{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:13:52Z","timestamp":1788401632764,"version":"build-2803163510"},"reference-count":109,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adverse events (AEs) associated with COVID-19 vaccines remain a critical aspect of safety surveillance. In 2022, we reported the first systematic profiling of COVID-19 vaccine AEs using the Vaccine Adverse Event Reporting System (VAERS). Since then, vaccines have evolved with the introduction of bivalent formulations. This study provides an updated analysis to capture evolving safety trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Building upon our previous analysis, we systematically analyzed AE profiles for the Pfizer-BioNTech, Moderna, and Janssen vaccines, along with the newer bivalent Pfizer-BioNTech and Moderna vaccines and the protein subunit Novavax vaccine, using VAERS data through 28 June 2024. We obtained processed VAERS data via Cov19VaxKB. Significance of each AE was determined using Pearson\u2019s Chi-square test, proportional reporting ratios, and case report frequencies with established thresholds. Overlap and age- or sex-stratified analyses were conducted to characterize shared and unique AE patterns across vaccine types. AE classification using the Ontology of Adverse Events was performed to categorize and interpret significant AEs within a structured hierarchy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We observed a marked decrease in unique AEs reported for the Pfizer-BioNTech and Moderna monovalent mRNA vaccines and the recombinant vector vaccine Janssen. The bivalent versions of Pfizer-BioNTech and Moderna exhibited distinct overlapping AE profiles compared to their monovalent counterparts, and bivalent vaccines were generally associated with fewer AEs than the classical monovalent vaccines. Significant differences were observed in thrombosis, myocarditis, and Guillain-Barr\u00e9 syndrome (GBS) across vaccines. Age-specific analyses revealed a bimodal pattern with higher AE reporting in children aged 0\u20139 and adults aged 50\u201369, and clear sex differences. Females reported more common AEs, while males were more often linked to serious AEs (thrombosis, myocarditis, and GBS). Death-related AEs were uncommon but more frequent among older males and primarily associated with monovalent formulations. Ontology-based classification revealed that females were more likely to experience sensory-related AEs, whereas males were more prone to cardiovascular-related AEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The adverse event profiles of COVID-19 vaccines during 2020\u20132024 largely overlapped those identified during 2020\u20132021, while also revealing new overall and age- and sex-specific AE patterns. Ontology-guided classification enhanced the interpretation of large-scale vaccine safety data, supporting more precise risk assessment across groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1741967","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T05:29:27Z","timestamp":1774502967000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Updated profiling of COVID-19 vaccine adverse events using VAERS case reports"],"prefix":"10.3389","volume":"17","author":[{"given":"Anna","family":"He","sequence":"first","affiliation":[{"name":"Huron High School","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Hur","sequence":"additional","affiliation":[{"name":"Red River High School","place":["Grand Forks, ND, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingxian","family":"Li","sequence":"additional","affiliation":[{"name":"College of Literature, Science, and the Arts, University of Michigan","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zheng","sequence":"additional","affiliation":[{"name":"Unit for Laboratory Animal Medicine, University of Michigan Medical School","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junguk","family":"Hur","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, University of North Dakota, School of Medicine and Health Sciences","place":["Grand Forks, ND, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongqun","family":"He","sequence":"additional","affiliation":[{"name":"Unit for Laboratory Animal Medicine, University of Michigan Medical School","place":["Ann Arbor, MI, United States"]},{"name":"Center of Computational Medicine and Bioinformatics, University of Michigan Medical School","place":["Ann Arbor, MI, United States"]},{"name":"Department of Learning Health Science, University of Michigan Medical School","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"103657","DOI":"10.1016\/j.amsu.2022.103657","article-title":"Myocarditis after BNT162b2 and mRNA-1273 COVID-19 vaccination: a report of 7 cases","volume":"77","author":"Ahmed","year":"2022","journal-title":"Ann. 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