Risk of death following COVID-19 vaccination or positive SARS-CoV-2 test in young people in England

Abstract

Several studies have reported associations between COVID-19 vaccination and risk of cardiac diseases, especially in young people; the impact on mortality, however, remains unclear. We use national, linked electronic health data in England to assess the impact of COVID-19 vaccination and positive SARS-CoV-2 tests on the risk of cardiac and all-cause mortality in young people (12 to 29 years) using a self-controlled case series design. Here, we show there is no significant increase in cardiac or all-cause mortality in the 12 weeks following COVID-19 vaccination compared to more than 12 weeks after any dose. However, we find an increase in cardiac death in women after a first dose of non mRNA vaccines. A positive SARS-CoV-2 test is associated with increased cardiac and all-cause mortality among people vaccinated or unvaccinated at time of testing.

Fig. 1. Relative incidence of cardiac death and all-cause death in each of the 12 weeks in the risk period after vaccination and in the risk period as a whole (1-12 weeks), compared to the baseline period.

Data are presented as incidence rate ratio with 95% confidence intervals. Models are adjusted for calendar time; IRR not shown if no event. n = 3807 all-cause registered deaths, 444 cardiac registered deaths and 1420 all-cause hospital deaths. a Results for all doses combined. b Results by dose.

Fig. 2. Relative incidence of cardiac and all-cause death in the risk period after vaccination, compared to the baseline period, by sex, age group and vaccine vector.

Data are presented as incidence rate ratio with 95% confidence intervals. Models are adjusted for calendar time. n = 3807 all-cause registered deaths, 444 cardiac registered deaths and 1420 all-cause hospital deaths. a Breakdowns by vaccine vector b Breakdowns by sex and age-group. Results are not presented for the third dose because these are almost all mRNA based.

Fig. 3. Relative incidence of cardiac death and all-cause death in each of the 12 weeks in the risk period after SARS-CoV-2 infection and in the risk period as a whole, compared to the baseline period.

Data are presented as incidence rate ratio with 95% confidence intervals. Models are adjusted for calendar time. n = 3219 all-cause registered deaths, 369 cardiac registered deaths and 1123 all-cause hospital deaths. a Results for individuals unvaccinated at time of SARS-CoV-2 positive test. b Results for individuals vaccinated at time of SARS-CoV-2 positive test. Cardiac-registered deaths not shown due to small numbers.

Fig. 4. Relative incidence of cardiac and all-cause death in the risk period after SARS-Cov-2 positive test, compared to the baseline period, by sex and age group.

Data are presented as incidence rate ratio with 95% confidence intervals. Models are adjusted for calendar time. n = 3219 all-cause registered deaths, 369 cardiac registered deaths and 1123 all-cause hospital deaths. a Results for individuals unvaccinated at time of SARS-CoV-2 positive test. b Results for individuals vaccinated at time of SARS-CoV-2 positive test. Cardiac-registered deaths not shown due to small numbers.