Here, we show that among the population of England aged 12–29, mortality is not significantly increased in the first twelve weeks after COVID-19 vaccination compared with more than 12 weeks after any dose. For comparison purposes, we assessed the impact of a positive test for SARS-CoV-2 on the same outcomes in vaccinated and unvaccinated individuals. To minimise potential confounding, we used a self-controlled case series (SCCS) design, where each participant acts as their own control, to compare the risk of death in the twelve weeks after vaccination (‘risk period’) to a subsequent reference period 18. The balance of risk and benefit is particularly important to determine in younger people, due to the lower risk of COVID-19 hospitalisation and death in this age group 17.Ĭomparisons of the risk of death in vaccinated and unvaccinated young people are subject to confounding due to the vaccine prioritisation of, and higher vaccination rates among, those with underlying health conditions. ![]() However, the absolute risk of severe complications is low and needs to be assessed against the increased risks associated with SARS-CoV-2 infection if unvaccinated 15, 16. There is also evidence of a range of other rare neurological complications 14. Previous studies have shown an increase in the risk of myocarditis and myopericarditis associated with mRNA vaccines including BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) 8, 11, and an increased risk of thrombotic and other rare cardiovascular events after the ChAdOx1 nCoV-19 vaccine (Oxford-AstraZeneca) 12, 13. There have been rare cases of serious adverse events reported with the COVID-19 vaccines. ![]() ![]() However, it is also important to consider their safety, which can be difficult to assess in randomised clinical trials that are not powered to detect rare adverse events 2, 3, 10. While the randomised clinical trials focused on short-term efficacy against symptomatic infection, which was subsequently found to wane and be escaped by SARS-CoV-2 variants 2, 3, 4, 5, 6, 7, real-world evidence has indicated stronger and more sustained effectiveness against severe disease and death due to COVID-19 6, 8, 9. On the 8 December 2020, the United Kingdom (UK) began administering vaccines against COVID-19 according to the priority groups determined by the Joint Committee on Vaccination and Immunisation (JCVI) 1.
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