According to the Union Health Ministry on Friday, India recorded 6,050 fresh coronavirus cases, the highest in 203 days, with 28,303 active cases.Giving the reassurance that a monster spike on the lines of the Delta wave in the spring of 2021 is unlikely due to the endemic nature of the virus, they also cautioned that the spread could be halted by following established protocols.
A health worker collects a swab sample for Covid-19 test at the District Hospital in Sector 30, in Noida, on Thursday.(HT_PRINT)
Giving the reassurance that a monster spike on the lines of the Delta wave in the spring of 2020-2021 is unlikely due to the endemic nature of the virus,that also cautioned that the spread could be halted by following established protocols in india.
“COVID-19 is effectively endemic in the country, and virtually all of us will have sustained an infection by now, whether we knew it or not.
The virus is behaving like coronaviruses that cause common-cold-like symptoms and can keep reinfecting us,” said Gautam I. Menon, dean (research) and professor, Departments of Physics and Biology at Haryana’s Ashoka University.
Stroke, Myocardial Infarction, and Pulmonary Embolism after Bivalent Booster
A bivalent messenger RNA vaccine targeting both the ancestral and omicron BA.4–BA.5 sublineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Pfizer–BioNTech) was introduced in France in early October 2022 and recommended for booster vaccination in vulnerable populations. Between October 6 and November 9, both monovalent and bivalent vaccines were available for administration to persons who were 50 years of age or older. In January 2023, the Vaccine Safety Datalink of the Centers for Disease Control and Prevention alerted the public about a possible increased risk of ischemic stroke within the 21 days after the bivalent injection in persons 65 years of age or older.1 We previously found no increase in the incidence of stroke, acute myocardial infarction, or pulmonary embolism after administration of the monovalent vaccine.2,3 Thus, we wanted to assess whether the risk of such events differed after receipt of the bivalent booster as compared with the monovalent booster.
In this population-based study, we used comprehensive data from the French National Health Data System linked to the national coronavirus disease 2019 (Covid-19) vaccination database. All persons who were 50 years of age or older and who had received a booster dose between October 6 and November 9, 2022, were included in the study. This time window captured the only period in which both vaccines were being administered in France. During this period, the uptake of the bivalent vaccine overtook the uptake of the monovalent vaccine, with 932,583 persons receiving the bivalent vaccine and 121,362 receiving the monovalent vaccine (Fig. S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org).
For each day during the study period, we matched each recipient of the monovalent vaccine with up to five randomly sampled recipients of the bivalent vaccine on the same day (Fig. S2). Recipients were followed until 21 days after vaccination. We estimated the risks of ischemic stroke, hemorrhagic stroke, myocardial infarction, and pulmonary embolism associated with the bivalent vaccine as compared with the monovalent vaccine by calculating hazard ratios as determined by propensity score–weighted Cox models (see the Supplementary Methods).4,5
Table 1.
Comparison between the Bivalent Booster and the Original Monovalent Booster in the Risk of Cardiovascular Events Of a total of 470,962 vaccine recipients 97,234 received the monovalent vaccine and 373,728received the bivalent vaccine After inverse probability of treatment weighting, sociodemographic and health-status characteristics were well balanced between the two groups At 21 days after the booster dose, we found no evidence of an increased risk of cardiovascular events among the recipients of the bivalent vaccine as compared with recipients of the monovalent vaccine. The evaluated events included ischemic stroke hemorrhagic stroke myocardial infarction , pulmonary embolism and all four events combined Thus, our results provide reassurance regarding the continued use of this bivalent vaccine.
Marie-Joelle Jabagi, Pharm.D., Ph.D.
Marion Bertrand, M.Sc.
Jérémie Botton, Pharm.D., Ph.D.
Stéphane Le Vu, Pharm.D., Ph.D.
Alain Weill, M.D.
Rosemary Dray-Spira, M.D., Ph.D.
Mahmoud Zureik, M.D., Ph.D.
EPI-PHARE Scientific Interest Group, Saint-Denis, France
marie-joelle.jabagi@ansm.sante.fr
Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.
This letter was published on March 29, 2023, at NEJM.org.
