Risk of Adverse Events and Delirium after COVID-19 Vaccination in Patients Living with Dementia.
Edmund C L Cheung, Miriam T Y Leung, Kailin Chen and 11 others
PMID 37156470WHAT IT FOUND
In older adults with dementia, CoronaVac and BNT162b2 did not show increased delirium or most adverse events within 28 days; a probable kidney and pancreatitis signal appeared after first BNT162b2 dose.
Key findings
01Delirium after vaccination was rare: 6 cases after first CoronaVac dose, 4 cases after second CoronaVac dose, and 1 case after third BNT162b2 dose.
02Compared with prepandemic dementia patients, vaccinated patients had no increased incidence of delirium or most adverse event groups; a probable increase in hepatorenal events appeared after first BNT162b2 dose.
03Compared with dementia patients who tested positive for SARS-CoV-2, vaccinated patients had no increased delirium and lower cardiovascular and circulatory event rates after CoronaVac doses.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not adjust for covariates between groups, so differences in baseline health may have affected the results. Age differed most between cohorts, although age subgroup analyses did not notably change the main results. Only 872 CoronaVac patients and 498 BNT162b2 patients received third doses, so third-dose findings are less certain. Outcomes relied on emergency department visits or hospitalizations, so milder events may have been missed. Dementia history could be captured only from 2018 onward, so earlier diagnoses may have been missed. The cohort was primarily ethnic Chinese, and private-sector care was not included. The study could not separate possible effects of better post-vaccination monitoring from true risk.
Declared interests
The study was funded by the Health Bureau of the Government of the Hong Kong SAR and partly supported by D24H and AIR@InnoHK. Several authors reported research grants, consultancy fees, speaker fees, or personal fees from pharmaceutical companies including Pfizer, Janssen, Merck Sharp & Dohme, Amgen, Bristol-Myers Squibb, Bayer, Takeda, Boehringer Ingelheim, Eisai, GSK, Novartis, and IQVIA, with most declarations noted as outside the submitted work.
The easy way to misread this
Do not read the rare delirium cases as proof that COVID-19 vaccination causes delirium in patients with dementia. The incidence was not increased compared with prepandemic dementia patients, and the study did not adjust for covariates.