Risk Factors for Grade 3 to Grade 4 Adverse Reactions to the ChAdOx1 nCoV-19 Vaccine (AZD1222) Against SARS-CoV-2

Sang Won Lee; Hyun Lee; Sun-Kyung Lee; Ji-Yong Moon; SeolHwa Moon; Sung Jun Chung; Yoomi Yeo; Tai Sun Park; Dong Won Park; Tae-Hyung Kim; Jang Won Sohn; Ho Joo Yoon; Sang-Heon Kim

doi:10.3389/fmed.2021.738049

Risk Factors for Grade 3 to Grade 4 Adverse Reactions to the ChAdOx1 nCoV-19 Vaccine (AZD1222) Against SARS-CoV-2

Front Med (Lausanne). 2021 Sep 30:8:738049. doi: 10.3389/fmed.2021.738049. eCollection 2021.

Authors

Affiliations

¹ Department of Clinical Pharmacology and Therapeutics, Hanyang University Hospital, Seoul, South Korea.
² Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
³ Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, South Korea.
⁴ College of Nursing, Hanyang University, Seoul, South Korea.

Abstract

Objective: Limited data are available regarding the rates and risk factors of severe to serious adverse reactions (ARs) to the ChAdOx1 nCoV-19 vaccine. Methods: Eligible participants were healthcare workers who received their first dose of the ChAdOx1 nCoV-19 vaccine in either of two university hospitals in Seoul, Korea. We evaluated the type and severity of ARs 7 days after the first dose of the ChAdOx1 nCoV-19 vaccine using a questionnaire survey delivered via a smartphone application link. Results: Among the 1,603 participants who completed the survey, 684 (42.7%) participants experienced any kind of grade 3 to grade 4 AR. Being young (adjusted odds ratio [OR] for age 21-30 years = 2.49, 95% confidence interval [CI] = 1.75-3.56; adjusted OR for 31-40 years = 1.78, 95% CI = 1.22-2.62; adjusted OR for 41-50 years = 1.47, 95% CI = 1.03-2.11), being female (adjusted OR = 2.16. 95% CI = 1.62-2.89), and being underweight (adjusted OR = 1.61, 95% CI = 1.02-2.55) were identified as risk factors for grade 3 to grade 4 ARs. Among comorbidities, only diabetes mellitus (adjusted OR = 2.36, 95% CI = 1.03-5.53) was identified as a risk factor. When stratified by the type of AR, being young and being female were risk factors for both local and systemic grade 3 to grade 4 ARs. Conclusions: Being young, female, or underweight and having diabetes mellitus were associated with an increased risk of developing grade 3 to grade 4 ARs after receiving the first dose of the ChAdOx1 nCoV-19 vaccine.

Keywords: ChAdOx1 nCoV-19 vaccine; adverse reactions; coronavirus disease 2019; healthcare workers; risk factors.