{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:30:17Z","timestamp":1781523017348,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000248157"],"award-info":[{"award-number":["RS\u20102023\u201000248157"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS\u20102022\u2010KH128740[HV22C0233]"],"award-info":[{"award-number":["RS\u20102022\u2010KH128740[HV22C0233]"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The scarcity of studies on vaccine\u2010induced thrombosis and thrombocytopenia syndrome (TTS) limits the comprehensive understanding of vaccine safety on a global scale. Therefore, the objective of this study is to assess the global burden of vaccine\u2010induced TTS, identify the vaccines most associated with it, and suggest clinical implications regarding vaccination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study employed the World Health Organization international pharmacovigilance database, extracting records of vaccine\u2010induced immune thrombotic thrombocytopenia from 1969 to 2023 (total reports, <jats:italic>n<\/jats:italic>\u2009&gt;\u2009130 million). Global reporting counts, reported odds ratios (ROR), and information components (IC) were calculated to identify the association between 19 vaccines and the occurrence of vaccine\u2010induced TTS across 156 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 24\u2009233 cases (male, <jats:italic>n<\/jats:italic>\u2009=\u200911\u2009559 [47.7%]) of vaccine\u2010induced TTS among 404\u2009388 reports of all\u2010cause TTS. There has been a significant increase in reports of vaccine\u2010induced TTS events over time, with a noteworthy surge observed after 2020, attributed to cases of TTS associated with COVID\u201019 vaccines. Measles, mumps, and rubella (MMR) vaccines were associated with most TTS reports (ROR [95% confidence interval], 2.87 [2.75\u20133.00]; IC [IC<jats:sub>0.25<\/jats:sub>], 1.51 [1.43]), followed by hepatitis B (HBV, 2.23 [2.07\u20132.39]; 1.15 [1.03]), rotavirus diarrhea (1.95 [1.78\u20132.13]; 0.81 [0.53]), encephalitis (1.80 [1.50\u20132.16]; 0.84 [0.53]), hepatitis A (1.67 [1.50\u20131.86]; 0.73 [0.55]), adenovirus Type 5 vector\u2010based (Ad5\u2010vectored) COVID\u201019 (1.64 [1.59\u20131.68]; 0.69 [0.64]), pneumococcal (1.57 [1.49\u20131.66]; 0.65 [0.56]), and typhoid vaccines (1.41 [1.12\u20131.78]; 0.49 [0.11]). Concerning age and sex\u2010specific risks, reports of vaccine\u2010induced TTS were more associated with females and younger age groups. The age group between 12 and 17\u2009years exhibited significant sex disproportion. Most of these adverse events had a short time to onset (days; mean [SD], 4.99 [40.30]) and the fatality rate was 2.20%, the highest rate observed in the age group over 65\u2009years (3.79%) and lowest in the age group between 0 and 11\u2009years (0.31%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A rise in vaccine\u2010induced TTS reports, notably MMR, HBV, and rotavirus diarrhea vaccines, was particularly related to young females. Ad5\u2010vectored COVID\u201019 vaccines showed comparable or lower association with TTS compared to other vaccines. Despite the rarity of these adverse events, vigilance is essential as rare complications can be fatal, especially in older groups. Further studies with validated reporting are imperative to improve the accuracy of assessing the vaccine\u2010induced TTS for preventive interventions and early diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14250","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T06:04:46Z","timestamp":1718172286000},"page":"426-440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Global and regional burden of vaccine\u2010induced thrombotic thrombocytopenia, 1969\u20132023: Comprehensive findings with critical analysis of the international pharmacovigilance database"],"prefix":"10.1111","volume":"113","author":[{"given":"Sooji","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medicine Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center Kyung Hee 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