Abstract
Purpose
The aim of the study was to present the rates of corneal transplant rejection from 2018 to 2022 at both Moorfields Eye Hospital UK, and Ospedali Privati Forli (OPF) “Villa Igea”, Italy and evaluate the purported association between COVID-19 vaccination and rejection.
Methods
We performed a retrospective review of rejection cases presenting to the two units. Monthly rates were correlated against regional vaccination programme rates. At OPF, conditional Poisson regression model was employed to estimate the incidence risk ratio (IRR) of graft rejection following COVID-19 vaccination risk period compared with the control period.
Results
Between January 2018 and March 2022, there were 471 (Moorfields), 95 (OPF) episodes of rejection. From the start of vaccination programme in the UK in late January 2021, the median number of graft rejections per month at Moorfields was 6 (range: 5–9), which was not significantly different to post-lockdown, pre-vaccination programme (March 2020–January 2021), p = 0.367. At OPF, the median rates of rejection before and after initiation of the vaccination programme were not significantly different (p = 0.124). No significant increase in incidence rate of rejection in the risk period following COVID-19 vaccination was found (IRR = 0.53, p = 0.71).
Conclusion
No notable increase in rates of transplant rejection was noted in year 2021 when COVID-19 vaccination was broadly implemented. The apparent temporal relationship between COVID-19 vaccination and corneal graft rejection highlighted in several case reports may not represent a causative association.
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Data availability
Data available upon written request to the corresponding author.
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HR has undertaken paid consultancy work for Alcon Inc (Fort Worth, TX, USA) in the past 36 months and has received honoraria from Thea Pharmaceuticals Ltd (Keele, UK). The other authors have no financial interest to disclose.
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Roberts, H.W., Wilkins, M.R., Malik, M. et al. A lack of an association between COVID-19 vaccination and corneal graft rejection: results of a large multi-country population based study. Eye 37, 2316–2319 (2023). https://doi.org/10.1038/s41433-022-02341-7
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DOI: https://doi.org/10.1038/s41433-022-02341-7
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