Informatics in Medicine Unlocked 49 (2024) 101564

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Informatics in Medicine Unlocked

journal homepage: www.elsevier.com/locate/imu

Evaluation of the effects of MERCK, MODERNA, PFIZER/BioNTech, and

JANSSEN COVID-19 vaccines on vaccinated people: A metadata analysis☆
Nadia Al-Rousan a, * , Hazem Al-Najjar b
a
SEEIT, Computer Engineering Department, German Jordanian University, Amman, Jordan
b
Faculty of Information Systems, University of Petra, Amman, Jordan

A R T I C L E I N F O A B S T R A C T

Keywords: Purpose: This research investigates the impact of four specific vaccines on the health of people who have been
Epidemiology vaccinated. The vaccines under scrutiny are MERCK, MODERNA, PFIZER BioNTech, and JANSSEN.
Symptoms Methods: The analysis considers a range of variables, including symptoms, mortality status, gender, age, number
COVID-19
of vaccine doses, hospitalization status, and the number of days following vaccination. The methodology involves
Vaccination
Data analysis
cross-tabulation analysis to establish connections between vaccinated individuals and the variables under ex-
amination. The dataset was compiled from the Centers for Disease Control and Prevention, encompassing
roughly 65,000 cases and documenting over 40 distinct symptoms.
Results: The overall mortality rate among the vaccinated population is noteworthy. Notably, 40 different mild to
severe symptoms were reported among vaccinated individuals. The research highlights the 10 most common
symptoms experienced after vaccination. Females under 60 years of age constitute the majority of the dataset.
Conclusions: The vaccination-related mortality rate stands at approximately 3 % of those who received the
vaccine, with the majority of cases occurring among individuals under the age of 60, who were not hospitalized
and had received their initial vaccine dose.

1. Introduction people against COVID-19 [6,7]. Vaccinations help the body’s immune
system recognize and fight off COVID-19 [8]. Moreover, vaccines help
Coronavirus disease (COVID-19) broke out in China towards the end the body develop defenses against COVID-19 [8,9]. More than 13 billion
of 2019 and was swiftly disseminated to various nations [1]. By COVID-19 vaccine doses have been administered globally [3,4]. As
December 31, 2019, the recorded count of confirmed cases stood at 27 shown in Fig. 2, 72 % of these cases have received at least one dose of a
[2], and it exponentially increased to more than 775 million cases COVID-19 vaccine, while 66 % have been fully vaccinated against the
globally by the end of May 2024, as shown in Fig. 1 [3]. The number of disease [4].
reported death cases is around 7 million [3,4]. Several companies have competed to develop and assess COVID-19
Several symptoms experienced by COVID-19-infected patients have vaccines in preclinical trials and studies (Table 1) [9]. The procedures
been reported. Flulike symptoms, a high fever, coughing, difficulty followed to develop COVID-19 vaccines can be classified into
breathing, sore throat, fatigue, headaches, muscle aches, and runny RNA-based, DNA-based, inactivated virus, non-replicating viral vector,
noses are common symptoms of COVID-19 [5]. Several symptoms protein subunit, and Virus-like particle (VLP) [10,11]. RNA-based vac-
appeared only in COVID-19 patients, namely, nausea/vomiting, loss of cines (i.e., PFIZER/BioNTech, Moderna, and Curevac) directly deliver a
taste/smell, diarrhea, hair loss, nose bleeds, trouble breathing, tiredness, messenger RNA (mRNA) to the body [12]. This mRNA can encode in-
and bluish face. All these symptoms were reported by the Centers for formation in the body to produce an antigen, which is a protein from a
Disease Control and Prevention (CDC) [3,5]. pathogen [13]. This antigen stimulates the immune system to protect the
Quarantines and vaccinations are the most effective ways to protect body against COVID-19. Meanwhile, DNA-based vaccines (i.e., Cadila

☆
Dr. Nadia and Dr. Hazem specialize in data analysis, artificial intelligence, and smart real-time applications. Dr. Nadia is classified as one of the top 10 women
working in artificial intelligence in the world. She is an assistant professor in the Computer Engineering Department of German Jordanian University, Jordan. Dr.
Hazem is an assistant professor in the Computer Science Department of the University of Petra, Jordan.
* Corresponding author.
E-mail address: [email protected] (N. Al-Rousan).

https://doi.org/10.1016/j.imu.2024.101564
Received 11 June 2024; Received in revised form 26 July 2024; Accepted 26 July 2024
Available online 30 July 2024
2352-9148/© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-
nc-nd/4.0/).
N. Al-Rousan and H. Al-Najjar Informatics in Medicine Unlocked 49 (2024) 101564

Healthcare and Osaka University/Takara Bio) directly inject plasmids the booster doses of these mRNA vaccines predominantly cause transient
containing the antigen-encoding DNA sequence into the appropriate symptoms aligning with existing safety data and providing reassurance
tissues [14]. regarding the lack of serious or unexpected adverse events [23].
One of the most popular procedures for developing vaccines is to Therefore, the United States Food and Drug Administration (FDA) has
inject the body with an inactivated virus (i.e., Sinovac, Sinopharm, collected data on each of the authorized COVID-19 vaccines to continue
Biotech, Chinese Academy of Medical Sciences, and the Research Insti- monitoring the safety of COVID-19 vaccines [22]. According to the CDC
tute for Biological Safety Problems) [12]. In contrast, some vaccines and FDA, several symptoms were recorded globally (i.e., headache,
have been developed by injecting only the antigenic parts of the path- chills, fatigue, nausea, dizziness, injection site reactions, erythema,
ogen (protein subunit) (i.e., Novavax, Anhui Zhifei Longcom Biophar- myalgia, rash, and arthralgia) [13,24]. Some cases of very rare side ef-
maceutical, and Clover Biopharmaceuticals Inc./GSK/Dynavax) [12, fects (i.e., colitis, gout, eye inflammation, and paralysis) have been re-
15]. Some companies used live attenuated viruses derived from ported [25,26].
COVID-19 that had been weakened in the laboratory [14]. The The Pfizer/BioNTech, Moderna, and J&J vaccines were approved for
non-replicating viral vector is another common method used to develop use in the United States [27], and the CDC has highly recommended the
COVID-19 vaccines (i.e., Gamaleya Research Institute, Beijing Institute Pfizer/BioNTech and Moderna vaccines to all other countries [28]. The
of Biotechnology, AstraZeneca, and J&J Pharmaceutical Companies) Pfizer/BioNTech vaccine received full approval from the FDA in August
[15,16]. 2021, and it is marketing name is Comirnaty [29]. Table 2 shows a
Some vaccines were approved and licensed by the CDC (i.e., PFIZER/ comparison between the symptoms of Pfizer/BioNTech, Moderna,
BioNTech, MODERNA, MERCK, AstraZeneca, and J&J) [13,17] due to MERCK, and J&J vaccines.
their level of safety and efficiency in preventing COVID-19 and protec- As shown in the table, the number of doses that should be given for
tion people against it [8,18,19]. Moreover, several studies have shown each vaccine varies from one dose for the J&J vaccine to two doses for
that vaccination could reduce the severity of illnesses caused by the Pfizer/BioNTech, Moderna, and MERCK vaccines [27]. Symptoms’
COVID-19 [18]. locations differed from one vaccine to another. The Pfizer/BioNTech
However, COVID-19 vaccination may cause side effects [20] as the vaccine caused fatigue, headache, chills, and muscle pain, especially
body protects itself against the injected pathogen [21]. Some people after the second dose [30], while Moderna caused fever, muscle aches,
have rare allergic reactions and, thus, do not show any symptoms, and headaches lasting a few days (also especially after the second dose)
whereas some symptoms may continue for a few days or longer in some [31]. The Merck vaccine caused nausea, vomiting, constipation, and
cases [22]. Moreover, several local reactions have been reported (i.e., injection site pain and reactions [32], while the J&J vaccine caused
redness, pain, and swelling at the injection site), and various systemic injection site pain, headache, fatigue, and muscle pain [33]. The per-
reactions have been recorded, such as fever, fatigue, joint pain, and centage of people protected against any infection caused by the vaccines
muscle pain [23]. These results were presented in a study conducted are 95 %, 94.1 %, 84 %, and 66.1 % for Pfizer/BioNTech, Moderna,
among 622 participants aged 17 and older in Italy to assess various side MERCK, and J&J, respectively [34].
effects of Pfizer/BioNTech and Moderna vaccines. This study revealed Some significant side effects were recorded globally. Both Pfizer/
that reactions are generally mild, with moderate and severe reactions BioNTech and Moderna were associated with extremely rare cases of
being less common. The study also revealed an increase in lymphade- anaphylaxis and Bell’s palsy, which is a type of temporary facial paral-
nopathy following the booster in the primary vaccination series while ysis [35]. The J&J vaccine caused blood clots with low platelets and
other reactions like malaise, fatigue, and headache were reported less thrombocytopenia [35,36]. Moreover, several claims ensured that the
frequently. Pfizer/BioNTech, Moderan, and Merck vaccines could integrate them-
However, factors such as prior SARS-CoV-2 infection and seasonal selves into the DNA of the patient and alter it [37]. Therefore, the FDA
influenza vaccination influence the occurrence of adverse events, with has issued a warning about heart inflammation for both the Pfi-
reporting higher frequencies of side effects. These findings suggest that zer/BioNTech and Moderna vaccines, as more than 1000 reports of

Fig. 1. Number of confirmed COVID-19 cases globally [4].

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myocarditis and pericarditis have been reported in both vaccines [38, (PQPA), vaccine lot, vaccine site, and vaccine dose are important vari-
39]. The FDA has also issued a serious warning about an increased risk of ables in the collected data. Moreover, different notes are provided for
developing Guillain-Barre syndrome associated with the J&J and each patient to show the patient-specific updates including death status,
AstraZeneca vaccines, as well as risks associated with receiving the stay in a hospital, and historical data.
Merck vaccine during pregnancy [40–43]. All the variables mentioned above are used to identify the side effects
The main aim of the present study is to confirm the validity of various of various vaccines and the most common symptoms occurring after the
claims about COVID-19 vaccinations by assessing the effects and vaccination process. The data contains 63,727 samples from 11 vaccine
symptoms of the Pfizer/BioNTech, Moderna, MERCK, and J&J vaccines sites in the US. The dataset contains other vaccines that were excluded
on vaccinated people according to their metadata (i.e. sex and age, etc.). from the test. Before the dataset was analyzed, a filtering process was
Crosstabulation analysis was used to connect vaccinated people and the used to remove outliers from the dataset. Statistical analysis and cross-
variables of interest: namely, symptoms, death, sex, age, number of tabulation were used to analyze the vaccine dataset and understand
doses, hospitalization status, and number of days after the vaccination. the effect of each vaccine on various symptoms, patients’ metadata, and
To the best of our knowledge, there is a lack of understanding of the other metrics. Statistical analysis was used to show the complexity of the
relationship between the metadata of the vaccinated people and the dataset and the variation within it. Cross-tabulation was used to study
symptoms that occurred after the vaccination, and no studies have used the relationship between one independent variable and one dependent
crosstabulation analysis to assess these relationships. Given that the variable to determine the movement of the dependent variable based on
investigation into this topic is still new and needs further attention, the the independent variables. The following tests were considered to
present study will aid the current understanding of different developed explore the impacts of the vaccinations on patients’ bodies:
vaccines and help people make decisions about the vaccination
procedure. 1. The common symptoms test: This test determines the symptoms
that are relevant to each patient after vaccination. Only the most
2. Methods common symptoms are selected after all patients are analyzed. The
test is intended to find the most important symptoms of each vaccine
The dataset was collected from the World Health Organization and extract the most effects on the patient’s body. Finally, the test
(WHO) and preprocessed to remove unnecessary data. The preprocess- identifies the noteworthy side effects of each vaccine and the safest
ing method retained only five types of COVID-19 vaccines: MERCK, vaccine based on the symptoms.
MODERNA, PFIZER_BioNTech, J&J, and one produced by an unknown 2. Gender and age test: This test determines which gender and age
manufacturer. For each patient in the dataset, a unique ID was used to group most often received each vaccine.
differentiate between different patients. In addition, each patient was 3. Dearth test: This test determines the death rate associated with each
associated with one or more symptoms (independent variables). The vaccine and identifies the vaccine with the highest death rate.
collected symptoms included age, sex, headache, chills, fatigue, nausea, 4. Death rate and age test: This test determines the death rate based
dizziness, injection site erythema, myalgia, rash, arthralgia, pruritus, on two age categories (60 and older than 60, and younger than 60).
vomiting, hypoaesthesia, lymphadenopathy, urticaria, diarrhea, This test will clarify each vaccine’s benefits to older people.
asthenia, malaise, hyperhidrosis, cough, heart rate increased, tremor, 5. Death rate and on set date: The test shows the death rate using the
blood pressure, tachycardia, musculoskeletal, migraine, anxiety, stiff- first nine days from the date of the vaccine. The test takes zero to nine
ness, syncope, dysgeusia, vision blurred, insomnia, eye pain, naso- days and calculates the death rate among vaccinated people.
pharyngitis, seizure, eye pruritus, Bell’s palsy, dyspepsia, deafness, 6. Death rate and hospital admission: This test shows the relation-
myocardial infarction, colitis, gout, eye infection, and palsy. Moreover, ship between the death rate and hospital admission. The test clarifies
test positive after the vaccination process (test positive) variable, whether hospital treatment decreases the COVID-19 death rate.
incorrect dose administration, poor-quality product administered

Fig. 2. Number of vaccinated COVID-19 cases globally.

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7. Death rate and number of vaccine doses: This test shows the and palsy.
number of doses taken before death to elucidate the effects of the first The most common symptoms in people vaccinated with the J&J
and second doses. vaccine are headache, chills, nausea, fatigue, dizziness, vomiting, rash,
blood pressure, migraine, cough, fainting, and anxiety (40.6 %, 39.8 %,
Overall, the tests are intended to explore the effects of different 19.1 %, 19.0 %, 7.7 %, 5.1 %, 4.8 %, 2.5 %, 2.3 %, 2.0 %, 1.1 %, and 1.0
vaccines on vaccinated people. This study attempts to determine the %, respectively). The most common symptoms in people vaccinated
most appropriate vaccine based on various analytical experiments. with the MERCK vaccine are rash, deafness, and headache (8.3 %, 6.0 %,
and 3.6 %, respectively). Chills, fatigue, dizziness, vomiting, syncope,
3. Results malaise, seizure, tremor, injection site erythema, hypoaesthesia, nausea,
anxiety, insomnia, pruritus, asthenia, and hyperhidrosis were observed
This section explains the analytical experiments that were conducted in 1.2 % of cases.
to study the effects of four COVID-19 vaccines on vaccinated people. The The most common symptoms in people vaccinated with the Moderna
study considers vaccines developed by MERCK, MODERNA, PFI- vaccine were headache, chills, injection site erythema, fatigue, nausea,
ZER_BioNTech, J&J, and an unknown manufacturer. dizziness, rash, myalgia, pruritus, arthralgia, vomiting, urticaria, and
PQPA (17.0 %, 12.9 %, 12.7 %, 12.4 %, 10.0 %, 8.3 %, 7.0 %, 6.2 %, 5.9
4. Dataset statistical analysis %, 4.8 %, 3.8 %, 3.6 %, and 3.4 %, respectively). The most common
symptoms in people vaccinated with the Pfizer/BioNTech vaccine were
The first step in understanding the dataset is to study the statistical headache, chills, fatigue, nausea, dizziness, myalgia, arthralgia, rash,
analysis. For brevity, only the overall analysis for all the vaccines is test positive, pruritus, hypoaesthesia, malaise, lymphadenopathy,
presented. The results in Table 3 show variation in the vaccines’ vomiting, asthenia, and diarrhea (21.4 %, 16.5 %, 15.2 %, 10.9 %, 9.1
symptoms. The top 10 symptoms are headache, chills, fatigue, nausea, %, 7.9 %, 6.0 %, 4.9 %, 4.0 %, 4.0 %, 3.8 %, 3.8 %, 3.7 %, 3.5 %, 3.1 %,
dizziness, injection site, erythema, myalgia, rash, and arthralgia. and 3.1 %, respectively).
Meanwhile, colitis, gout, eye inflammation, and paralysis were rarely Finally, the most common symptoms for the vaccine produced by the
noticed after the vaccination process. One or more symptoms may unknown manufacturer were headache, chills, nausea, fatigue,
appear after vaccination, depending on the vaccinated person and the arthralgia, vomiting, myalgia, rash, and coughing (10.2 %, 9.7 %, 8.0 %,
vaccine. Moreover, many people either exhibited no symptoms or their 7.4 %, 6.3 %, 5.1 %, 4.5 %, 4.0 %, and 3.4 %, respectively). The results
symptoms were not recorded. There were 581 deceased cases after the show that the 10 most common symptoms, when considering all vac-
vaccine across all the vaccines in the dataset, which represents less than cines (from most to least common) are headache, chills, fatigue, nausea,
1 % of all vaccinated people. The percentage of positive test cases (2.12 dizziness, injection site erythema, myalgia, rash, arthralgia, and
%) was low compared to the total number of vaccinated cases. pruritus.
The studied vaccines (J&J, MERCK, MODERNA, PFIZER_BioNTech, The results indicate that not all vaccinated people had symptoms.
and UNKNOWN MANUFACTURER) are shown in Table 4. The total The J&J, Merck, Moderna, Pfizer/BioNTech, and unknown vaccines
numbers of vaccinated people using the studied vaccines are 2964, 84, resulted in no symptoms in 25.9 %, 75.0 %, 34.7 %, 37.2 %, and 59.1 %
33,056, 27,448, and 175, respectively. The analysis showed that Mod- of the vaccinated people, respectively. Furthermore, the results revealed
erna and Pfizer/BioNTech are the dominant vaccines on the list; MERCK that 35 % of all vaccinated people had no symptoms. This indicates that
& CO. INC is rare in the dataset. The results indicate that many people side effects may differ based on human records and history.
experience different mild to severe post-vaccination symptoms from
symptoms based on the vaccine and the vaccinated people. 6. Gender and age test

5. The common symptoms test The analysis of the gender data showed three categories: undefined,
male, and female (Table 6). The percentages of the vaccination process
Vaccinated people need to understand the expected symptoms of for J&J, MERCK, MODERNA, PFIZER_BioNTech, UNKNOWN MANU-
vaccinations so that they can decide how to treat them. In this test, all FACTURER are 0.6 %, 42.9 %, 5.6 %, 2.9 %, and 7.4 % for undefined
the symptoms of the vaccines were compared to find the most important cases; 28.5 %, 27.4 %, 20.8 %, 22.7 %, and 34.1 % for males; and 70.9 %,
symptoms. A cross-tabulation analysis was used to find the relationship 29.8 %, 73.6 %, 74.4 % and 58.5 % for females, respectively. More than
between vaccines and symptoms (Table 5). For brevity, Table 5 only 70 % of the subjects vaccinated with J&J, MODERNA, and PFIZER
shows symptoms that affected more than 1 % of the vaccinated people. BioNTech were female. The overall results indicate that the majority of
The symptoms that are not included are migraine, anxiety, stiffness, the vaccinated people were female.
syncope, dysgeusia, vision blurred, insomnia, eye pain, incorrect dose In addition, the age of the vaccinated varied, and the study divided
administered, nasopharyngitis, seizure, eye pruritus, Bell’s palsy, people based on their age into three groups: younger than 60 years,
dyspepsia, deafness, myocardial infarction, colitis, gout, eye infection, older than 60 years, and unknown (Table 7). The results for the J&J,

Table 1
Types of COVID-19 vaccines.
Vaccine Type

Developed by/ RNA-Based DNA-Based Inactivated Virus Non-Replicating Viral Vector Protein Subunit
researcher BioNTech/Fosun Cadila Healthcare Sinovac Gamaleya Research Institute/ Novavax
Pharma/Pfizer Ltd. Health Ministry Russia
Moderna/NIAID Osaka University/ Beijing Institute of Biological CanSino Biological Inc./Beijing Anhui Zhifei Longcom
AnGes/Takara Bio Products/Sinopharm Institute of Biotechnology Biopharmaceutical
Curevac Wuhan Institute of Biological University of Oxford/ Clover Biopharmaceuticals
Products/Sinopharm AstraZeneca Inc./GSK/Dynavax
Bharat Biotech J&J Pharmaceutical Companies
Chinese Academy of Medical
Sciences
Research Institute for Biological
Safety Problems, Rep. of Kazakhstan

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Table 2
Comparison of the Side Effects of the Pfizer/BioNTech, Moderna, MERCK, and J&J vaccines.
Vaccine developer Pfizer/BioNTech Moderna MERCK J&J

Number of Doses Two doses, three weeks apart Two doses, 4 weeks apart Two doses, 2–4 weeks One dose
apart
Symptoms after Fatigue, headache, chills, and muscle Fever, muscle aches, headaches lasting Nausea, vomiting, and Pain at the injection site, headache,
vaccination pain, especially after the second dose a few days. Effects are worse after the constipation. Injection site fatigue, and muscle pain.
second dose. pain and injection site
reactions.
Warnings The FDA issued a warning about heart The FDA issued a warning about heart The FDA issued a warning The FDA issued a warning about an
inflammation. Since April 2021, there inflammation. Since April 2021, there about risks during increased risk of developing
have been more than 1000 reports of have been more than 1000 reports of pregnancy. Guillain-Barre syndrome and
myocarditis and pericarditis. myocarditis and pericarditis. thrombocytopenia
Percentage of people 95 % 94.1 % 84 % 66.1 % globally; 72 % in the U.S.;
protected from 86 % effective against severe disease
getting infected in
clinical studies
Significant side effects Extremely rare cases of anaphylaxis Extremely rare cases of anaphylaxis The drug could integrate Blood clots with low platelets may
and Bell’s palsy, a type of temporary and Bell’s palsy, a type of temporary itself into patients’ DNA occur.
facial paralysis. facial paralysis. and alter it.

indicated that the percentage of vaccinated people younger than 60

Table 3
years is very high compared to those older than 60 years.
Symptoms and data analysis for the collected dataset.
Symptom Sum Symptom Sum Symptom Sum 7. Death rate test
Headache 11,577 Malaise 1702 Vision blurred 337
Chills 8865 Hyperhidrosis 1417 Insomnia 324 After the vaccination process, the medical protocol requires vacci-
Fatigue 8349 Test positive 1354 Eye pain 200
nated people to remain in the vaccinated area for a few minutes so that
Nausea 6340 Cough 1296 Incorrect dose 198
administered can receive assistance in case of an emergency. The current protocol
Dizziness 5252 PQPA 1136 Nasopharyngitis 179 attempts to record the status of vaccinated persons only at the vacci-
Injection site 4710 Heart rate 1129 Seizure 167 nation site without looking at their condition afterward. Unfortunately,
Erythema increased many cases were recorded as deceased after the vaccination process.
Myalgia 4234 Tremor 912 Eye pruritus 142
In the death rate test, the effect of vaccines on the death of vacci-
Rash 3689 Blood pressure 875 Bell’s palsy 131
Arthralgia 3265 Tachycardia 859 Dyspepsia 98 nated people was studied to determine the relationship between the
Pruritus 3078 Musculoskeletal 630 Deafness 80 vaccine received and other metadata of vaccinated people (i.e., age and
Vomiting 2258 Death 581 Myocardial 42 gender). Table 8 shows the percentages of deaths for different vaccines.
infarction
The results show that the death rates for J&J, MERCK, MODERNA,
Hypoaesthesia 1985 Migraine 580 Colitis 12
Lymphad- 1982 Anxiety 558 Gout 8
PFIZER_BioNTech, and UNKNOWN MANUFACTURER are 0.3 %, 6.0 %,
enopathy 2.8 %, 3.1 %, and 21.0 %, respectively. The results indicate that the J&J
Urticaria 1977 Stiffness 509 Eye infection 5 vaccine had the lowest death rate, whereas the unknown manufacturer’s
Diarrhea 1758 Syncope 466 Palsy 3 vaccine had the largest death rate. MERCK showed a higher death rate
Asthenia 1719 Dysgeusia 398
than the MODERNA and PFIZER_BioNTech vaccines. The overall results
show that the overall death rate for all the vaccines is less than 3 %.
In addition, the death rate is correlated with the age of the vacci-
Table 4 nated people. Therefore, the study divided people into three groups
The studied vaccine types. based on their age: younger than 60 years, older than 60 years, and
Vaccine Type Frequency Percent Valid Cumulative unknown (Table 9). The death rate ranges for those older than 60,
Percent Percent younger than 60, and of an unknown age are 14–31 %, 13%–77 %, and
J&J 2964 4.7 4.7 4.7 1%–32 %, respectively.
MERCK 84 0.1 0.1 4.8 The unknown vaccine was associated with the highest percentage
MODERNA 33,056 51.9 51.9 56.7
(31 %) of death cases for people older than 60 years, whereas MERCK
PFIZER_BioNTech 27,448 43.1 43.1 99.7
UNKNOWN 175 0.3 0.3 100.0
showed the lowest percentage (13 %). For patients younger than 60
MANUFACTURER years, J&J was associated with the highest percentage of death cases
Total 63,727 100.0 100.0 (77 %), whereas MERCK showed the lowest percentage (13 %). MOD-
ERNA and PFIZER_BioNTech were associated with a very high per-
centage of deaths (i.e., 66 %) for people younger than 60 years. For the
MERCK & CO. INC, MODERNA and PFIZER_BioNTech vaccines show
unknown age category, MERCK and J&J were associated with the
that no more than 25 % of vaccinated people are over 60 years old, as the
highest (73 %) and the lowest (1 %) percentages of deaths, respectively.
percentage of people under 60 years of age differs from the same vac-
For MODERNA, PFIZER_BioNTech, and unknown vaccines, the death
cines. The proportions of people under 60 years of age who received the
rates were 8 %, 11 %, and 32 %, respectively.
J&J, MERCK, MODERNA, and PFIZER_BioNTech vaccines are 76 %, 11
The overall results show that the death rate for vaccinated people
%, 65 %, and 64 %, respectively. Less than 11 % of the people who
younger than 60 years is very high compared with those older than 60
received each vaccine were of an unknown age, except for the MERCK
years (97.4 % of the total number of deaths), whereas unknown vaccines
vaccine (72.6 %). The unknown vaccine results show that the percent-
showed a death rate below 0.2 %. The results indicate that people under
ages for people older than 60, younger than 60, and of an unknown age
the age of 60 who are vaccinated have a higher risk of death than people
are 39 %, 32 %, and 29 %, respectively. The overall results show that the
over the age of 60.
percentages of people younger than 60 years, older than 60 years, and of
After the vaccination process, people who have been vaccinated may
an undefined age are 26 %, 65 %, and 8.9 %, respectively. The results

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Table 5
The most common symptoms observed after COVID-19 vaccination.
Symptoms JANSSEN MERCK & CO. INC. MODERNA PFIZER_BioNTech UNKNOWN MANUFACTURER Total

Headache 40.6 % 3.6 % 17.0 % 21.4 % 10.2 % 20.1 %

Chills 39.8 % 2.4 % 12.9 % 16.5 % 9.7 % 15.8 %
Fatigue 19.0 % 2.4 % 12.4 % 15.2 % 7.4 % 13.9 %
Nausea 19.1 % 1.2 % 10.0 % 10.9 % 8.0 % 10.8 %
Dizziness 7.7 % 2.4 % 8.3 % 9.1 % 2.3 % 8.5 %
Injection Site erythema 0.0 % 2.4 % 12.7 % 1.8 % 1.1 % 7.3 %
Myalgia 0.3 % 0.0 % 6.2 % 7.9 % 4.5 % 6.6 %
Rash 4.8 % 8.3 % 7.0 % 4.9 % 4.0 % 6.0 %
Arthralgia 0.0 % 0.0 % 4.8 % 6.0 % 6.3 % 5.1 %
Pruritus 0.0 % 1.2 % 5.9 % 4.0 % 2.8 % 4.8 %
Vomiting 5.1 % 2.4 % 3.8 % 3.5 % 5.1 % 3.8 %
Hypoesthesia 0.0 % 2.4 % 2.8 % 3.8 % 1.7 % 3.1 %
Lymphadenopathy 0.0 % 0.0 % 2.8 % 3.7 % 2.3 % 3.1 %
Urticaria 0.2 % 0.0 % 3.6 % 2.9 % 1.1 % 3.1 %
DIED 0.3 % 6.0 % 2.8 % 3.1 % 21.0 % 2.9 %
Diarrhea 0.0 % 0.0 % 2.7 % 3.1 % 2.3 % 2.7 %
Asthenia 0.0 % 1.2 % 2.6 % 3.1 % 1.7 % 2.7 %
Malaise 0.9 % 2.4 % 2.0 % 3.8 % 2.3 % 2.7 %
Hyperhidrosis 0.0 % 1.2 % 2.2 % 2.5 % 1.7 % 2.2 %
Test positive 0.0 % 0.0 % 0.7 % 4.0 % 0.6 % 2.1 %
Cough 2.0 % 0.0 % 1.8 % 2.5 % 3.4 % 2.1 %
PQPA 0.0 % 0.0 % 3.4 % 0.0 % 0.0 % 1.8 %
Heart rate increased 0.0 % 0.0 % 1.7 % 2.1 % 1.8 %
Tremor 2.5 % 0.0 % 1.2 % 1.7 % 1.7 % 1.5 %
Blood pressure 0.4 % 2.4 % 1.4 % 1.6 % 1.1 % 1.4 %
Tachycardia 0.6 % 0.0 % 1.2 % 1.7 % 0.0 % 1.4 %
Musculoskeletal 2.3 % 0.0 % 0.9 % 1.0 % 0.6 % 1.0 %

Table 6
The genders of vaccinated people who received different vaccines.
JANSSEN MERCK & CO. INC. MODERNA PFIZER_BioNTech UNKNOWN MANUFACTURER Total

Undefined 0.60 % 42.90 % 5.60 % 2.90 % 7.40 % 4.20 %

Male 28.5 % 27.4 % 20.8 % 22.7 % 34.1 % 22.1 %
Female 70.9 % 29.8 % 73.6 % 74.4 % 58.5 % 73.7 %

Table 7
Number of Vaccinated People Older than and Younger than 60 years.
JANSSEN MERCK & CO. INC. MODERNA PFIZER_BioNTech UNKNOWN MANUFACTURER Overall

Older than 60 23 % 17 % 28 % 25 % 39 % 26 %
younger than 60 76 % 11 % 65 % 64 % 32 % 65 %
Unkown 1% 73 % 8% 11 % 29 % 8.9 %

Table 8
Death rate of people who received different vaccines.
Vaccine JANSSEN MERCK & CO. INC. MODERNA PFIZER_BioNTech UNKNOWN MANUFACTURER Overall

Death Rate 0.30 % 6.00 % 2.80 % 3.10 % 21.0 % 2.90 %

Table 9
Death rates of vaccinated people based on age.
JANSSEN MERCK & CO. INC. MODERNA PFIZER_BioNTech Unknown Overall

Older than 60 22 % 14 % 26 % 23 % 31 % 2.4 %

Younger than 60 77 % 13 % 66 % 66 % 37 % 97.4 %
Unknown 1% 73 % 8% 11 % 32 % 0.2 %

or may not have some symptoms, while other people may die on the the remaining cases occurring nine days after vaccination. For the
same day as the vaccination or several days later. This study focused on MODERNA, PFIZER_BioNTech, and UNKNOWN MANUFACTURER
the first nine days after the vaccination to identify the most critical vaccines, the majority of deaths (71 %, 66 %, and 54 %, respectively)
period. For the J&J vaccine, the majority of deaths occurred one day occurred between zero and nine days. Finally, 80 % of deaths occurred
after the vaccination process, and the death rate was 55.6 %. The rest of between zero and nine days from the date of vaccination. As shown in
the deaths occurred between two and six days after vaccination. For the Table 10, the majority of deaths for all the vaccines occurred nine days
MERCK vaccine, only 20 % of deaths occurred after the first day, with after the vaccination, which can encourage vaccinated people to follow

6
N. Al-Rousan and H. Al-Najjar Informatics in Medicine Unlocked 49 (2024) 101564

Table 10
The relationship between death cases and number of days after vaccination.
Vaccination NUMDAYS

0 1 2 3 4 5 6 7 8 9

JANSSEN % DIED 0% 55.6 % 0% 22.2 % 11.1 % 0% 11.1 % 0% 0% 0%

MERCK & CO. INC. % DIED 0% 20.0 %% 0% 0% 0% 0% 0% 0% 0% 0%
MODERNA % DIED 15.0 %% 21.7 % 9.9 % 5.70 % 4.20 % 4.10 % 1.90 % 4.30 % 1.50 % 2.90 %
PFIZER_BioNTech % DIED 15.9 % 17.0 %% 7.80 % 6.00 % 5.70 % 3.50 % 3.10 % 2.60 % 2.30 % 2.40 %
UNKNOWN MANUFACTURER % DIED 13.5 % 16.2 % 13.5 % 5.40 % 2.70 % 0% 0% 0% 2.70 % 0%

up at this time.
Table 12
Hospitalization is an important factor in understanding the severity
The relationship between death cases and the number of vaccine doses.
of the condition of vaccinated people after the vaccination process. The
results show that the death rates among subjects vaccinated with J&J, VAX_DOSE_SERIES

MERCK, MODERNA, PFIZER_BioNTech, UNKNOWN MANUFACTURER 1 2 UNK

vaccines are 4.3 %, 0 %, 6 %, 7 %, and 12 %, respectively (Table 11). For JANSSEN 77.8 % 0% 22.20 %
unvaccinated people, these percentages are 96 %, 100 %, 94 %, 93 %, MERCK & CO. INC. 0.00 % 0.00 % 100.00 %
and 88 %, respectively. The results show that the majority of deaths MODERNA 74.8 % 11.2 % 14.0 %
among vaccinated individuals occurred without prior hospitalization. PFIZER_BioNTech 53.7 % 31.3 % 15.0 %
UNKNOWN MANUFACTURER 24.3 % 13.5 % 62.2 %
This finding indicates that these vaccinated people did not present se-
vere symptoms or complications that necessitated hospital admission.
This suggests that the progression to a fatal outcome was rapid or that after the first or second dose. The results indicated that the majority of
the symptoms were not recognized as severe enough to warrant imme- deaths occurred after the first dose. In addition, minor deaths cases
diate medical intervention. This highlights a potential gap in the early needed to be admitted to the hospital, and the majority of them died
detection and management of adverse reactions in vaccinated people, without being hospitalized. Those who died because of the vaccine were
underscoring the need for post-vaccination monitoring in addition to younger than 60 years old, which indicates that younger people are at
medical responses to symptoms that may initially appear mild but could risk because of the vaccine. Moreover, the results show that the first
escalate quickly. three days after the vaccination are very important in determining the
The World Health Organization has suggested that one dose is not status of vaccinated people.
enough to protect against COVID-19. This test examines the death rate Recent findings also extend to pediatric populations, among which
by considering the number of doses (Table 12). This test aims to deter- vaccination strategies have been pivotal in safeguarding children and
mine the effect of the number of doses on the death rate. For the J&J and adolescents against COVID-19. Emerging data shows varying immune
MODERNA vaccines, the death rates were very high after the first dose responses and potential side effects among younger age groups, neces-
(about 78 % and 75 % respectively). Moreover, the other vaccines were sitating tailored vaccination approaches. While adverse effects are rare,
associated with lower death rates with both the second and unknown ongoing surveillance is crucial to comprehensively evaluate the long-
doses (22 % and 23 %, respectively). For the PFIZER_BioNTech vaccine, term safety and efficacy of pediatric vaccination campaigns [44].
the death rates after the first, second, and unknown doses are 54 %, 32 Incorporating these pediatric insights enhances the general under-
%, and 15 %, respectively. The unknown vaccine presented a different standing of vaccine impacts across diverse demographics, reinforcing
pattern than PFIZER_BioNTech, with death rates of 24 %, 14 %, and 62 the need for continued vigilance and research to optimize COVID-19
%, respectively. Meanwhile, no information about the number of vaccination strategies globally.
MERCK doses was provided. Finally, for the J&J, MODERNA, and PFI-
ZER_BioNTech vaccines, the death rate is higher than 50 % after the first 9. Conclusion
dose; the percentage becomes lower after subsequent doses.
This research explored the effect of five different COVID-19 vaccines
8. Discussion on vaccinated people. The five vaccines include J&J, MERCK, MOD-
ERNA, PFIZER_BioNTech, and UNKNOWN MANUFACTURER. Various
The COVID-19 pandemic has spread across the globe, causing dam- analyses were conducted on the collected data to uncover the relation-
age to various sectors. To stop the spread and fight the virus, the World ship between vaccinated people (as well as their age and gender) and the
Health Organization has proposed the use of different vaccines after the most common symptoms. The results revealed that headache, chills, and
required permissions have been obtained. A preliminary analysis of fatigue were the most common symptoms reported across all vaccines.
COVID-19 symptoms, gender, and age showed variance among vacci- The majority of vaccinated people were females under 60 years old.
nated people. The majority of vaccinated people showed different Moreover, various tests were conducted to determine the incidence
symptoms, and the majority of vaccinated subjects were females under of death. Deaths were analyzed using five variables to comprehend the
60 years of age. The three most common symptoms were headache, vaccine’s effect on the human body. The findings show that the total
chill, and fatigue. Moreover, many people took different numbers of death rate was less than 3 % among all vaccinated individuals, most of
doses. whom were not hospitalized and were under 60 years old. Furthermore,
After the vaccination process, vaccinated people suffered from the analysis revealed that the death rate was higher after the first dose
different side effects, and less than 3 % of the vaccinated people died than after the second dose, with the majority of cases occurring within

Table 11
The relationship between death cases and hospitalization.
JANSSEN MERCK & CO. INC. MODERNA PFIZER_BioNTech UNKNOWN MANUFACTURER

Admitted 4.3 % 0% 6% 7% 12 %
Not Admitted 96 % 100 % 94 % 93 % 88 %

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N. Al-Rousan and H. Al-Najjar Informatics in Medicine Unlocked 49 (2024) 101564

three days after vaccination. The results provide evidence that some Acknowledgment
vaccines are safer than others. Additionally, individuals under 60 years
of age had a higher probability of death than those over 60. This in- All authors equally contributed to this research.
formation is crucial in encouraging younger populations not to under-
estimate the severity of the COVID-19 virus’s side effects. Abbreviations
Future research will employ machine-learning models to better
explain the impact of the studied variables on recovery and death rates. J&J Johnson & Johnson
These models could identify patterns and predict outcomes, thereby CDC Centers for Disease Control and Prevention
contributing to vaccination strategies and health interventions. FDA Food and Drug Administration
mRNA messenger RNA
Ethical Statement WHO World Health Organization
PQPA poor-quality product administered
1) This material is the authors’ own original work, which has not been
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