No association found between vaccination and corneal graft rejection
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Key takeaways:
- A matched case-control study found no association between corneal graft rejection and vaccination.
- These findings provide support for the completion of recommended vaccinations for corneal graft recipients.
A matched case-control study performed at Kaiser Permanente Southern California found no evidence to suggest an association between vaccination and corneal graft rejection.
Cases of graft rejection following administration of the SARS-CoV-2 and other vaccines have been anecdotally reported, raising concern that stimulation of the immune system and formation of antibodies against the graft could potentially trigger rejection. However, evidence of this association has been largely limited to case reports and small case series studies with inconsistent findings, the authors wrote in the American Journal of Ophthalmology.
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Transplant recipients who experienced graft rejection between 2008 and 2022 were identified through electronic health records. Controls who did not experience graft rejection were matched in a 3:1 ratio to cases, with 1,803 controls and 601 cases. In both groups, penetrating keratoplasty and endothelial keratoplasty were the most commonly performed procedures.
Among patients who experienced graft rejection, 23% had received one or more vaccinations within the 12 weeks before rejection vs. 21.7% of controls. Among all patients analyzed, mRNA vaccines were the most commonly administered (60%), followed by adjuvated or high-dose vaccines (27.3%).
The adjusted odd ratio (aOR) of receiving any vaccinations in the 12 weeks before rejection comparing cases to controls was 1.17, with the aOR increasing from 1.09 with one vaccination to 1.53 with two vaccinations and to 1.79 with three or more vaccinations. This increase, the authors noted, was not statistically significant.
Concerning the type of vaccine, the aOR was 1.60 for mRNA vaccines and 1.19 for adjuvanted or high-dose vaccines.
“Overall, we did not find sufficient evidence to suggest an association between vaccination and increased risk of corneal graft rejection,” the authors wrote.
The increased risk of rejection with mRNA vaccines was also deemed as not statistically significant.
“Our findings provide support for the completion of recommended vaccinations for patients who are planning or have received a corneal transplant, without a significantly increased risk of graft rejection,” the authors said.
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