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. 2021 Oct 29;70(43):1520-1524.
doi: 10.15585/mmwr.mm7043e2.

COVID-19 Vaccination and Non-COVID-19 Mortality Risk - Seven Integrated Health Care Organizations, United States, December 14, 2020-July 31, 2021

Stanley Xu, Runxin Huang, Lina S Sy, Sungching C Glenn, Denison S Ryan, Kerresa Morrissette, David K Shay, Gabriela Vazquez-Benitez, Jason M Glanz, Nicola P Klein, David McClure, Elizabeth G Liles, Eric S Weintraub, Hung-Fu Tseng, Lei Qian

COVID-19 Vaccination and Non-COVID-19 Mortality Risk - Seven Integrated Health Care Organizations, United States, December 14, 2020-July 31, 2021

Stanley Xu et al. MMWR Morb Mortal Wkly Rep. .

Abstract

By September 21, 2021, an estimated 182 million persons in the United States were fully vaccinated against COVID-19.* Clinical trials indicate that Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Janssen (Johnson & Johnson; Ad.26.COV2.S) vaccines are effective and generally well tolerated (1-3). However, daily vaccination rates have declined approximately 78% since April 13, 2021†; vaccine safety concerns have contributed to vaccine hesitancy (4). A cohort study of 19,625 nursing home residents found that those who received an mRNA vaccine (Pfizer-BioNTech or Moderna) had lower all-cause mortality than did unvaccinated residents (5), but no studies comparing mortality rates within the general population of vaccinated and unvaccinated persons have been conducted. To assess mortality not associated with COVID-19 (non-COVID-19 mortality) after COVID-19 vaccination in a general population setting, a cohort study was conducted during December 2020-July 2021 among approximately 11 million persons enrolled in seven Vaccine Safety Datalink (VSD) sites.§ After standardizing mortality rates by age and sex, this study found that COVID-19 vaccine recipients had lower non-COVID-19 mortality than did unvaccinated persons. After adjusting for demographic characteristics and VSD site, this study found that adjusted relative risk (aRR) of non-COVID-19 mortality for the Pfizer-BioNTech vaccine was 0.41 (95% confidence interval [CI] = 0.38-0.44) after dose 1 and 0.34 (95% CI = 0.33-0.36) after dose 2. The aRRs of non-COVID-19 mortality for the Moderna vaccine were 0.34 (95% CI = 0.32-0.37) after dose 1 and 0.31 (95% CI = 0.30-0.33) after dose 2. The aRR after receipt of the Janssen vaccine was 0.54 (95% CI = 0.49-0.59). There is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Runxin Huang reports support for attending meetings or travel from Dynavax Technologies. Nicola P. Klein reports institutional support from Pfizer, Sanofi Pasteur, Merck, GlaxoSmithKline, and Protein Science (now Sanofi Pasteur to support vaccine studies). Elizabeth G. Liles reports research contracts from the National Human Genome Research Institute and Pfizer. Kerresa Morrissette reports research contracts from the National Institutes of Health, GlaxoSmithKline, and Merck Sharp & Dohme Corporation, outside the submitted work. No other potential conflicts of interest were disclosed.

References

    1. Polack FP, Thomas SJ, Kitchin N, et al.; C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine. N Engl J Med 2020;383:2603–15. 10.1056/NEJMoa2034577 - DOI - PMC - PubMed
    1. Baden LR, El Sahly HM, Essink B, et al.; COVE Study Group. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403–16. 10.1056/NEJMoa2035389 - DOI - PMC - PubMed
    1. Food and Drug Administration. Janssen COVID-19 vaccine Emergency Use Authorization letter. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2021. https://www.fda.gov/media/146303/download
    1. Finney Rutten LJ, Zhu X, Leppin AL, et al. Evidence-based strategies for clinical organizations to address COVID-19 vaccine hesitancy. Mayo Clin Proc 2021;96:699–707. 10.1016/j.mayocp.2020.12.024 - DOI - PMC - PubMed
    1. Bardenheier BH, Gravenstein S, Blackman C, et al. Adverse events following mRNA SARS-CoV-2 vaccination among U.S. nursing home residents. Vaccine 2021;39:3844–51. 10.1016/j.vaccine.2021.05.088 - DOI - PMC - PubMed

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