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Association between SARS-CoV-2 vaccination and healthcare contacts for menstrual disturbance and bleeding in women before and after menopause: nationwide, register based cohort study.
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- Ljung, Rickard (author)
- Karolinska Institutet
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- Xu, Yiyi (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Univ Gothenburg, Inst Med, Sahlgrenska Acad, Sch Publ Hlth & Community Med, Gothenburg, Sweden.
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- Sundström, Anders (author)
- Div Use & Informat, Swedish Med Prod Agcy, Uppsala, Sweden.
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- Leach, Susannah, 1983 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för mikrobiologi och immunologi,Institute of Biomedicine, Department of Microbiology and Immunology,Univ Gothenburg, Inst Biomed, Sahlgrenska Acad, Dept Microbiol & Immunol, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Clin Pharmacol, Gothenburg, Sweden.
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- Hallberg, Ebba (author)
- Div Use & Informat, Swedish Med Prod Agcy, Uppsala, Sweden.
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- Bygdell, Maria (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, School of Public Health and Community Medicine,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Div Use & Informat, Swedish Med Prod Agcy, Uppsala, Sweden.;Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Gothenburg, Sweden.
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Larsson, Maria (author)
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- Arthurson, Veronica (author)
- Div Use & Informat, Swedish Med Prod Agcy, Uppsala, Sweden.
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- Gisslén, Magnus, 1962 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine,Univ Gothenburg, Inst Biomed, Sahlgrenska Acad, Dept Infect Dis, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Infect Dis, Reg Vistra Gotaland, Gothenburg, Sweden.
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- Gedeborg, Rolf (author)
- Uppsala universitet,Anestesiologi och intensivvård,Div Licensing, Swedish Med Prod Agcy, POB 26, S-75103 Uppsala, Sweden
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- Nyberg, Fredrik, 1961 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Univ Gothenburg, Inst Med, Sahlgrenska Acad, Sch Publ Hlth & Community Med, Gothenburg, Sweden.
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(creator_code:org_t)
- BMJ Publishing Group Ltd, 2023
- 2023
- English.
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In: BMJ (Clinical research ed.). - : BMJ Publishing Group Ltd. - 0959-535X .- 1756-1833 .- 0959-8146. ; 381
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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Abstract
Subject headings
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- To evaluate the risks of any menstrual disturbance and bleeding following SARS-CoV-2 vaccination in women who are premenopausal or postmenopausal.A nationwide, register based cohort study.All inpatient and specialised outpatient care in Sweden from 27 December 2020 to 28 February 2022. A subset covering primary care for 40% of the Swedish female population was also included.2946448 Swedish women aged 12-74 years were included. Pregnant women, women living in nursing homes, and women with history of any menstruation or bleeding disorders, breast cancer, cancer of female genital organs, or who underwent a hysterectomy between 1 January 2015 and 26 December 2020 were excluded.SARS-CoV-2 vaccination, by vaccine product (BNT162b2, mRNA-1273, or ChAdOx1 nCoV-19 (AZD1222)) and dose (unvaccinated and first, second, and third dose) over two time windows (one to seven days, considered the control period, and 8-90 days).Healthcare contact (admission to hospital or visit) for menstrual disturbance or bleeding before or after menopause (diagnosed with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes N91, N92, N93, N95).2580007 (87.6%) of 2946448 women received at least one SARS-CoV-2 vaccination and 1652472 (64.0%) 2580007 of vaccinated women received three doses before the end of follow-up. The highest risks for bleeding in women who were postmenopausal were observed after the third dose, in the one to seven days risk window (hazard ratio 1.28 (95% confidence interval 1.01 to 1.62)) and in the 8-90 days risk window (1.25 (1.04 to 1.50)). The impact of adjustment for covariates was modest. Risk of postmenopausal bleeding suggested a 23-33% increased risk after 8-90 days with BNT162b2 and mRNA-1273 after the third dose, but the association with ChAdOx1 nCoV-19 was less clear. For menstrual disturbance or bleeding in women who were premenopausal, adjustment for covariates almost completely removed the weak associations noted in the crude analyses.Weak and inconsistent associations were observed between SARS-CoV-2 vaccination and healthcare contacts for bleeding in women who are postmenopausal, and even less evidence was recorded of an association for menstrual disturbance or bleeding in women who were premenopausal. These findings do not provide substantial support for a causal association between SARS-CoV-2 vaccination and healthcare contacts related to menstrual or bleeding disorders.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
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- art (subject category)
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Ljung, Rickard
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Xu, Yiyi
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Sundström, Ander ...
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Leach, Susannah, ...
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Hallberg, Ebba
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Bygdell, Maria
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Larsson, Maria
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Arthurson, Veron ...
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Gisslén, Magnus, ...
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Gedeborg, Rolf
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Nyberg, Fredrik, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Respiratory Medi ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Infectious Medic ...
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BMJ (Clinical re ...
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University of Gothenburg
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Uppsala University
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Karolinska Institutet