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We conducted a national multi\u2010center retrospective cohort study with 151\u2009597 vaccinated and 151\u2009597 unvaccinated COVID\u201019 patients using the TriNetX database, from January 1, 2020 to December 31, 2023. Patients baseline characteristics were balanced with propensity score matching (PSM). The outcomes were incident cerebrovascular diseases occurred between 1st and 30th days (short\u2010term) after COVID\u201019 diagnosis. Nine subgroup analyses were conducted to explore potential effect modifications. We performed six sensitivity analyses, including evaluation of outcomes between 1st to 180th days, accounting for competing risk, and incorporating different variant timeline to test the robustness of our results. Kaplan\u2010Meier curves and Log\u2010Rank tests were performed to evaluate survival difference. Cox proportional hazards regressions were adopted to estimate the PSM\u2010adjusted hazard ratios (HR). The overall short\u2010term cerebrovascular risks were lower in the vaccinated group compared to the unvaccinated group (HR: 0.66, 95% CI: 0.56\u20130.77), specifically cerebral infarction (HR: 0.62, 95% CI: 0.48\u20130.79), occlusion and stenosis of precerebral arteries (HR: 0.74, 95% CI: 0.53\u20130.98), other cerebrovascular diseases (HR: 0.57, 95% CI: 0.42\u20130.77), and sequelae of cerebrovascular disease (HR: 0.39, 95% CI:0.23\u20130.68). Similarly, the overall cerebrovascular risks were lower in those vaccinated among most subgroups. The long\u2010term outcomes, though slightly attenuated, were consistent (HR: 0.80, 95% CI: 0.73\u20130.87). Full 2\u2010dose vaccination was associated with a further reduced risk of cerebrovascular diseases (HR: 0.63, 95% CI: 0.50\u20130.80) compared to unvaccinated patients. Unvaccinated COVID\u201019 survivors have significantly higher cerebrovascular risks than their vaccinated counterparts. Thus, clinicians are recommended to monitor this population closely for stroke events during postinfection follow\u2010up.<\/jats:p>","DOI":"10.1002\/jmv.29648","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T07:39:07Z","timestamp":1715326747000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prior COVID\u201019 vaccination and reduced risk of cerebrovascular diseases among COVID\u201019 survivors"],"prefix":"10.1002","volume":"96","author":[{"given":"Sheng\u2010Yin","family":"Chen","sequence":"first","affiliation":[{"name":"Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston MA"},{"name":"Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston MA"},{"name":"Department of Epidemiology Harvard T. H. 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