BackgroundThis study assessed and compared the frequency and type of adverse events (AEs) of the Pfizer-BioNTech, Moderna, and Janssen coronavirus disease 2019 (COVID-19) vaccines reported in the Vaccine Adverse Event Reporting System (VAERS).MethodsA retrospective analysis examined VAERS reports between 14 December 2020 and 8 October 2021 and focused on AE reports related to COVID-19 vaccines and AE outcomes [e.g., emergency room (ER) visits after being vaccinated, hospitalization, prolongation of existing hospitalization, life-threatening events, disability, birth defect, and death]. Reporting odds ratios (RORs) and Breslow-Day statistics were used to compare AE reporting between COVID-19 and non-COVID vaccines and between individual COVID-19 vaccines.ResultsA total of 604,157 AEs of COVID-19 vaccines were reported, including 43.51% for the Pfizer-BioNTech vaccine, 47.13% for the Moderna vaccine, and 9.12% for the Janssen COVID-19 vaccine. About 12.56% of patients visited ER after being vaccinated, 5.96% reported hospitalization, and 1.52% reported life-threatening events. Among the number of death cases (n = 7,674; mean age = 73), 2,025 patients (26.39%) had hypertension and 1,237 (16.12%) patients had cancer. RORs between COVID-19 vaccines and non-COVID vaccines identified increased ROR in ER visits, hospitalization, and life-threatening events. The results of the Breslow-Day statistics indicated heterogeneities between the disproportionality of reports across the four serious AE outcomes (i.e., ER visits, hospitalization, life-threatening events, and disability) between individual COVID-19 vaccines.ConclusionMost current VAERS reports showed that the most commonly reported AEs of COVID-19 vaccines were mild. Cases with a mortality outcome tended to occur in older adults with underneath conditions. Close ongoing surveillance in the safety of COVID-19 vaccines is critical and will inform the use of individual COVID-19 vaccines. Given the known limitations associated with the passive spontaneous reporting system, such as VAERS, our findings need to be further assessed and verified through longitudinal, large healthcare data systems.
data submitted for FDA approval, was reviewed along with target patient distribution, coverage status, and commentary from Medicare and the top 20 commercial insurers (by number of covered lives). Results: Eight FDA-approved interventions with BDD status were identified across 7 broad therapeutic indicationsemphysema, diabetic retinopathy, iris defects, type 1 diabetes, and chronic heart failure therapies; and traumatic brain injury and solid tumor cancer diagnostics. Of these devices, 3 were widely non-covered, 4 had limited coverage, and 1 had insufficient data for analysis among commercial insurers; in contrast, Medicare and its regional contractors explicitly covered 1 of these devices, with no formal policy for the remaining devices. Non-coverage rationale stated by health plan policies was primarily insufficiently compelling evidence of clinical efficacy. A prospective analysis of these products, assuming retroactive coverage aligned with H.R. 5333 (116 th Congress; 2019-2020 or similar legislation, determined that during a 3-year effective period, market access would increase by 55% or more, driven primarily by the distribution of Medicare beneficiaries across target patient populations. Conclusions: Breakthrough Device Designation, while potentially valuable to expedite U.S. regulatory clearance, does not directly correlate with coverage by payer stakeholders. While pending legislative efforts may offer guaranteed, temporary Medicare coverage, innovators must pair these initiatives with additional, payerresonant clinical evidence to secure widespread market access.
BackgroundThere have been numerous cases of adverse events since the introduction of Essure medical devices for sterilization in 2002. This study analyzed the safety event reports of the Essure reported in the Manufacturer and User Facility Device Experience (MAUDE).MethodsA retrospective analysis examined the MAUDE reports between Jan-1, 2018, and Oct-31, 2018 and focused on safety reports related to the Essure device. Safety reports were categorized and analyzed by their event type, device problem, patients’ symptoms and the level of harm. Of this study cohort, 10% of samples were randomly selected for quantitative analyses. Thematic analysis was conducted for reports included death cases.ResultsA total of 4,994 eligible reports were analyzed. There were ten reports associated with individuals’ deaths, and the main themes of safety reports from qualitative analysis were pains, bleeding, surgery, migraine, and infection. Quantitative analysis of 500 randomly selected samples showed that 98% of adverse event reports were associated with different injuries such as surgery, pain, bleeding, hysterectomy, and menorrhagia. Additionally, more than 90% of reports were submitted by the manufacturer.ConclusionThese findings indicated several safety issues of Essure. More meaningful pre- and post-marketing surveillance and regulation are warranted in the medical device market to ensure safety and effectiveness, including investigating complaints, promptly sharing relevant information with regulators and users, and implementing corrective actions
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