J Korean Med Sci.  2023 Mar;38(11):e94. 10.3346/jkms.2023.38.e94.

Relationship Between Coronavirus Disease 2019 Vaccination Rates and Rare But Potentially Fatal Adverse Events: A Regression Discontinuity Analysis of Western Countries

• Chae SH
• Park HJ
• Radnaabaatar M
• Park H
• Jung J

• KMID: 2540655
• DOI: http://doi.org/10.3346/jkms.2023.38.e94

Abstract

Background
Owing to limited experience with the new vaccine platforms, discussion of vaccine safety is inevitable. However, media coverage of adverse events of special interest could influence the vaccination rate; thus, evaluating the outcomes of adverse events of special interest influencing vaccine administration is crucial.
Methods
We conducted regression discontinuity in time analysis to calculate the local average treatment effect (LATE) using datasets from Our World in Data and Johns Hopkins University Center for Systems Science and Engineering. For the United States, the United Kingdom, and Europe, the cutoff points were April 23rd and June 23rd, April 7th, and the 14th week of 2021, respectively.
Results
The LATE of the Advisory Committee on Immunization Practices (ACIP) meeting held on April 23rd was −0.249 for all vaccines, −0.133 (−0.189 to −0.076) for Pfizer, −0.064 (−0.115 to −0.012) for Moderna, and −0.038 (−0.047 to −0.030) for Johnson & Johnson. Discontinuities were observed for all three types of vaccines in the United States. The June 23rd meeting of the ACIP (mRNA vaccines and myocarditis) did not convene any discontinuities. Furthermore, there was no significant drop in the weekly average vaccination rates in Europe following the European Medicines Agency (EMA) statement on April 7th. Conversely, there was a significant drop in the first-dose vaccination rates in the United Kingdom related to the EMA report. The first-dose vaccination rate for all vaccines changed by −0.104 (−0.176 to −0.032).
Conclusion
Although monitoring and reporting of adverse events of special interest are important, a careful approach towards public announcements is warranted.

Keyword

SARS-CoV-2; COVID-19; Regression Discontinuity Analysis

Figure

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  Fig. 1 Regression discontinuities in the United States with (A) April 23rd, 2021, as the cutoff (B) June 23rd as the cutoff.

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  Fig. 2 Regression discontinuities in the United Kingdom and Europe with April 7th, 2021, as the cutoff.

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  Fig. 3 Sensitivity analysis with cumulative vaccination rate as a covariate on 2021 (US and UK).

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