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Scientific reports
NATURE
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The coronavirus disease 2019 (COVID-19) pandemic has been a major challenge worldwide for the
past years with high morbidity and mortality rates. While vaccination was the cornerstone to control
the pandemic and disease spread, concerns regarding safety and adverse events (AEs) have been
raised lately. A cross-sectional study was conducted between January 1st and January 22nd, 2022, in
six Arabic countries namely Saudi Arabia, Egypt, Syria, Libya, Iraq, and Algeria. We utilized a selfadministered
questionnaire validated in Arabic which encompassed two main parts. The first was
regarding sociodemographic data while the second was about COVID-19 vaccination history, types,
doses, and experienced AEs. A multistage sampling was employed in each country, involving the
random selection of three governorates from each country, followed by the selection of one urban
area and one rural area from each governorate. We included the responses of 1564 participants. The
most common AEs after the first and second doses were local AEs (67.9% and 46.6%, respectively)
followed by bone pain and myalgia (37.6% and 31.8%, respectively). After the third dose, the most
common AEs were local AEs (45.7%) and fever (32.4%). Johnson and Johnson, Sputnik Light, and
Moderna vaccines showed the highest frequency of AEs. Factors associated with AEs after the first
dose included an increase in age (aOR of 61–75 years compared to the 12–18 years group: 2.60, 95%
CI: 1.59–4.25, p = 0.001) and male gender (OR: 0.72, 95% CI: 0.63–0.82, p < 0.001). The cumulative postvaccination
COVID-19 disease was reported with Sinovac (16.1%), Sinopharm (15.8%), and Johnson
and Johnson (14.9) vaccines. History of pre-vaccination SARS-CoV-2 infection significantly increases
the risk of post-vaccination COVID-19 after the first, second, and booster doses (OR: 3.09, CI: 1.9–5.07,
p < 0.0001; OR: 2.56, CI: 1.89–3.47, p < 0.0001; and OR: 2.94, CI: 1.6–5.39, p = 0.0005 respectively).
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