International Journal of Infectious Diseases最新文献

{"title":"Severe dengue hemorrhagic fever after TAK-003 dengue vaccination: A case report of a potential vaccine-associated adverse reaction.","authors":"Pinyo Rattanaumpawan, Navin Horthongkham, Kamol Suwannakarn, Artittaya Athipanyasilp, Ubonvan Jongwutiwes","doi":"10.1016/j.ijid.2025.108062","DOIUrl":"10.1016/j.ijid.2025.108062","url":null,"abstract":"<p><p>We report a severe dengue case that developed symptoms 5 days post-TAK-003 dengue vaccine administration. Whole-genome sequencing confirmed co-detection of all four dengue serotypes with high similarity to vaccine strains, especially DENV-2. This finding warrants further investigation into a potential association with vaccine adverse events.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"108062"},"PeriodicalIF":4.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public health in the age of TikTok: A content analysis of measles narratives","authors":"Corey H. Basch ,&nbsp;Carlee Denholtz ,&nbsp;Rafael Gonzalez Castillo ,&nbsp;Christie Jaime","doi":"10.1016/j.ijid.2025.108055","DOIUrl":"10.1016/j.ijid.2025.108055","url":null,"abstract":"<div><h3>Objectives</h3><div>This cross-sectional study aimed to analyze TikTok content related to measles.</div></div><div><h3>Methods</h3><div>TikTok videos tagged #measles were sampled by selecting the first 100 results. Using a structured codebook, videos were classified by source, tone, vaccination stance, content focus, target audience, and Vitamin A mention. Engagement metrics were analyzed using t-tests or Wilcoxon rank-sum tests for binary predictors and two-way ANOVA for source–tone interactions. Analyses were conducted in Excel and RStudio.</div></div><div><h3>Results</h3><div>The 100 TikTok videos tagged with #measles in this sample garnered over 30 million views, with experts producing 44% of them. Expert-created videos received significantly more views, likes, favorites, and comments than non-expert ones, and tone was linked to differences in saves, with an expertise–tone interaction affecting comments. Most coded content features, such as conspiracy theories, policy mentions, side effects, or Vitamin A, appeared in fewer than 5% of videos and showed no significant relationship to engagement. Two-way ANOVAs confirmed that comments were the only metric significantly influenced by the interplay between expertise and tone, with no other meaningful interactions observed.</div></div><div><h3>Conclusions</h3><div>These results highlight the importance of credible messengers and carefully chosen tone to maximize audience engagement with measles-related content on TikTok. Future research is needed to determine whether such engagement translates into changes in vaccine attitudes or behaviors.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108055"},"PeriodicalIF":4.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Peritoneal Hydatid Cyst in the Douglas Pouch: A Rare Presentation of Echinococcosis.","authors":"Hazem Alouani, Ghazi Lâamiri, Jasser Rchidi, Khadija Yaich, Mahdi Bouassida, Hassen Touinsi","doi":"10.1016/j.ijid.2025.108060","DOIUrl":"https://doi.org/10.1016/j.ijid.2025.108060","url":null,"abstract":"<p><strong>Introduction: </strong>Hydatid disease due to Echinococcus granulosus commonly involves the liver and lungs. Primary peritoneal hydatidosis is rare, and localization in the Douglas pouch is exceptional, often mimicking other pelvic pathologies.</p><p><strong>Case presentation: </strong>We report a 72-year-old Tunisian woman with progressive left hypochondrium pain. Clinical exam and hydatid serology were unremarkable. CT revealed a 9 × 5 × 6 cm cystic mass in the Douglas pouch, displacing the rectum and abutting the bladder. Pelvic MRI showed a unilocular cystic lesion with peripheral fat, suggesting a hydatid cyst. Midline laparotomy identified a non-adherent cyst between rectum and bladder, which was resected intact. Postoperative recovery was uneventful, with no recurrence over 3 years. Albendazole was not given due to complete resection and absence of dissemination.</p><p><strong>Discussion: </strong>Primary pelvic hydatid disease is rare and difficult to diagnose due to nonspecific symptoms. Imaging, particularly CT and MRI, is key for diagnosis. Serological tests may be negative in isolated extra-hepatic disease. Surgery is the treatment of choice; anti-parasitic therapy may be reserved for selected cases.</p><p><strong>Conclusion: </strong>Douglas pouch hydatid cysts are rare but should be considered in endemic regions. Accurate imaging, complete resection, and follow-up are essential for successful management.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"108060"},"PeriodicalIF":4.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal epidemiology of pulmonary nontuberculous mycobacteria and tuberculosis in Singapore (2006-2024): Emerging dominance of Mycobacterium abscessus","authors":"Jarett Vanz-Brian Pereira ,&nbsp;Cassandra Yong Xin Wong ,&nbsp;Li Hwei Sng ,&nbsp;Jenny Guek Hong Low ,&nbsp;Dorothy Hui Lin Ng","doi":"10.1016/j.ijid.2025.108054","DOIUrl":"10.1016/j.ijid.2025.108054","url":null,"abstract":"<div><h3>Background</h3><div>Nontuberculous mycobacteria (NTM) are increasingly recognized as important pulmonary pathogens, with rising incidence reported globally as tuberculosis (TB) declines. While epidemiology is well described in temperate regions, long-term data from tropical, high-density cities such as Singapore remain scarce. Prior local studies suggested a shift from Mycobacterium avium complex (MAC) to M. abscessus as the predominant NTM species, but comprehensive longitudinal analyses are lacking.</div></div><div><h3>Methods</h3><div>We performed a retrospective review of all respiratory mycobacterial cultures at Singapore General Hospital between 2006 and 2024. Pulmonary NTM (pNTM) was defined using 2007 ATS/IDSA microbiologic criteria (≥2 specimens with same species or one positive BAL/biopsy), and pulmonary TB (pTB) as a single culture-positive respiratory specimen. Only the first isolate per patient per species was included. ICD-10 coding data (2018–2024) were also analysed to verify trends.</div></div><div><h3>Results</h3><div>A total of 3877 pTB and 1825 pNTM cases met inclusion criteria. Incidence of pNTM increased from 35 to 65 per 100,000 patient-years, while pTB declined from 225 to 70 per 100,000 patient-years. ICD-10 coding data confirmed similar trends, with pTB incidence declining from 185 to 41 per 100,000 patient-years between 2018 and 2024, while pNTM remained stable at 40-43. Species distribution, derived from microbiological isolates, showed a steady decline in MAC and a marked rise in M. abscessus, which surpassed MAC as the most common species after 2014.</div></div><div><h3>Conclusion</h3><div>pNTM incidence has risen substantially in Singapore, now approaching that of TB. The emergence of M. abscessus as the predominant NTM species has important clinical and public health implications, underscoring the need for ongoing integrated surveillance and tailored management strategies in tropical urban environments.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108054"},"PeriodicalIF":4.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of febrile urinary tract infections caused by Enterococcus faecalis in male patients: A national survey among French infectiologists","authors":"Pierre Danneels ,&nbsp;Charles Maurille ,&nbsp;Lucia Grandière-Perez ,&nbsp;Vincent Dubée ,&nbsp;Sophie Blanchi","doi":"10.1016/j.ijid.2025.108059","DOIUrl":"10.1016/j.ijid.2025.108059","url":null,"abstract":"<div><h3>Objectives</h3><div>The management of <em>Enterococcus faecalis</em> febrile urinary tract infections in men (FUTIEfM) is poorly standardized. We aimed to describe current prescribing practices among French infectious disease physicians.</div></div><div><h3>Methods</h3><div>An anonymous questionnaire was distributed via two national mailing lists between December 2023 and January 2024. The survey explored antibiotic choices, treatment duration, and scenarios prompting therapeutic abstention.</div></div><div><h3>Results</h3><div>A total of 203 physicians responded. Most (98%) reported managing at least one FUTIEfM case every six months. Amoxicillin was the preferred first-line treatment (86%), typically prescribed at 80-100 mg/kg/day (74%); treatment duration was 14 days in 69% and 21 days in 29% of cases. In penicillin-allergic patients, linezolid was the preferred alternative (51%), followed by fluoroquinolones (38%). Fluoroquinolones were deemed inappropriate by 37% of respondents, versus 9% for linezolid and 3% for amoxicillin. Among those considering treatment appropriate, a 14-day course was favored by 81% for linezolid and 92% for fluoroquinolones. Therapeutic abstention was frequently selected in cases of catheterization (51%), polymicrobial cultures (50%), or leukocyturia &lt;10⁴/mL (64%).</div></div><div><h3>Conclusions</h3><div>High-dose oral amoxicillin is the preferred treatment for FUTIEfM. Linezolid and fluoroquinolones (especially levofloxacin) are also used, though with less consensus. Therapeutic abstention appears appropriate in select clinical scenarios.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108059"},"PeriodicalIF":4.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contaminated sponges as source of Klebsiella pneumoniae prostatitis outbreak after transrectal ultrasound-guided prostate biopsy.","authors":"Victor Renault, Samuel Chelly, Marie Prime, Guillaume Aubin, Nathalie Bodet, Agnès Guillot, Franck Bruyère, Stéphane Corvec, Gabriel Birgand","doi":"10.1016/j.ijid.2025.108058","DOIUrl":"10.1016/j.ijid.2025.108058","url":null,"abstract":"<p><strong>Objectives: </strong>The infection rates following transrectal ultrasound-guided (TRUS) prostate biopsy range from 1-5%, mostly caused by Escherichia coli. We investigated an abnormal increase in Klebsiella pneumoniae prostatitis rate following TRUS prostate biopsy in a urological surgery center.</p><p><strong>Methods: </strong>The outbreak occurred in a 217-bed private hospital performing TRUS prostate biopsies. After an antibiotic prophylaxis (single 3 g dose of fosfomycin-trometamol 2 hours before the procedure), each biopsy was placed on a pre-impregnated sponge and then transferred to a plastic cassette for pathological analysis. The outbreak investigation relied on a retrospective analysis of cases defined as the occurrence of a urinary or systemic infection caused by K. pneumoniae within 7 days following a TRUS prostate biopsy, including a review of procedures and microbiological analysis.</p><p><strong>Results: </strong>Between January 1 and March 31, 2024, 13/49 (27%) patients who underwent TRUS prostate biopsy developed clinical symptoms of prostatitis requiring hospitalization. The incidence rate was 20% (5/25, three with E. coli) from January 3 to February 20, 2024 and increased to 33% (8/24, seven with K. pneumoniae) from February 21 to March 31, 2024. During the investigation, K. pneumoniae strains isolated from clinical samples and moistened sponges were genotypically similar, confirming the latter as the source of infection. The pack of sponges in use was discarded, with sterilization of sponges and trays before their use. No other case of K. pneumoniae prostatitis was identified following these measures from April to December 2024.</p><p><strong>Conclusions: </strong>This investigation underlines the critical need for evaluation of practices around the preparation of sponges and cassettes in contact with the puncture needle when performing TRUS prostate biopsy.</p>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"108058"},"PeriodicalIF":4.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of tick-borne encephalitis in unvaccinated populations across Europe (2020-2023)","authors":"Kate Halsby ,&nbsp;Alexander Davidson ,&nbsp;Julie Davis ,&nbsp;Kyra Zens ,&nbsp;Gerhard Dobler ,&nbsp;Andreas Pilz ,&nbsp;Frederick J. Angulo ,&nbsp;Pingping Zhang ,&nbsp;Patrick H. Kelly ,&nbsp;James H. Stark","doi":"10.1016/j.ijid.2025.108052","DOIUrl":"10.1016/j.ijid.2025.108052","url":null,"abstract":"<div><h3>Background</h3><div>Tick-borne encephalitis (TBE) is a vaccine-preventable disease. While many European countries conduct TBE surveillance, resulting incidence estimates do not distinguish between vaccinated and unvaccinated populations. To understand TBE risk to unvaccinated individuals, we assessed incidence among unvaccinated populations in Europe.</div></div><div><h3>Methods</h3><div>TBE incidence was calculated as cases per 100,000 population per year (PPY) using publicly available surveillance data for 34 countries (2020-2023). Unvaccinated incidence was calculated for 21 countries using TBE vaccine uptake data from population surveys, and assuming 95.1% of TBE cases were unvaccinated. The number of cases averted by vaccination in 2023 was also estimated.</div></div><div><h3>Results</h3><div>The surveillance-reported TBE incidence (2020-2023) was ≥5 per 100,000 PPY for Lithuania, Latvia, Estonia, Czechia, and Slovenia. When the unvaccinated incidence is calculated, Sweden and Austria also had an incidence ≥5 per 100,000 PPY. In 2023, 2498 TBE cases were estimated to have been averted in 21 countries by vaccination.</div></div><div><h3>Conclusion</h3><div>The incidence of TBE remains a significant public health concern, with &gt;35 million people living in highly endemic areas of Europe. TBE incidence in the unvaccinated population is substantially higher than the incidence of surveillance-reported TBE cases. Enhanced efforts are needed to increase the uptake of preventive measures, including vaccination.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108052"},"PeriodicalIF":4.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for persisting SARS-CoV-2 infection in patients with B-cell malignancies in the Omicron era: A multicenter cohort study","authors":"Zeno Pasquini ,&nbsp;Alice Toschi ,&nbsp;Dino Gibertoni ,&nbsp;Armando Amicucci ,&nbsp;Beatrice Casadei ,&nbsp;Cinzia Pellegrini ,&nbsp;Alessandra D’Abramo ,&nbsp;Patrizia De Marco ,&nbsp;Linda Bussini ,&nbsp;Maria Ciccone ,&nbsp;Alessandro Visentin ,&nbsp;Paula Olivares-Navarro ,&nbsp;Michele Bartoletti ,&nbsp;Emanuele Nicastri ,&nbsp;Mauro Krampera ,&nbsp;Pier Luigi Zinzani ,&nbsp;Francesca Bonifazi ,&nbsp;Pierluigi Viale ,&nbsp;Zaira R. Palacios-Baena ,&nbsp;Evelina Tacconelli ,&nbsp;Maddalena Giannella","doi":"10.1016/j.ijid.2025.108053","DOIUrl":"10.1016/j.ijid.2025.108053","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients with B-cell malignancies are at high risk of persisting SARS-CoV-2 infection, which may delay oncologic treatments and increase morbidity. We aimed to assess risk factors for persisting infection in this population.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective study across five tertiary hospitals between January 1, 2022, and January 1, 2023. Adult patients with B-cell malignancies and SARS-CoV-2 infection were included. Persisting infection was defined as viral shedding ≥21 days with clinical and/or radiological signs. Risk factors were evaluated through multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among 307 patients, 26.1% developed persisting infection. The cohort included non-Hodgkin lymphoma (67.4%), chronic lymphocytic leukemia (19.2%), and Hodgkin lymphoma (9.1%). Independent risk factors included anti-cluster of differentiation 20 therapy (odds ratio [OR], 3.22; 95% confidence interval [CI], 2.37-4.39; <em>P</em> &lt;0.001), and hospital admission at diagnosis (OR, 5.16; 95% CI, 2.37-12.45; <em>P</em> &lt;0.001). Early therapy with nirmatrelvir/ritonavir (OR, 0.32; 95% CI, 0.19-0.54; <em>P</em> &lt;0.001), remdesivir (OR, 0.26; 95% CI, 0.18-0.37; <em>P</em> &lt;0.001), and sotrovimab (OR, 0.32; 95% CI, 0.15-0.67; <em>P</em> = 0.003) were protective. Mortality at 120 days was higher in the persisting group, though not statistically significant (12.5% vs 8.4%; <em>P</em> = 0.277).</div></div><div><h3>Conclusions</h3><div>Our findings help define risk factors for persisting SARS-CoV-2 infection and support early treatment in patients with B-cell malignancies.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108053"},"PeriodicalIF":4.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disseminated Mycobacterium simiae infection causing rhinosinusitis in a severely immunocompromised patient","authors":"Christoffel Opperman ,&nbsp;Nectarios Papavarnavas ,&nbsp;Sally Candy ,&nbsp;Sarishna Singh ,&nbsp;Yonas Ghebrekristos ,&nbsp;Robin Warren ,&nbsp;Wynand Goosen","doi":"10.1016/j.ijid.2025.108051","DOIUrl":"10.1016/j.ijid.2025.108051","url":null,"abstract":"<div><h3>Objectives</h3><div><em>Mycobacterium simiae</em> is a slow-growing environmental nontuberculous mycobacterium (NTM), commonly isolated from soil and water. <em>M. simiae</em> is not known to transmit zoonotically or via human-to-human contact; infection is presumed to occur through direct environmental exposure. Although <em>M. simiae</em> represents a small proportion of NTM isolates globally, its clinical relevance is increasingly recognized. Extrapulmonary manifestations are rare, and to date, no cases of rhinosinusitis attributable to <em>M. simiae</em> have been reported.</div></div><div><h3>Case presentation and management</h3><div>A 33-year-old male with advanced HIV (cluster of differentiation 4⁺ count 6 cells/µL), who completed tuberculosis treatment 2 months prior to the current admission, presented with right eye proptosis, pain, restricted ocular movement, nasal discharge, and fever. Three weeks earlier, he was hospitalized and discharged for chronic diarrhea complicated by acute-on-chronic kidney injury and pancytopenia. Imaging showed sinus opacification with bony erosion extending into the orbit. Cultures from blood and sinus aspirate identified <em>Mycobacterium simiae</em>, confirmed by line-probe assay. Despite multidisciplinary care, minimal improvement occurred, and he died 2 weeks after admission.</div></div><div><h3>Conclusions</h3><div>This case represents the first documented instance of <em>M. simiae</em>-associated rhinosinusitis and highlights the pathogenic potential of environmental NTM in causing destructive and disseminated disease in severely immunocompromised patients.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108051"},"PeriodicalIF":4.3,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse events associated with COVID-19 vaccination or diagnosis among pregnant and non-pregnant women in the United States, 2021-2022","authors":"Stacey L. Rowe ,&nbsp;Sheena G. Sullivan ,&nbsp;Julia J. Koerber ,&nbsp;Flor M. Muñoz ,&nbsp;Matthew M. Coates ,&nbsp;Onyebuchi A. Arah ,&nbsp;Annette K. Regan","doi":"10.1016/j.ijid.2025.108050","DOIUrl":"10.1016/j.ijid.2025.108050","url":null,"abstract":"<div><h3>Objectives</h3><div>To quantify the incidence of adverse events after COVID-19 vaccination and COVID-19 diagnosis in women of reproductive age; to examine pregnancy as a potential risk modifier.</div></div><div><h3>Methods</h3><div>An exposure-matched cohort study of &gt;1 million women, 11 December 2020–30 September 2022, United States. COVID-19 vaccination, COVID-19 diagnoses, and medically-attended adverse events – including immunologic, neurologic, cerebrovascular, thromboembolic, cardiovascular, respiratory, thrombocytopenic, and coagulative events – were identified from inpatient and outpatient medical claims. Exposed participants were matched with up to four unexposed participants on pregnancy and propensity for COVID-19 vaccination (or diagnosis). Odds ratios quantifying the associations between exposures and adverse events were estimated using logistic regression models, with pregnancy incorporated as an effect modifier.</div></div><div><h3>Results</h3><div>We identified 3556 (120.6 per 10,000) adverse events among pregnant women, with near-identical incidence rates between those unvaccinated and vaccinated against COVID-19 (120.5 and 120.7 per 10,000; adjusted odds ratio [aOR]=1.04 [95% CI: 0.96, 1.13]). The incidence of adverse events was lower among non-pregnant women (<em>n</em> = 3581; 95.5 per 10,000); however, vaccination effects were stronger (90.2 and 101.6 per 10,000 among unvaccinated and vaccinated women, respectively; aOR = 1.19, 95% CI: 1.11, 1.28). More adverse events occurred following COVID-19 diagnosis, including pericarditis (pregnant: aOR = 5.35, 95% CI: 2.24, 12.79; non-pregnant: aOR = 5.57, 95% CI: 3.02, 10.27) and acute myocardial infarction (pregnant: aOR = 3.15, 95% CI: 1.56, 6.37; non-pregnant: aOR = 4.34, 95% CI: 2.79, 6.76).</div></div><div><h3>Conclusion</h3><div>Adverse events associated with COVID-19 vaccination were rare in women, but substantially elevated following COVID-19 diagnosis. Being pregnant did not increase adverse event risk, reinforcing the safety of COVID-19 vaccination during pregnancy.</div></div>","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":"160 ","pages":"Article 108050"},"PeriodicalIF":4.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}