{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:24:31Z","timestamp":1777875871679,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thyroiditis and Graves' disease have been reported after coronavirus disease 2019 (COVID-19) vaccination. We evaluated the risks of adverse events after COVID-19 vaccination among patients treated for hypothyroidism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this retrospective population-based cohort study of Hong Kong Hospital Authority electronic health records with the Department of Health vaccination records linkage, levothyroxine (LT4) users were categorized into unvaccinated, vaccinated with BNT162b2 (mRNA vaccine), or CoronaVac (inactivated vaccine) between February 23, 2021, and September 9, 2021. Study outcomes were dosage reduction or escalation in LT4, emergency department (ED) visit, unscheduled hospitalization, adverse events of special interest (AESI) according to the World Health Organization's Global Advisory Committee on Vaccine Safety, and all-cause mortality. Inverse probability of treatment weighting for propensity score was applied to balance baseline patient characteristics among the three groups. Hazard ratios (HR) were estimated using Cox regression models. Patients were observed from the index date until the occurrence of study outcome, death, or censored on September 30, 2021, whichever came first.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In total, 47,086 LT4 users were identified (BNT162b2:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200912,310; CoronaVac:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200911,353; and unvaccinated:\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200923,423). COVID-19 vaccination was not associated with increased risks of LT4 dosage reduction (BNT162b2: HR\u2009=\u20090.971 [confidence interval; CI 0.892\u20131.058]; CoronaVac: HR\u2009=\u20090.968 [CI 0.904\u20131.037]) or escalation (BNT162b2: HR\u2009=\u20090.779 [CI 0.519\u20131.169]; CoronaVac: HR\u2009=\u20090.715 [CI 0.481\u20131.062]). Besides, COVID-19 vaccination was not associated with a higher risk of ED visits (BNT162b2: HR\u2009=\u20090.944 [CI 0.700\u20131.273]; CoronaVac: HR\u2009=\u20090.851 [CI 0.647\u20131.120]) or unscheduled hospitalization (BNT162b2: HR\u2009=\u20090.905 [CI 0.539\u20131.520]; CoronaVac: HR\u2009=\u20090.735 [CI 0.448\u20131.207]). There were two (0.016%) deaths and six (0.062%) AESI recorded for BNT162b2 recipients, and one (0.009%) and three (0.035%) for CoronaVac recipients, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>BNT162b2 or CoronaVac vaccination is not associated with unstable thyroid status or an increased risk of adverse outcomes among patients treated for hypothyroidism in general. These reassuring data should encourage them to get vaccinated against COVID-19 for protection from potentially worse COVID-19-related outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2021.0684","type":"journal-article","created":{"date-parts":[[2022,2,26]],"date-time":"2022-02-26T02:17:54Z","timestamp":1645841874000},"page":"505-514","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":45,"title":["Safety of Inactivated and mRNA COVID-19 Vaccination Among Patients Treated for Hypothyroidism: A Population-Based Cohort Study"],"prefix":"10.1177","volume":"32","author":[{"given":"Xi","family":"Xiong","sequence":"first","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6895-6071","authenticated-orcid":false,"given":"Carlos King Ho","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."},{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."},{"name":"Laboratory of Data Discovery for Health (D, 24H), Hong Kong Science and Technology Park, Hong Kong SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan Chi Ho","family":"Au","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, 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China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Yuk Fai","family":"Wan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."},{"name":"Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."},{"name":"Laboratory of Data Discovery for Health (D, 24H), Hong Kong Science and Technology Park, Hong Kong SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celine Sze Ling","family":"Chui","sequence":"additional","affiliation":[{"name":"Laboratory of Data Discovery for Health (D, 24H), Hong Kong Science and Technology Park, Hong Kong SAR, China."},{"name":"Department of School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."},{"name":"Department of School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther Wai Yin","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."},{"name":"Laboratory of Data Discovery for Health (D, 24H), Hong Kong Science and Technology Park, Hong Kong SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco Wing Tak","family":"Cheng","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristy Tsz 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