Prospective Monitoring of Patients with COVID-19 Vaccination for Outcomes of Hospitalization Using Electronic Medical Record Network

OBJECTIVES: To assess if patients that received two doses of COVID-19 vaccination were at higher risk for hospitalization compared to patients who received an additional booster vaccine using real-world data from an electronic medical record network.

METHODS: We utilized the TriNetX federated network of de-identified health data to identify patients receiving COVID-19 vaccination from October 2022-November 2022. TriNetX identified 1,995,566 fully vaccinated patients and 1,639,750 patients that received a booster vaccine using a combination of a CVX vaccination term or a CPT, ICD-10-PCS, or SNOMED procedural term for the vaccine occurring. Fully vaccinated patients and booster shot-receiving patients were analyzed and 1:1 propensity score-matched to adjust for potential confounders. Hazard ratios (HR) were evaluated for significance using 95% confidence intervals (CI).

RESULTS: 1,995,566 fully vaccinated patients and 1,639,750 booster vaccine receiving patients were identified. After one month of prospective monitoring, 17,282 and 22,107 fully vaccinated patients and booster shot receiving incident patients, respectively were identified, and enrolled in the cohort for analysis. The adjusted HR with 95% CI was 1.091 (1.08, 1.101). This pairwise comparison suggests an increased risk of hospitalization for fully vaccinated patients compared to patients that received additional booster vaccination.

CONCLUSIONS: Using a real-world electronic medical record network data source, there was a statistically significant increased risk of hospitalization found among fully vaccinated patients compared with booster vaccine receiving patients.