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Mid-term follow-up after COVID-19 vaccination in adults with CHD: a prospective study
- Flavia Fusco, Giancarlo Scognamiglio, Anna Selvaggia Roma, Massimiliana Abbate, Giovanni Papaccioli, Assunta Merola, Michela Palma, Nunzia Borrelli, Rosaria Barracano, Anna Correra, Nicola Grimaldi, Giovanni Domenico Ciriello, Maurizio D’Abbraccio, Cristina Scavone, Annalisa Capuano, Berardo Sarubbi
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- Journal:
- Cardiology in the Young / Volume 33 / Issue 12 / December 2023
- Published online by Cambridge University Press:
- 11 April 2023, pp. 2574-2580
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- Article
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Background:
Long-term data on COVID-19 vaccine safety, immunogenicity, and acceptance in adults with CHD are lacking.
Methods:This is a prospective study including adults with CHD patients undergoing COVID-19 vaccination from January 2021 to June 2022. Data on adverse events, antispike IgG titre, previous or subsequent COVID-19 infection, booster doses, and patients’ attitude towards vaccination were collected.
Results:Four hundred and ninety CHD patients (36 ± 13 years, 53% male, 94% with moderate/complex defects) were prospectively included: 433 (88%) received a Pfizer–BioNTech mRNA vaccine, 31 (6%) Moderna mRNA vaccine, 23 (5%) AstraZeneca–Oxford ChAdOx1 nCov-19 vaccine, and 3 (0.6%) Janssen Vaccine; 310 (63%) received a booster dose. Median follow-up after vaccination was 1.53 [1.41–1.58] years. No major adverse event was reported. Eighty-two fully vaccinated patients contracted COVID-19 during follow-up after a median of 5.4 [4.3–6.5] months from the last dose. One patient with Ebstein’s disease died from severe COVID-19. Symptoms’ duration in patients who tested positive after vaccination was significantly shorter than in the group tested positive before vaccination (5.5 [3–8] versus 9 [2.2–15] days, p = 0.04). Median antispike IgG titre measured in 280 individuals (57%) at a median of 1.4 [0.7–3.3] months from the last dose was 2381 [901–8307] BAU/ml. Sixty patients (12%) also showed positive antinucleocapsid antibodies, demonstrating previous SARS-COV2 exposure. Twenty-nine percent appeared to have concerns regarding vaccine safety and 42% reported fearing potential effects of the vaccine on their cardiac disease before discussing with their CHD cardiologist.
Conclusion:COVID-19 vaccines appear safe in the mid-term follow-up in adults with CHD with satisfactory immunogenicity and reduction of symptoms’ duration in case of infection.