2024-2025 COVID-19 Vaccine and Major Adverse Cardiovascular Events Among US Veterans
- cohort study
- target-trial emulation
- US Department of Veterans Affairs (VA) electronic health records
- inverse probability weighting
+3 more
- target-trial emulation
- US Department of Veterans Affairs (VA) electronic health records
- inverse probability weighting
Authors' conclusion
In this cohort study, receipt of the 2024-2025 COVID-19 vaccine was associated with reduced risk of COVID-19-associated MACE, with reductions most prominent in those 75 years or older and those with comorbidities. While the reduction in COVID-19-associated MACE was modest, the substantially larger reduction in all-cause MACE suggests that the vaccine’s protective association extends to the hidden burden of undetected SARS-CoV-2 and its sequelae.
Study context
- Population
- Veterans with vaccination encounters between September 3, 2024, and December 31, 2024, who received influenza vaccineparticipants who received influenza vaccine (mean [SD] age, 70.1 [12.4] years, 954,341 [91.8%] men) · received COVID-19 vaccine 349,085 · did not receive COVID-19 vaccine 690,574
- Participants
- 1,039,659 veterans
- Exposure
- COVID-19 vaccine vs Influenza vaccine alone
- COVID-19 vaccinen = 349,085
- Influenza vaccine alonen = 690,574
- Outcome
- Composite end point of COVID-19-associated MACE (COVID-19-associated cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failure)
- Follow-up
- 8 months
Main finding
As reported in the abstract
- lower risk with COVID-19 vaccine; Vaccine effectiveness (VE) calculated as 1 minus the risk ratio
- VE 37.7% (95% CI 18.2%–54.9%)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | risk difference (95% CI) | |
|---|---|---|
| All-cause MACE, all-cause hospitalization, all-cause death (secondary) | 23.7 (14.1–34.7) | |
| −2002040Difference (linear scale) |
| Outcome | VE (95% CI) |
|---|---|
| COVID-19-associated MACE, individuals older than 75 years (subgroup) · statistically significant only in this age group | 50.7% (31.8%–65.6%) |
- COVID-19-associated MACE, individuals older than 75 years (subgroup) — Largest absolute risk reduction (fewer events per 10 000 individuals)
- 5.5
- All-cause MACE, all-cause hospitalization, all-cause death (secondary): substantially larger absolute risk reductions than COVID-19-associated MACE; no risk difference values reported for all-cause hospitalization or all-cause death
COVID-19-associated MACE, younger than 65 years or aged 65 to 75 years (subgroups)
- No statistically significant vaccine effectiveness
COVID-19-associated MACE, subgroups with and without comorbid health conditions
- Relative VE statistically significant across subgroups; absolute benefit consistently and substantially greater with the comorbid health condition
Original publication
Summarised from the published abstract; every number is checked against it