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Comparison of medium-term adverse reactions induced by the first and second dose of mRNA BNT162b2 (Comirnaty, Pfizer-BioNTech) vaccine: a post-marketing Italian study conducted between 1 January and 28 February 2021
  1. Andrea Ossato1,
  2. Roberto Tessari2,
  3. Carlotta Trabucchi2,
  4. Teresa Zuppini2,
  5. Nicola Realdon1,
  6. Francesca Marchesini2
  1. 1 Pharmaceutical & Pharmacological Sciences Department, University of Padua, Padova, Italy
  2. 2 Hospital Pharmacy, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
  1. Correspondence to Dr Francesca Marchesini, HOSPITAL PHARMACY, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy; francesca.marchesini{at}


Objectives On 21 December 2020 the European Commission granted conditional marketing authorisation in the European Union for the anti-COVID-19 mRNA vaccine Bnt162b2 (Comirnaty, Pfizer/BioNTech). The main endpoint of this epidemiological, observational, prospective and monocentric study was to identify the number, types, and severity of adverse events following immunisation that occurred in subjects who had been previously infected with COVID-19, and in those who had not, after vaccination with Comirnaty, and to compare the two groups of subjects looking at events that occurred within a month after the first and the second dose.

Methods Data were gathered by a questionnaire. The results included the responses of all healthcare workers (2030) of the IRCCS Sacro Cuore Don Calabria Hospital (Italy) vaccinated between 1st January and 28th February 2021. Adverse effects of the vaccine were reported after the first and the second doses.

Results There was a statistically significant increase (p<0.001, χ2=35.60) in participants who experienced some side-effects after receiving the first dose of the vaccine and who had previously been infected with the coronavirus, compared with participants who had not previously been infected. 46.76% (136) of the participants who had previously been infected experienced some side-effects after the first dose of vaccine, and 63.23% (184) experienced some side-effects after the second dose, compared with 29.15% (507) after the first dose and 70.79% (1231) after the second dose in those who had not been previously infected. The number of participants who experienced side-effects after the second dose and had previously been infected was significantly lower compared with participants who had not previously been infected (p=0.0094, χ2=6.743).

Conclusions Most of the side-effects identified in this trial were also reported by the manufacturer and the US Food and Drug Administration. Active surveillance should always continue to constantly check the vaccine’s risk/benefit ratio over time.

  • COVID-19
  • drug monitoring
  • drug-related side effects and adverse reactions
  • evidence-based medicine
  • immunization
  • pharmacy service
  • hospital

Data availability statement

No data are available. Not applicable.

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