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Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.

Abstract

INTRODUCTION: Whether BNT162b2 (Pfizer-BioNTech) vaccination increases stroke risk remains a public health concern. This is the first meta-analysis to synthesize self-controlled case series (SCCS)-derived stroke risk estimates specifically for BNT162b2 vaccination. METHODS: PubMed and Embase were searched from inception through 9 May 2026, following PRISMA 2020 guidelines. Eight eligible SCCS studies were pooled using a random-effects model with restricted maximum likelihood (REML) estimation and the Knapp-Hartung adjustment. RESULTS: Eight studies across six countries encompassing several million vaccinated individuals were included. The pooled incidence rate ratio (IRR) was 0.967 (95% CI 0.892-1.049; I2 = 69.2%), indicating no statistically significant increase in stroke risk. Subgroup analyses showed no evidence of effect modification across continent, risk-window length, dose category, SCCS variant, or age group. CONCLUSIONS: These findings provide no evidence of increased short-term stroke risk following BNT162b2 vaccination at the population level. The observed heterogeneity appeared to be partly driven by methodological differences rather than true biological variation in vaccine effect.

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Seol Jang, Sung-Inn Pyo, Eun Jin Kim, Woojoo Lee, Soon-Sun Kwon. 2026-08-27. Stroke risk following BNT162b2 vaccination: a systematic review and meta-analysis of self-controlled case series studies.. https://doi.org/10.1080/14760584.2026.2720955

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