venous thromboembolism

Journal article

Peer reviewed

Effectiveness of the original monovalent mRNA COVID-19 vaccination series against hospitalization for COVID-19-associated venous thromboembolism

David N Hager, Yuwei Zhu, Ine Sohn, William B Stubblefield, Michael B Streiff, Manjusha Gaglani, Jay S Steingrub, Abhijit Duggal, Jamie R Felzer, Mary O'Rourke, …

The Journal of infectious diseases, Vol.231(2), pp.378-385

02/20/2025

DOI: 10.1093/infdis/jiae502

PMCID: PMC12063076

PMID: 39405261

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Abstract

COVID-19 is a strong risk factor for venous thromboembolism (VTE). Few studies have evaluated the effectiveness of COVID-19 vaccination in preventing hospitalization for COVID-19 with VTE. Adults hospitalized at 21 sites between March 2021 and October 2022 with symptoms of acute respiratory illness were assessed for COVID-19, completion of the original monovalent mRNA COVID-19 vaccination series, and VTE. Prevalence of VTE was compared between unvaccinated and vaccinated patients with COVID-19. Vaccine effectiveness in preventing COVID-19 hospitalization with VTE was calculated using a test negative design. Vaccine effectiveness was also stratified by predominant circulating SARS-CoV-2 variant. Among 18,811 patients (median age 63 [IQR:50-73], 49% women, 59% non-Hispanic White, 20% non-Hispanic Black, 14% Hispanic, and median of 2 comorbid conditions [IQR:1-3]), 9,792 were admitted with COVID-19 (44% vaccinated) and 9,019 were test-negative controls (73% vaccinated). Among patients with COVID-19, 601 were diagnosed with VTE by hospital day 28, of whom 170 were vaccinated. VTE was more common among unvaccinated than vaccinated COVID-19 patients (7.8% versus 4.0%; p=0.001). Vaccine effectiveness against COVID-19 hospitalization with VTE was 84% (95% CI: 80-87%) overall. Vaccine effectiveness stratified by predominant circulating variant was 88% (73-95%) for alpha, 93% (90-95%) for delta, and 68% (58-76%) for omicron variants. Vaccination with the original monovalent mRNA series was associated with a decrease in COVID-19 hospitalization with VTE, though data detailing prior history of VTE and use of anticoagulation were not available. These findings will inform risk-benefit considerations for those considering vaccination.

COVID-19

pulmonary embolus

SARS-CoV-2

vaccine

deep venous thrombosis

venous thromboembolism

Details

Title: Subtitle: Effectiveness of the original monovalent mRNA COVID-19 vaccination series against hospitalization for COVID-19-associated venous thromboembolism
Creators: David N Hager - Johns Hopkins Medicine
Yuwei Zhu - Vanderbilt University Medical Center
Ine Sohn - Vanderbilt University Medical Center
William B Stubblefield - Vanderbilt University Medical Center
Michael B Streiff - Johns Hopkins Medicine
Manjusha Gaglani - Baylor Scott & White Medical Center - Temple
Jay S Steingrub - Baystate Medical Center
Abhijit Duggal - Cleveland Clinic
Jamie R Felzer - Emory University
Mary O'Rourke - Hennepin County Medical Center
Ithan D Peltan - Intermountain Medical Center
Amira Mohamed - Albert Einstein College of Medicine
Robin Stiller - Oregon Health & Science University
Jennifer G Wilson - Stanford University
Nida Qadir - University of California, Los Angeles
Adit A Ginde - University of Colorado Denver
Anne E Zepeski - University of Iowa
Christopher Mallow - University of Miami
Adam S Lauring - University of Michigan
Nicholas J Johnson - University of Washington
Kevin W Gibbs - Wake Forest University
Jennie H Kwon - Washington University in St. Louis
Wesley H Self - Vanderbilt University Medical Center
Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Resource Type: Journal article
Publication Details: The Journal of infectious diseases, Vol.231(2), pp.378-385
DOI: 10.1093/infdis/jiae502
PMID: 39405261
PMCID: PMC12063076
NLM abbreviation: J Infect Dis
ISSN: 0022-1899
eISSN: 1537-6613
Publisher: OXFORD UNIV PRESS INC
Grant note: US Centers for Disease Control and Prevention: 75D30119C05670, 75D30120C07637, 75D30120F00002, 75D30122C12914
This work was supported by the US Centers for Disease Control and Prevention (contracts 75D30119C05670, 75D30120C07637, 75D30120F00002, and 75D30122C12914).
Language: English
Electronic publication date: 10/15/2024
Date published: 02/20/2025
Academic Unit: Emergency Medicine; Pharmacy Practice and Science
Record Identifier: 9984736600902771

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