Published: 14 September 2022
Archived: 21 August 2024
About Medsafe
COVID-19 Archive
Adverse events following immunisation with COVID-19 vaccines: Safety Report #45 – 31 August 2022
- What you need to know
- Introduction
- Adverse events following immunisation (AEFI) reported
- Summary of reported deaths
- Observed versus expected analyses
- Adverse events of special interest
- Summary of safety signals
- Definitions
- More information
What you need to know – up to and including 31 August 2022
Note that counts may change due to receipt of additional information.
For the Comirnaty (Pfizer) vaccine
1,124
New AEFI reports since last update
(1,026 non-serious and 98 serious)
1
New safety signal (potential safety issue) has been identified
(Vasculitis)
11,682,248
Total doses administered
(cumulative)
60,511
Total AEFI reports that were non-serious
3,550
Total AEFI reports that were serious
64,061
Total AEFI reports that were received
(cumulative)
For the Vaxzevria (AstraZeneca) vaccine
6
AEFI reports
(6 non-serious and 0 serious)
0
New safety signals (potential safety issues) have been identified
9,087
Total doses administered
(cumulative)
298
Total AEFI reports that were non-serious
21
Total AEFI reports that were serious
319
Total AEFI reports that were received
(cumulative)
- The protective benefits of vaccination against COVID-19 far outweigh the potential risks of vaccination.
- The Ministry of Health, the National Immunisation Programme, Medsafe, the Centre for Adverse Reactions Monitoring and manufacturers continue to closely monitor the safety of COVID-19 vaccines. We’ll respond to any safety issues right away and will inform New Zealanders about any risks that arise in New Zealand.
- For more information about Covid Vaccine Immunisation Programme, please go to Unite against COVID-19 or call Healthline 0800 611 116 to talk to someone about your concerns.
- Comirnaty: There were 1,026 non-serious and 98 serious reports since the last update. Sadly, have 6 further notifications of death to report. Any possibility of a causal link is investigated as part of our routine investigations and no new safety concerns with the Comirnaty vaccine were raised by these 6 reports. For information about reported deaths, please refer to the summary of reported deaths.
- Vaxzevria: The vaccine became available on 26 November 2021. Up to 31 August 2022, there have been 298 non-serious and 21 serious reports for the Vaxzevria vaccine, including 6 non-serious and no serious reports since the last update. There have been no notifications of death.
- Comirnaty: Up to 31 August 2022 a total of 11,682,248 doses of Comirnaty have been administered and 64,061 AEFIs were reported. This means that more than 11.61 million doses of Comirnaty were administered that did not result in a report of an adverse event. On average for every 10,000 people who are vaccinated 55 people report an AEFI. It is also important to keep in mind that a report can be submitted for any cause and is not necessarily associated with the vaccine.
- Vaxzevria: Up to 31 August 2022, a total of 9,087 doses of Vaxzevria vaccine have been administered and 319 AEFIs were reported. This means that more than 8,750 doses of Vaxzevria vaccine were administered that did not result in a report of an adverse event. On average for every 10,000 people who are vaccinated 351 people report an AEFI. It is also important to keep in mind that a report can be submitted for any cause and is not necessarily associated with the vaccine.
- Nuvaxovid: The Nuvaxovid COVID-19 vaccine became available in New Zealand on 18 March 2022. Up to 31 August 2022, 5,891 doses of the vaccine had been administered and 72 AEFI reports were submitted. We will provide more information about this vaccine in future safety reports.
- Nuvaxovid Safety Alert: Medsafe has issued an alert communication about reports of myocarditis and pericarditis following immunisation with Nuvaxovid.
- The next safety report (#46) will be published on 14 December 2022, for the period ending 30 November 2022.
Introduction
The national roll-out of COVID-19 vaccines commenced on 20 February 2021 with Pfizer-BioNTech (Comirnaty). The AstraZeneca vaccine (also known as Vaxzevria) became available on 26 November 2021, and Nuvaxovid on 18 March 2022.
This page provides information on the number of adverse events following immunisation (AEFI) reports received for COVID-19 vaccines.
An AEFI is an untoward medical event which follows immunisation and does not necessarily have a causal relationship with the administration of the vaccine. The adverse event may be an unfavourable or unintended sign, abnormal laboratory finding, symptom or disease.
All medicines can cause side effects, the known side effects for COVID-19 vaccines are listed in the data sheets and consumer medicine information (CMI).
Search for a data sheet or CMI
Suspected AEFI to COVID-19 vaccines are reported to the Centre for Adverse Reactions Monitoring (CARM). The Ministry of Health (through Medsafe) contracts the collection of this information to CARM, based at the University of Otago in Dunedin. Medsafe is closely monitoring the AEFI reported from the use of the COVID-19 vaccine. Find out more about vaccine safety monitoring.
Medsafe and CARM thank everyone who has contributed to the monitoring of COVID-19 vaccines. Please continue to report any adverse events following immunisation.
Adverse events following immunisation (AEFI) reported
The information below includes:
- AEFI reports by prioritised ethnicity and vaccine dose
- AEFI reports by age band and vaccine dose
- the top 10 most frequently reported AEFIs by vaccine dose
- reported AEFIs by reporter type.
Table 1: AEFI reports received by prioritised ethnicity and vaccine dose, by vaccine, up to and including 31 August 2022
Ethnicitya | Comirnaty | Vaxzevria | |||
---|---|---|---|---|---|
Dose 1 | Dose 2 | Dose 3 | Total | Total | |
Māori | 2,707 | 2,149 | 932 | 5,788 | 31 |
Pacific Peoples | 816 | 774 | 310 | 1,900 | 3 |
Asian | 2,812 | 2,332 | 1,371 | 6,515 | 12 |
European or other | 21,169 | 18,084 | 9,405 | 48,658 | 268 |
Unknownb | 297 | 196 | 71 | 564 | 5 |
Total | 27,801 | 23,535 | 12,089 | 63,425c | 319d |
Notes:
- The prioritised ethnicity classification system allocates each person to a single ethnic group, based on the ethnic groups they identify with. Where people identify with more than one group, they are assigned in this order of priority: Māori, Pacific Peoples, Asian, and European/Other. So, if a person identifies as being Māori and New Zealand European, the person is counted as Māori. See Ethnicity Data Protocols for further information.
- There were 564 Comirnaty and 5 Vaxzevria AEFI reports where the person’s ethnicity was not reported. Counts may change due to receipt of additional information. Ethnicity is not required for an AEFI report to be considered valid. See ‘Valid report’ in the Definitions section below.
- The Comirnaty total is different from the cumulative total above because this table only includes reports following dose 1, 2, and 3. The table also excludes 22 AEFI reports received for infants who did not receive the vaccine. Dose 4 will be included once more reports have been received.
- Due to the low numbers of reports to date, only totals for Vaxzevria are shown to protect privacy.
Table 2: AEFI reports received by age band and vaccine dose, by vaccine, up to and including 31 August 2022
Age | Comirnaty | Vaxzevria | |||
---|---|---|---|---|---|
Dose 1 | Dose 2 | Dose 3 | Total | Total | |
5 - 11 years | 628 | 199 | 0 | 827 | 0 |
12 - 19 years | 2,843 | 1,768 | 288 | 4,899 | 10 |
20 - 29 years | 5,356 | 4,101 | 2,171 | 11,628 | 41 |
30 - 39 years | 6,024 | 5,146 | 2,762 | 13,932 | 71 |
40 - 49 years | 4,767 | 4,501 | 2,461 | 11,729 | 81 |
50 - 59 years | 4,041 | 3,811 | 2,166 | 10,018 | 80 |
60 - 69 years | 2,447 | 2,326 | 1,336 | 6,109 | 27 |
70 - 79 years | 1,168 | 1,183 | 643 | 2,994 | 7 |
80+ years | 496 | 488 | 258 | 1,242 | 2 |
Unknowna | 31 | 12 | 4 | 47 | 0 |
Total | 27,801 | 23,535 | 12,089 | 63,425b | 319c |
Notes:
- There were 47 Comirnaty AEFI reports where the person’s age was not reported. Counts may change due to receipt of additional information. Age is not required for an AEFI report to be considered valid. See ‘Valid report’ in the Definitions section below.
- The Comirnaty total is different from the cumulative total above because this table only includes reports following dose 1, 2, and 3. The table also excludes 22 AEFI reports received for infants who did not receive the vaccine. Dose 4 will be included once more reports have been received
- Due to the low numbers of reports to date, only totals for Vaxzevria are shown to protect privacy.
Figure 1: Top 10 most frequently reported AEFIs for the Comirnaty vaccine, by dose, up to and including 31 August 2022
Table 3: Top 10 most frequently reported AEFIs for the Comirnaty vaccine, by dose, up to and including 31 August 2022
Reaction | Number doses 1-3 | Number dose 1 | Number dose 2 | Number dose 3 |
---|---|---|---|---|
Headache | 19,318 | 6,899 | 8,228 | 4,191 |
Dizziness | 18,129 | 9,308 | 6,129 | 2,692 |
Injection site pain | 16,355 | 5,575 | 6,674 | 4,106 |
Lethargy | 14,657 | 5,516 | 6,721 | 2,420 |
Chest discomfort | 13,072 | 5,456 | 4,936 | 2,680 |
Nausea | 13,067 | 5,489 | 5,042 | 2,536 |
Fever | 8,906 | 2,179 | 4,370 | 2,357 |
Influenza-like illness | 8,466 | 2,295 | 4,082 | 2,089 |
Shortness of breath | 7,491 | 3,240 | 2,920 | 1,331 |
Lymphadenopathy | 7,458 | 1,309 | 2,904 | 3,245 |
Figure 2: Top 10 most frequently reported AEFIs for the Vaxzevria vaccine, any dose, up to and including 31 August 2022
Table 4: Top 10 most frequently reported AEFIs for the Vaxzevria vaccine, any dose, up to and including 31 August 2022
Reaction | Number any dose |
---|---|
Headache | 148 |
Dizziness | 105 |
Injection site pain | 97 |
Lethargy | 97 |
Fever | 96 |
Chest discomfort | 93 |
Influenza-like illness | 92 |
Nausea | 92 |
Shortness of breath | 66 |
Numbness | 64 |
Download a list of the top 50 most frequently reported
AEFIs (any dose) (Excel 21 KB).
Table 5: Reported AEFIs by reporter type (any vaccine) up to and including 31 August 2022
Reporter type | Number of reportsa |
---|---|
Public Patient | 26,762 |
CIR Vaccinator | 15,109 |
Nurse | 8,651 |
Other | 6,327 |
General Practitioner | 8,574 |
Public: On behalf of a patient | 2,223 |
Pharmacist | 382 |
Not specified | 115 |
- The total number here differs from the total reported cases elsewhere because a single case can contain multiple reports from different sources.
Please note that one adverse event report, which represents one person, may report on more than one symptom. Reports are sent to CARM if the reporter suspects that the vaccine may have caused the event. This does not necessarily mean that the vaccine did cause the event.
The number of reports can be influenced by how many people are being vaccinated, media attention, the nature of the events (eg, how painful the vaccination was), and other factors which vary over time. Not everyone who has an adverse reaction reports it, and some people may report AEFIs after each vaccination. The information here shows the number of reports not the number of people who experienced an AEFI.
The information is limited by the information provided in the report and may change over time due to quality control procedures and/or receipt of additional information. Non-valid reports are not included in the data.
Summary of reported deaths
Up to and including 31 August 2022, a total of 177 deaths were reported to CARM after the administration of the Comirnaty vaccine. Following medical assessments by CARM and Medsafe it has been determined that:
- 159 of these deaths are unlikely related to the COVID-19 vaccine
- 7 deaths could not be assessed due to insufficient information
- 8 cases are still under investigation
- 1 death was determined by the Coroner to be due to myocarditis following first dose Covid-19 (Pfizer) vaccination
- 2 deaths were likely due to vaccine induced myocarditis (awaiting Coroner’s determination).
By chance, some people will experience new illnesses or die from a pre-existing condition shortly after vaccination, especially if they are elderly. Therefore, part of our review process includes comparing natural death rates to observed death rates following vaccination, to determine if there are any specific trends or patterns that might indicate a vaccine safety concern. See below for more information about these observed-versus-expected analyses.
To date, the observed number of deaths reported after vaccination is actually less than the expected number of natural deaths.
There have been no deaths reported for the Vaxzevria or Nuvaxovid vaccines.
Table 6: Mortalities by age group up to and including 31 August 2022 reported to CARM, Comirnaty vaccine
Age | Mortalitiesa |
---|---|
10 - 29 years | 9 |
30 - 59 years | 34 |
60 - 79 years | 81 |
80+ years | 53 |
- Counts may change due to receipt of additional information, for example, identification of duplicate reports.
Observed-versus-expected analyses – Comirnaty vaccine
It is important to note that no conclusions should be made from these observed-versus-expected analyses in isolation. Other investigations looking at pre-existing risk factors are always required.
The analyses below show that the number of deaths recorded in the mortality register for people vaccinated with the Comirnaty vaccine is lower than expected based on the average number of deaths in previous years over the same number of days (natural death rate).
For these observed-versus-expected analyses, we compare the vaccinated population to natural (expected) rates (taken from past data). The comparison is done by dividing the observed rate of death in the vaccinated population by the expected rate to give the relative risk (RR).
Observed / Expected Rate = Relative Risk (RR)
The methods used to calculate the relative risk also provide a confidence interval (CI). The confidence interval is a range of values that we are fairly sure our true value lies in. We are using a 95 percent confidence interval (95% CI), which is the range that will include the true value 95 percent of the time. If both the relative risk AND the lower end of the confidence interval are greater than one (>1.0), this is statistically significant and could indicate an increased risk of death in the vaccinated population. This will be highlighted in the table when applicable.
We are monitoring people for 21 days after vaccination. This monitoring period was chosen because people can receive their second dose a minimum of 21 days after the first dose. Age-specific natural (expected) death rates were obtained for the period 2008–2019. One reason for the number of deaths in the vaccinated group appearing to be lower could be that healthcare professional of extremely frail patients give the advice not to get vaccinated.
These analyses do not consider causality and instead, report on all deaths that have occurred in the monitoring period (observed deaths). This results in a much higher number than those reported to CARM where the reporter (eg, family member or health care provider) might have had a suspicion the vaccine could have played a role. The number of observed deaths also includes deaths from other causes, such as deaths due to accidents, medical conditions, other medicines or medical treatments.
Please note that the mortality collections operate many weeks in arrears. This means that these observed-versus-expected analyses will also be in arrears – for example, the tables below are for the period up to 30 June 2022.
Table 7: Observed-versus-expected deathsa by age group from any cause, up to 21 days after Comirnaty dose 1, 19 February 2021 to 30 June 2022
Age | Dose 1 – number administered | Expected deathsb in monitoring period | Observed deathsc in monitoring period | Relative riskc (95% confidence interval) |
---|---|---|---|---|
0 to 9 | 179,237 | 6.27 | 0 | - d |
10 to 19 | 584,435 | 10.94 | 12 | 1.10e [0.57 – 1.92] |
20 to 29 | 651,499 | 22.62 | 24 | 1.06f [0.68 – 1.58] |
30 to 39 | 677,516 | 31.17 | 14 | 0.45 [0.25 – 0.75] |
40 to 49 | 593,284 | 57.56 | 24 | 0.42 [0.27 – 0.62] |
50 to 59 | 608,436 | 135.77 | 64 | 0.47 [0.36 – 0.60] |
60 to 69 | 516,903 | 269.49 | 128 | 0.47 [0.40 – 0.56] |
70 to 79 | 349,460 | 492.19 | 240 | 0.49 [0.43 – 0.55] |
80+ | 182,823 | 1,083.85 | 606 | 0.56 [0.52 – 0.61] |
Total | 4,343,593 | 2,109.86 | 1,112 | 0.53 [0.50 – 0.56] |
- Expected and observed deaths among people who have received dose 1 of the Comirnaty vaccine during the specified period, by age group. Inclusion criteria were: monitoring time of 21 days after receiving dose 1, all genders, all ethnicities, aged 5 years and older. The data was collected from the Mortality database.
- Data for expected death rates was obtained from the AESI background rate (SAFE) study provided by the University of Auckland (however, please note that the publicly available information only shows rates of sudden death not all deaths). The age-specific background rates used are the average from 2008-2019.
- The observed deaths column (4th column) is a raw data observation, and this is used to calculate the relative risk (5th column).
- The relative risk has not been calculated for the 0 - 9 years age group because no deaths were observed during the monitoring period.
- The relative risk of 1.10 does not indicate there is an increased risk of mortality in the 10 - 19 age group because the lower end of the confidence interval is 0.57 (ie, <1.0). The COVID-19 Independent Safety Monitoring Board (CV-ISMB) has reviewed AEFIs in children and found that this group was not disproportionately affected by the vaccine. Medsafe will continue to monitor this closely.
- The relative risk of 1.06 does not indicate there is an increased risk of mortality in the 20 - 29 year age group because the lower end of the confidence interval is 0.68 (ie, <1.0).
Table 8: Observed-versus-expected deathsa by age group from any cause, up to 21 days after Comirnaty dose 2, 19 February 2021 to 30 June 2022
Age | Dose 2 – number administered | Expected deathsb in monitoring period | Observed deathsc in monitoring period | Relative riskc (95% confidence interval) |
---|---|---|---|---|
0 to 9 | 85,659 | 2.93 | 0 | - d |
10 to 19 | 529,527 | 9.89 | 10 | 1.01e [0.48 – 1.86] |
20 to 29 | 640,326 | 22.23 | 7 | 0.31 [0.13 – 0.65] |
30 to 39 | 669,255 | 30.79 | 16 | 0.52 [0.30 – 0.84] |
40 to 49 | 586,878 | 56.94 | 33 | 0.58 [0.40 – 0.81] |
50 to 59 | 604,593 | 134.90 | 85 | 0.63 [0.50 – 0.78] |
60 to 69 | 516,036 | 268.97 | 152 | 0.57 [0.48 – 0.66] |
70 to 79 | 349,585 | 492.31 | 218 | 0.44 [0.39 – 0.51] |
80+ | 182,584 | 1,082.39 | 625 | 0.58 [0.53 – 0.62] |
Total | 4,164,443 | 2,101.35 | 1,146 | 0.55 [0.51 – 0.58] |
- Expected and observed deaths among people who have received dose 2 of the Comirnaty vaccine during the specified period, by age group. Inclusion criteria were: monitoring time of 21 days after receiving dose 2, all genders, all ethnicities, aged 5 years and older. The data was collected from the Mortality database.
- Data for expected death rates was obtained from the AESI background rate (SAFE) study provided by the University of Auckland (however, please note that the publicly available information only shows rates of sudden death not all deaths). The age-specific background rates used are the average from 2008-2019.
- The observed deaths column is a raw data observation, and this is used to calculate the relative risk (5th column).
- The relative risk has not been calculated for the 0 - 9 age group because no deaths were observed during the monitoring period.
- The relative risk of 1.01 does not indicate there is an increased risk of mortality in the 10 - 19 age group because the lower end of the confidence interval is 0.48 (ie, <1.0). The COVID-19 Independent Safety Monitoring Board (CV-ISMB) has reviewed AEFIs in children and found that this group was not disproportionately affected by the vaccine. Medsafe will continue to monitor this closely.
Table 9: Observed-versus-expected deathsa by age group from any cause, up to 21 days after Comirnaty dose 3, 19 February 2021 to 30 June 2022
Age | Dose 3 – number administered | Expected deathsb in monitoring period | Observed deathsc in monitoring period | Relative riskc (95% confidence interval) |
---|---|---|---|---|
10 to 19 | 75,602 | 1.39 | 0 | - d |
20 to 29 | 333,952 | 11.53 | <6 | - e |
30 to 39 | 414,077 | 18.97 | 8 | 0.42 [0.18 - 0.83] |
40 to 49 | 421,066 | 40.74 | 15 | 0.37 [0.21 – 0.61] |
50 to 59 | 482,261 | 107.39 | 55 | 0.51 [0.39 – 0.67] |
60 to 69 | 454,654 | 236.66 | 106 | 0.45 [0.37 – 0.54] |
70 to 79 | 328,058 | 461.57 | 208 | 0.45 [0.39 – 0.52] |
80+ | 175,420 | 1,038.96 | 539 | 0.52 [0.48 – 0.56] |
Total | 2,685,090 | 1,917.21 | 933 | 0.49 [0.46 – 0.52] |
- Expected and observed deaths among people who have received dose 3 (including the ‘booster’ dose) of the Comirnaty vaccine during the specified period, by age group. Inclusion criteria were: monitoring time of 21 days after receiving dose 3, all genders, all ethnicities, aged 12 years and older. The data was collected from the Mortality database.
- Data for expected death rates was obtained from the AESI background rate (SAFE) study provided by the University of Auckland (however, please note that the publicly available information only shows rates of sudden death not all deaths). The age-specific background rates used are the average from 2008-2019.
- The observed deaths column (4th column) is a raw data observation, and this is used to calculate the relative risk (5th column).
- The relative risk has not been calculated for the 10 - 19 year olds because no deaths were observed during the monitoring period.
- The relative risk has not been calculated for the 20 - 29 year olds because fewer than six deaths have occurred in this age group.
For further reading about the methodology used to analyse death rates, see:
- Centers for Disease Control and Prevention (CDC) – Rapid Cycle Analysis (RCA) to monitor the safety of COVID-19 vaccines in near real-time within the Vaccine Safety Datalink. URL: https://www.cdc.gov/vaccinesafety/pdf/VSD-1342-COVID19-RCA-Protocol_FinalV1.1_508.pdf
- Kulldorff M, Davis RL, Kolczak M, et al. A maximised sequential probability ratio test for drug and vaccine safety surveillance. Sequential Analysis 30(1): 58–78. URL: https://www.tandfonline.com/doi/full/10.1080/07474946.2011.539924.
Download the data used to calculate the number of expected deaths in the monitoring period:
Expected mortality data (Excel 22 KB)
Adverse events of special interest
Adverse events of special interest (AESI) are pre-specified medically significant events that have the potential to be causally associated with the vaccine and must be carefully monitored. AESI can be serious or non-serious and can include:
- Events of interest due to their association with COVID-19 infection
- Events of interest for vaccines in general (eg, to the specific vaccine type or adjuvants).
The list of AESIs below takes into consideration the lists of AESIs from expert groups such as the Brighton Collaboration, manufacturers and other regulatory authorities. The AESI list changes based on the evolving safety profile of vaccines. It is important to note that although these adverse events may occur after being vaccinated with a COVID-19 vaccine in New Zealand, they are rare and may not necessarily be related to the vaccine. Medsafe and CARM review the reports to determine whether the vaccine may have played a role in the occurrence of these events.
Table 10: Adverse events of special interest (AESI) up to and including 31 August 2022
AESI Category | AESI | Comirnaty totala | Vaxzevria totala | Background rate (hospitalisations per year)b |
---|---|---|---|---|
Immune system disorders | Guillain-Barré Syndrome | 34 | 0 | 273 |
Thrombocytopenia | 38 | <6 | 4,325 | |
Thrombosis with thrombocytopenia syndrome (TTS) | n/ac | 0 | ||
Anaphylaxisd | 127 | <6 | 1,102 | |
Cardiovascular system | Myocardial infarction (heart attack) | 99 | 0 | 16,347 |
Myocarditis/pericarditis | 944 | <6 | 931 | |
Blood and lymphatic system | Thrombosis | 61 | 0 | 2,863 |
Embolism | 159 | <6 | 4,571 | |
Deep vein thrombosis (DVT) | 126 | <6 | 519 | |
Vasculitis | 74 | 0 | 4,325 | |
Haemorrhagee | 165 | 0 | ||
Hepato-gastrointestinal and renal system | Acute kidney injury | 30 | 0 | 38,631 |
Acute liver injury | 8 | 0 | 420 | |
Pancreatitisf | 15 | 0 | 3,359 | |
Appendicitisg | 23 | 0 | 6,048 | |
Nervous system | Aseptic meningitis | <6 | 0 | 744 |
Encephalitis | 12 | 0 | 409 | |
Stroke | 130 | 0 | 14,776 | |
Bell's Palsy/facial paralysis | 226 | <6 | 694 | |
Myelitis/myelitis transverse | 9 | 0 | 53 | |
Infections and musculoskeletal | Erythema multiforme | 20 | 0 | 97 |
Arthritis | 127 | 0 | 178 | |
Herpes zoster | 406 | <6 | 1,148 | |
Pregnancy, puerperium and perinatal conditions | Abortion (spontaneous abortion /miscarriage)h | 66 | 0 | 2,680 |
- Includes all AESI reports, both serious and non-serious. Counts below 6 are reported as <6 for privacy reasons. Counts may change due to receipt of additional information and subsequent reclassification of cases.
- AESI background hospitalisation rates used to estimate the expected number of events in the general population, which help in vaccine safety surveillance. Counts indicate average of hospitalisation rates for the calendar years 2016-2019.
- The thrombosis with thrombocytopenia syndrome (TTS) AESI occurs only in non-replicating viral vaccines (eg, the Vaxzevria vaccine)
- Includes anaphylaxis reports meeting levels 1-3 of the Brighton Collaboration case definition.
- Haemorrhage can manifest in different ways depending on the mechanism and anatomic location. It is difficult to know if the haemorrhage was minor or significant through the hospitalisation background rates.
- The background rate for pancreatitis has been changed since the last report to reflect the results of a review of the ICD-10 codes used to generate the background rates.
- The background rate for appendicitis has been changed since the last report to reflect the results of a review of the ICD-10 codes used to generate the background rates.
- The background rate for abortion (spontaneous abortion/miscarriage) has been changed since the last report to reflect the results of a review of the ICD-10 codes used to generate the background rates.
Download a list of all ICD-10 codes used to produce the hospitalisation rates for Table 10.
ICD-10 Codes (Excel, 23 KB)
Further information on Myocarditis and Pericarditis
Myocarditis is inflammation of the heart muscle, while pericarditis is inflammation of the tissue forming a sac around the heart. Myo-pericarditis means that both the heart muscle and the sac are inflamed.
There are many possible causes of myocarditis, the most common being viral infection. New Zealand data from the Global Vaccine Data Network indicates that the background rate of non-infective myocarditis (pre COVID-19) in the overall population from 2011 to 2019 was 1.81 per 100,000 person-years.
Up to 31 August 2022, the Centre for Adverse Reactions Monitoring (CARM) has received 500 spontaneous reports of myocarditis, pericarditis or myopericarditis where the report contained evidence of a clinical diagnosis and the symptom onset time was within 30 days of vaccination (to reduce the risk of including coincidental cases). These reports do not necessarily have a causal relationship with administration of Comirnaty and may represent coincidental events. The age ranges, by dose number, are shown in Figure 3. Of the 500 reports, 62% were for males. Thirty-one percent of reports were associated with dose one, 46% of reports were associated with dose two and 22% reported that the myocarditis/pericarditis was experienced after dose three.
Figure 3: Ages of people reported with myocarditis/pericarditis after Comirnaty vaccination in New Zealand, by dose number, up to 31 August 2022
Table 11: Ages of people reported with myocarditis/pericarditis after Comirnaty vaccination in New Zealand, by dose number, up to 31 August 2022
10 year age banda | Dose 1 | Dose 2 | Dose 3 |
---|---|---|---|
< 10 | 0 | 0 | 0 |
10 to 19 | 18 | 31 | 8 |
20 to 29 | 35 | 71 | 30 |
30 to 39 | 42 | 51 | 32 |
40 to 49 | 26 | 36 | 14 |
50 to 59 | 21 | 22 | 10 |
60 to 69 | 8 | 11 | 8 |
70 to 79 | 4 | 7 | 7 |
80 plus | 2 | 2 | 3 |
- The total in the table may be different from the total reported above. This is because some AEFI reports may not include age. Age is not required for an AEFI report to be considered valid as long as there is one other patient identifier. See ‘Valid report’ in the Definitions section below.
Summary of safety signals
Comirnaty: There has been one new safety signal identified since the last safety report (vasculitis).
Nuvaxovid: Medsafe has issued an alert communication about reports of myocarditis and pericarditis following immunisation with Nuvaxovid.
Medsafe will continue to monitor reports for safety signals through routine pharmacovigilance.
Table 12: Summary of Medsafe’s investigations into possible safety signals
Safety signal | Outcome |
---|---|
Comirnaty vaccine | |
Blood clots | Continue to monitor. See also the Monitoring communication |
Appendicitis | Continue to monitor |
Myocarditis/pericarditis | Information has been added to Comirnaty data sheet. See also the Alert communication. Medsafe will continue to monitor this closely. |
Herpes zoster | Continue to monitor |
Bell’s palsy/facial paralysis | Continue to monitor |
Menstrual disorder | Continue to monitor. See also the monitoring communication. |
Stroke | Continue to monitor |
Tinnitus | Continue to monitor |
AEFIs in the elderly | Continue to monitor and updated data sheet |
Pancreatitis | Continue to monitor |
Glomerular diseases | Continue to monitor |
Guillain-Barré Syndrome | Continue to monitor |
Thrombocytopenia | Continue to monitor |
AEFIs in children | Continue to monitor |
Erythema multiforme | Continue to monitor |
Pregnancy | Continue to monitor. See also the monitoring communication. |
Persisting disability | Continue to monitor |
Thyroid conditions | Continue to monitor |
Vasculitis | Continue to monitor |
Vaxzevria vaccine | |
Overview of AEFI reports to date | No safety signals identified |
Nuvaxovid vaccine | |
Myocarditis/pericarditis | Information will be added to the Nuvaxovid data sheet. See the alert communication. Medsafe will continue to monitor this closely. |
Definitions
- Adverse event following immunisation (AEFI)
- An AEFI is an untoward medical event which follows immunisation and does not necessarily have a causal relationship with the administration of the vaccine. The adverse event may be an unfavourable or unintended sign, abnormal laboratory finding, symptom or disease.
- Serious adverse event following immunisation
- An AEFI is considered serious if it:
- is a medically important event or reaction
- requires hospitalisation or prolongs an existing hospitalisation
- causes persistent or significant disability or incapacity
- is life threatening
- causes a congenital anomaly/birth defect
- results in death.
- Adverse events of special interest (AESI)
- An AESI is a pre-specified medically significant event that has the potential to be causally associated with the vaccine product based on past experience, the technology used to make the vaccine or the infection the vaccine is used to protect against. AESIs need to be carefully monitored and any potential association to vaccination confirmed by further analysis and studies.
- Safety signal
- Information on a new or known adverse event that may be caused by the vaccine and requires further investigation. Safety signals can be detected from a wide range of sources such as CARM reports, clinical studies and scientific literature.
- Valid report
- There are only four requirements for a valid AEFI report:
- one patient identifier (eg, name, initials, gender, date of birth, age)
- suspect medicine(s)
- suspected reaction(s)
- reporter details.
More information
See the data sheets and consumer medicine information for the expected reactions for approved COVID-19 vaccines.
COVID-19 Vaccine Safety Monitoring Process
View Ministry of Health COVID-19 vaccine data
Latest listing of all cases received
The latest listing of AEFIs received is included in the attached spreadsheet. Medsafe advises patients NOT to make any decisions about vaccination based on information contained here.
Download AEFI-line-listing.xlsx (Excel, 9004 KB)