Utilization of health care services before and after media attention about fatal side effects of the AstraZeneca vaccine: a nation-wide register-based event study
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Abstract
Background
Survey studies have found that vaccinated persons tend to report more side effects after being given information about side effects rather than benefits. However, the impact of high media attention about vaccine-related side effects on the utilization of health care is unknown. We aimed to assess whether utilization of health care services for newly vaccinated health care workers changed after media attention about fatal side effects of the AstraZeneca vaccine on March 11th, 2021, and whether changes differed by age, sex, or occupation.
Methods
We utilized individual-level data on health care use, vaccination, employment, and demographics available in the Norwegian emergency preparedness register Beredt C19. In all 99,899 health care workers in Norway who were vaccinated with AstraZeneca between February 11th and March 11th, we used an event-study design with a matched comparison group to compare the change in primary and inpatient specialist care use from 14 days before to 14 days after the information shock on March 11th, 2021.
Results
Primary health care use increased with 8.2 daily consultations per 1000 health care workers (95% CI 7.51 to 8.89) the week following March 11th for those vaccinated with AstraZeneca ( n = 99,899), compared with no increase for the unvaccinated comparison group ( n = 186,885). Utilization of inpatient care also increased with 0.8 daily hospitalizations per 1000 health care workers (95% CI 0.37 to 1.23) in week two after March 11th. The sharpest increase in daily primary health care use in the first week after March 11th was found for women aged 18–44 (10.6 consultations per 1000, 95% CI 9.52 to 11.68) and for cleaners working in the health care sector (9.8 consultations per 1000, 95% CI 3.41 to 16.19).
Conclusions
Health care use was higher after the media reports of a few cases of fatal or severe side effects of the AstraZeneca vaccine. Our results suggest that the reports did not only lead vaccinated individuals to contact primary health care more, but also that physicians referred and treated more cases to specialist care after the new information.
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SciScore for 10.1101/2021.07.09.21260250: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, there are also, certain limitations to our analysis. First, we do not attempt to shed any light on whether the increase in health care use led to better health, and to what cost. To assess this, further research should strive to quantify the health gain and costs of increases in health care utilization under such information …
SciScore for 10.1101/2021.07.09.21260250: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, there are also, certain limitations to our analysis. First, we do not attempt to shed any light on whether the increase in health care use led to better health, and to what cost. To assess this, further research should strive to quantify the health gain and costs of increases in health care utilization under such information shocks. Second, our data only contains registered consultations and hospital admissions. This may have led to an underestimation of the results as our study population consisted solely of HCWs who could potentially have received second opinions from colleagues, particularly in periods of greater pressure on the health care services. In addition, due to our specific study population, the external validity of our results may not go beyond HCW. Accordingly, our stratified analysis showed different impacts of the information shock for different occupations, with occupations not requiring formal health education, such as cleaners, having a larger increase in health care use than other occupations working in the health care sector. This may imply that the individual level of health literacy could have been a mediating factor when responding to the information shock, and hence that our estimates of the impact of the information shock again may be underestimated compared to the general population. The observed increase in health care use is driven, at least partly, by behavioral responses to information shocks, which implies that general utilization data...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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