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This study has several limitations. First, it is limited by the nature of using EMR-based data, which could potentially lead to misclassified immune dysfunction and comorbid conditions, although we anticipate this misclassification to be nondifferential. Second, SARS-CoV-2 vaccination status was captured in the EMR of large academic medical centers, which may not fully account for vaccinations that occur outside of their hospital settings, such as pharmacies and mass vaccination sites. However, this underreporting is less likely to affect patients with immune dysfunction because they are more likely to receive regular care, and would not alter the comparisons of risk. Third, we did not evaluate the risk for a breakthrough infection among patients with other immune dysfunctions, such as cancer and other rheumatoid diseases, nor did we directly evaluate exposure to immunosuppressant regimens. However, the sensitivity analysis we performed that excluded patients with cancer and other rheumatoid diseases yielded consistent results with the primary analyses.
by Cat on Thu Dec 30th, 2021 at 06:35:11 PM EST
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