Cardio-oncology & otherCohort study
COVID-19 vaccination and risk of post-COVID-19 cardiovascular disease: a population-based cohort and target trial emulation study
- statewide population-based cohort study
- linked administrative health data
- time-varying Cox proportional hazards regression
- causal mediation analysis
- target trial emulation
Authors' conclusion
Vaccination before or after SARS-CoV-2 infection was associated with lower hazards of post-COVID-19 cardiovascular outcomes, with stronger observed associations at higher dose numbers. Most of the estimated association was not explained by infection prevention alone. These findings support COVID-19 vaccination as an important component of strategies to reduce the burden of post-COVID-19 CVD while highlighting the need for further studies to clarify the mechanisms underlying these associations.
Study context
- Population
- Adults in Victoria, Australia (2019–25)
- Participants
- 2,391,456 adults
- Exposure
- Associations of pre- or post-infection vaccination with major adverse cardiovascular events
- Outcome
- major adverse cardiovascular events (MACE)
Main finding
As reported in the abstract
Estimated absolute risk reduction for major adverse cardiovascular events (MACE) with pre-infection vaccination
0.21%
Estimated absolute risk reduction for MACE with post-infection vaccination
0.24%
Observational data: associations, not effects.
Secondary outcomes
stroke, heart failure, acute myocardial infarction, acute coronary syndrome, atrial fibrillation, and venous thromboembolism
- Vaccination was associated with lower hazards of all secondary outcomes
Cardiovascular outcomes by number of vaccine doses
- Three or more vaccine doses were associated with progressively lower hazards across cardiovascular outcomes
Mediation by prevention of SARS-CoV-2 infection
- Share of the estimated association between vaccination and lower post-COVID cardiovascular risk not explained by prevention of SARS-CoV-2 infection
- ∼68%
Original publication
Summarised from the published abstract; every number is checked against it