COVID-19 vaccination does not alter thyroid function in adults with hypothyroidism
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ATLANTA — COVID-19 vaccination is not associated with changes in thyroid function or an increased risk for adverse outcomes for people with hypothyroidism, according to data presented at ENDO 2022.
“Our current study represents the first to evaluate the safety of COVID-19 vaccination specifically among patients treated for hypothyroidism in a population-based cohort,” David T. W. Lui, MBBS, clinical assistant professor in the department of medicine at The University of Hong Kong, told Healio. “Although there were reports of thyroid dysfunction — such as thyroiditis and Graves’ disease — after COVID-19 vaccination, we showed that both inactivated and mRNA COVID-19 vaccines are not causing disturbances to thyroid function among patients treated for hypothyroidism.”
Lui and colleagues conducted a population-based cohort study using electronic health records from the Hong Kong Hospital Authority. Adults using levothyroxine were categorized as unvaccinated (n = 23,423) or having received one of two vaccines available in Hong Kong during the study period: BNT162b2 (Pfizer-BioNTech) mRNA vaccine (n = 12,310) and CoronaVac (Sinovac Life Sciences) inactivated vaccine (n = 11,353). Data was obtained between Feb. 23, 2021, and Sept. 9, 2021. Outcomes included dose reduction or escalation of levothyroxine, emergency department visits, unscheduled hospitalization, adverse events of special interest according to the WHO global advisory committee on vaccine safety, and all-cause mortality.
“The thyroid gland is a potential target of attack by SARS-CoV-2,” Lui said during a press conference. “Studies have found the expression of angiotensin-converting enzyme 2, the entry receptor for SARS-CoV-2, expressed in the thyroid cells. There were also cases of subacute thyroiditis and Graves’ disease among COVID-19 patients. Therefore, there were also similar concerns raised regarding the potential of COVID-19 vaccination in inducing thyroid dysfunction.”
Both COVID-19 vaccines were not associated with increased risks for levothyroxine dose changes, emergency department visits or unscheduled hospitalization. Sensitivity analyses according to age, gender and pre-vaccination thyroid status was consistent with the main analysis.
Of the study cohort, two who received the BNT162b2 vaccine died during the follow-up period and six had adverse events of special interests. Of those who received CoronaVac, one died and three had adverse events of special interest.
“These reassuring data should encourage patients treated for hypothyroidism to get vaccinated against COVID-19 for protection from potentially worse COVID-19-related outcomes,” Lui told Healio.
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Lui DTW, et al. ODP514. Presented at: ENDO annual meeting; June 11-14; Atlanta (hybrid meeting).
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