Reports of suspected adverse reactions to COVID-19 vaccines in Switzerland – update 24

08.04.2022

Reporting period 01.01.2021–05.04.2022

14,624 reports of suspected adverse reactions evaluated – the overall positive benefit-risk ratio of the vaccines remains

Up to 5 April 2022, Swissmedic evaluated 14,624 reports on suspected adverse drug reactions (ADRs).

9,133 (62.5 %) were reported to Swissmedic as “not serious”, while 5,491 suspected cases (37.5 %) were classified as «serious».1 The majority of the reports involved more than one reaction. In total, 45,637 reactions were reported, corresponding to an average of 3.12 reactions per report.

 

The reporting individuals themselves defined whether they classified the cases as serious or not serious. According to international pharmacovigilance practice, this categorisation is revised only for events that were reported as not serious if the ADR is subsequently classified as serious on the basis of further information.

Reports

14,624

Not serious

9,133 (62,5 %)

Reporting rate

0.93

Serious

5,491 (37.5 %)

Vaccine doses

15 702 712

Vaccinated people

6 106 917

Primary reporter
The Therapeutic Products Act (TPA) requires healthcare professionals to report serious adverse effects and as yet unknown effects to Swissmedic. 6,742 (46.2%) reports were submitted by healthcare professionals. Members of the public may voluntarily report suspected side effects of medicines: 7,855 reports (53.8%) were received directly from those affected, i.e. the patients, or their relatives.

Age and gender of persons affected
Most of those affected were aged between 18 and 64 years (50.3 years on average). 20.2 % of the individuals were older than 65, while 1.2 % were 12 to 17 years old.

9,072 (62.1%) of the reports concerned women, 5,141 (35%) of the reports concerned men. In a few reports no age or gender was specified.

Evaluations of individual vaccines

10,122 (69.2%) of the reports involve Moderna’s COVID-19 vaccine Spikevax® (with approx. 63 % of the vaccine doses administered, this is the most widely used vaccine in Switzerland) while 4,068 (27.9%) are associated with Pfizer/BioNTech’s Comirnaty® (approx. 37 % of administered vaccine doses). In some cases, the vaccine was not specified.

Number of reports by vaccine and dose

Vaccine

Total reports

of which non-serious

of which serious

Total vaccine doses * [3]

Spikevax® (Moderna) [1]

8,400 (57.4 %)

5,457 (59.3 %)

2,874 (55.6 %)

9,813,888 (62.5 %)

Spikevax® (Moderna) [2]

1,722 (11.8 %)

1,271 (13.9 %)

304 (5.9 %)

Comirnaty® (Pfizer/BioNTech) [1]

3,738 (25.6 %)

2,007 (22.0 %)

1,665 (32.2 %)

5,828,328 (37.1 %)

Comirnaty® (Pfizer/BioNTech) [2]

330 (2.3 %)

194 (2.1 %)

106 (2.1 %)

COVID-19 Vaccine Janssen

126 (0.9 %)

67 (0.7 %)

55 (1.1 %)

60 496 (0.4 %)

Unknown [1]

285 (1.9 %)

124 (1.5 %)

153 (3.0 %)

 

Unknown [2]

23 (0.2 %)

3 (0.1 %)

8 (0.2 %)

 

Total

14,624 (100 %)

9,133 (100 %)

5,491 (100 %)

15,702,712 (100 %)

[1] Basic immunisation (two doses)

[2] Booster

[3] Basic immunisation and booster

* Switzerland and Principality of Liechtenstein, 21.12.2020–04.04.2022 (Source: FOPH)

Reports classified as serious

Around 38 % of cases were classified by the reporters as serious. In these reports, the average age of those affected was 52.9. The most commonly reported reactions were fever, headache, fatigue, shivering, nausea and dizziness. These known reactions also predominated in the cases classified as not serious.

In 209 of the serious cases, a fatality was reported at differing intervals after receiving the vaccine. The average age of those who died was 79.3 years. Despite a temporal association, an in-depth analysis of the data available for these cases showed that there were other more likely causes of the reported deaths.

Reported vaccine reactions and affected organ systems by vaccine


The reports of adverse reactions received and analysed to date do not alter the positive benefit-risk profile of the COVID-19 vaccines used in Switzerland. This largely confirms their known side effects profile. Known side effects of COVID-19 vaccines are listed in the continually updated medicinal product information texts published on www.swissmedicinfo.ch.

The reports of suspected adverse drug reactions (ADR) to COVID-19 vaccinations are evaluated in collaboration with the regional pharmacovigilance centres and in particular with the Ticino reference centre (EOC cantonal hospital authority).

The next report of suspected adverse reactions of COVID-19 vaccines in Switzerland will be released on 6 May 2022.
You can find the latest report on suspected adverse reactions to COVID-19 vaccines in Switzerland at the following permalink: www.swissmedic.ch/covid-19-vaccines-safety-update-en

Information from Swissmedic on individual safety aspects

Reports of urticaria (hives, nettle rash) after booster vaccination

The profile for the adverse effects reported after a vaccine booster/third dose largely resembles the profile after the first and second vaccine doses. There is, however, an exception: cases of urticaria reported to Swissmedic, mostly after booster vaccinations with Spikevax.

To date, 1,060 such reports have been received that have a correlation in time with the vaccination (interval of 0-72 days), most of which (approx. 75%) were sent by the people affected themselves. The cases reported often relate to urticaria that appears on various parts of the body with a time lag (on average around 11 days after the booster vaccination), with episodes recurring over a lengthy period. The clinical pic-ture as described in many of the reports corresponds most closely to an acute (< 6 weeks) or chronic (> 6 weeks) spontaneous urticaria. On average, the reports were submitted 32 days after the onset of symptoms and for most of the persons affected the symptoms had not yet receded by the time of writing. 60% of the reports related to women and 40% to men. The mean age was approximately 40 years.

Urticaria is a relatively common disorder that can have many different causes. This should be taken into account when evaluating the cases reported, which must be seen against the background of over 2.1 million booster vaccinations given with Spikevax in Switzerland.

Swissmedic is continuing to investigate the reports of urticaria and is in contact with drug regulatory authorities abroad as well as with medical experts and the manufacturer. To date, it has mostly been in Switzerland that cases of urticaria following booster vaccinations have been reported. It has not yet been properly established whether this is due to particular attention being focused on these reactions in Switzerland or whether other factors are involved. The possible connection between urticaria and the booster vaccination with Spikevax will continue to be investigated by Swissmedic and the benefit-risk ratio of COVID vaccines reevaluated as necessary.


Myocarditis / pericarditis

Very rare cases of myocarditis and pericarditis (inflammation of the heart muscle/pericardium) have been reported following vaccination with the COVID-19 mRNA vaccines. Cases generally occur within 14 days of vaccination and more frequently after the second dose and in younger men.

Healthcare professionals should pay attention to the signs and symptoms of myocarditis and pericarditis and inform vaccinated people that they should seek immediate medical advice and assistance in the event of chest pains, shortness of breath or palpitations. Strong physical exertion should be avoided if such symptoms occur until the cause of the symptoms has been ascertained.

By 4 April 2022, 400 cases of myocarditis and/or pericarditis with a suspected link to vaccinations had been reported in Switzerland and evaluated out of a total of around 15.7 million vaccine doses administered. Of these, 90 were linked chronologically with Comirnaty (15 of which were after the third dose) and 295 with Spikevax (16 of which were after the third dose); in 11 cases, the vaccine has not yet been identified, while 4 cases concerned the COVID-19 vaccine from Janssen. The large majority of cases involved males (n = 295, 73.7%), and the mean age was 36.5 years (median 33, range 14 to 88 years). The persons affected received medical treatment and most have now recovered. There is currently no indication that the number of reports of myocarditis and/or pericarditis is increasing following booster shots/third vaccinations.

Various studies have shown that inflammation of the heart muscle and heart sac in those under 30 years of age is observed more frequently after vaccination with Spikevax than after vaccination with Comirnaty. Newly published data will be analysed continuously and, if necessary, the vaccination recommendation for mRNA vaccines against COVID-19 will be reviewed by the Federal Commission for Vaccination (FCV).

Previous reports

11.03.2022

Reports of suspected adverse reactions to COVID-19 vaccines

13,388 reports of suspected adverse vaccination reactions evaluated

11.02.2022

Reports of suspected adverse reactions to COVID-19 vaccines

12,334 reports of suspected adverse vaccination reactions evaluated

14.01.2022

Reports of suspected adverse reactions to COVID-19 vaccines

11,467 reports of suspected adverse vaccination reactions evaluated

17.12.2021

Reports of suspected adverse reactions to COVID-19 vaccines

10,842 reports of suspected adverse vaccination reactions evaluated

26.11.2021

Reports of suspected adverse reactions to COVID-19 vaccines

10,386 reports of suspected adverse vaccination reactions evaluated

05.11.2021

Reports of suspected adverse reactions to COVID-19 vaccines

9,834 reports of suspected adverse vaccination reactions evaluated

15.10.2021

Reports of suspected adverse reactions to COVID-19 vaccines

8,757 reports of suspected adverse vaccination reactions (ADR) evaluated – the overall positive benefit-risk ratio of the vaccines remains

24.09.2021

Reports of suspected adverse reactions to COVID-19 vaccines

7,571 reports evaluated – the overall positive benefit-risk ratio of the vaccines remains

03.09.2021

Reports of suspected adverse reactions to COVID-19 vaccines

6,603 reports evaluated – the overall positive benefit-risk ratio of the vaccines remains

13.08.2021

Reports of suspected adverse reactions to COVID-19 vaccines in Switzerland – update

5,304 reports evaluated – the overall positive benefit-risk ratio of the vaccines remains

23.07.2021

Reports of suspected adverse reactions to COVID-19 vaccines in Switzerland – update

4,319 reports evaluated – the overall positive benefit-risk ratio of the vaccines remains

02.07.2021

Reports of suspected adverse reactions to COVID-19 vaccines in Switzerland – update

3,419 reports evaluated – the overall positive benefit-risk ratio of the vaccines remains

18.06.2021

Reports of suspected adverse reactions to COVID-19 vaccines in Switzerland – update

2,944 reports evaluated – the overall positive benefit-risk ratio of the vaccines remains

04.06.2021

Side effects of COVID-19 vaccines in Switzerland – update

2,701 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

21.05.2021

Side effects of COVID-19 vaccines in Switzerland – update

2269 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

07.05.2021

Side effects of COVID-19 vaccines in Switzerland – update

1953 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

22.04.2021

Side effects of COVID-19 vaccines in Switzerland – update

1485 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

09.04.2021

Side effects of COVID-19 vaccines in Switzerland – update

1174 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

11.03.2021

Side effects of COVID-19 vaccines in Switzerland – update

597 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

26.02.2021

Side effects of COVID-19 vaccines in Switzerland – update

364 reports of suspected adverse reactions to COVID-19 vaccines in Switzerland evaluated

05.02.2021

Reports of suspected adverse reactions to the COVID-19 vaccines in Switzerland – Update

To date, 63 side effect reports in connection with COVID-19 vaccinations in Switzerland have been evaluated

22.01.2021

Reports of suspected adverse reactions to the COVID-19 vaccines in Switzerland

Reports to date in line with the known risk profile

Supplementary information

Guide to interpreting the data

Given the methodology of the spontaneous reporting system, the following factors need to be taken into account when interpreting the data presented here:

  • The figures provided relate to suspected reactions reported to Swissmedic and entered in the database after being reviewed.
  • All the reactions reported are suspected cases. In individual cases it has not been ascertained whether the reported reaction was only observed in a temporal relationship with the vaccination or was actually caused by it.
  • The number of suspected cases for each vaccine can depend greatly on how many people received this vaccine in the period in question.The nu mber of vaccination reactions could be higher than the number of reports. Depending on the authorised use (e.g. age group, high-risk individual) and the latest vac cination recommendations, certain vaccines are more frequently administered to people with a serious preexisting condition.
  • This can influence the occurrence of certain reactions which, however, are only indirectly related to the particular vaccine.
  • The figures for suspected cases of vaccination reactions are just one of many elements used to monitor the risk-benefit profile of vaccines. Only a detailed scientific evaluation of all the available data will enable the correct conclusions to be made about a vaccine’s safety profile.