{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T09:04:06Z","timestamp":1774343046296,"version":"3.50.1"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>The Oxford-AstraZeneca ChAdOx1 nCoV-19 is a vaccine against the COVID-19 infection that was granted a conditional marketing authorization by the European Commission in January 2021. However, following a report from the Pharmacovigilance Risk Assessment Committee (PRAC) of European Medicines Agency, which reported an association with thrombo-embolic events (TEE), in particular disseminated intravascular coagulation (DIC) and cerebral venous sinus thrombosis (CVST), many European countries either limited it to individuals older than 55\u201360 years or suspended its use. We used publicly available data to carry out a quantitative benefit\u2013risk analysis of the vaccine among people under 60 in Italy. Specifically, we used data from PRAC, Eudravigilance and ECDC to estimate the excess number of deaths for TEE, DIC and CVST expected in vaccine users, stratified by age groups. We then used data from the National Institute of Health to calculate age-specific COVID-19 mortality rates in Italy. Preventable deaths were calculated assuming a 72% vaccine efficacy over an eight-month period. Finally, the benefit\u2013risk ratio of ChAdOx1 nCoV-19 vaccination was calculated as the ratio of preventable COVID-19 deaths to vaccine-related deaths, using Monte-Carlo simulations. We found that among subjects aged 20\u201329 years the benefit\u2013risk (B-R) ratio was not clearly favorable (0.70; 95% Uncertainty Interval (UI): 0.27\u20132.11). However, in the other age groups the benefits of vaccination largely exceeded the risks (for age 30\u201349, B-R ratio: 22.9: 95%UI: 10.1\u2013186.4). For age 50\u201359, B-R ratio: 1577.1: 95%UI: 1176.9\u20132121.5). Although many countries have limited the use of the ChAdOx1 nCoV-19 vaccine, the benefits of using this vaccine clearly outweigh the risks in people older than 30 years. Study limitations included risk of underreporting and that we did not provide age-specific estimates. The use of this vaccine should be a strategic and fundamental part of the immunization campaign considering its safety and efficacy in preventing COVID-19 and its complications.<\/jats:p>","DOI":"10.3390\/vaccines9060618","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T21:16:58Z","timestamp":1623187018000},"page":"618","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Quantitative Benefit\u2013Risk Analysis of ChAdOx1 nCoV-19 Vaccine among People under 60 in Italy"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3437-812X","authenticated-orcid":false,"given":"Raffaele","family":"Palladino","sequence":"first","affiliation":[{"name":"Department of Public Health, University \u201cFederico II\u201d of Naples, 80131 Napoli, Italy"},{"name":"Department of Primary Care and Public Health, Imperial College, London W68RP, UK"},{"name":"CIRMIS\u2014Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare, University \u201cFederico II\u201d of Naples, 80131 Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Ceriotti","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damiano","family":"De Ambrosi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"De Vito","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Farsoni","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Seminara","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1550-436X","authenticated-orcid":false,"given":"Francesco","family":"Barone-Adesi","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy"},{"name":"CRIMEDIM\u2014Research Center in Emergency and Disaster Medicine, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Greinacher, A., Thiele, T., Warkentin, T.E., Weisser, K., Kyrle, P.A., and Eichinger, S. 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