Symptomology following mRNA vaccination against SARS-CoV-2

Abstract

Despite demonstrated efficacy of vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease-2019 (COVID-19), widespread hesitancy to vaccination persists. Improved knowledge regarding frequency, severity, and duration of vaccine-associated symptoms may help reduce hesitancy. In this prospective observational study, we studied 1032 healthcare workers who received both doses of the Pfizer-BioNTech SARS-CoV-2 mRNA vaccine and completed post-vaccine symptom surveys both after dose 1 and after dose 2. We defined appreciable post-vaccine symptoms as those of at least moderate severity and lasting at least 2 days. We found that symptoms were more frequent following the second vaccine dose than the first (74% vs. 60%, P < 0.001), with >80% of all symptoms resolving within 2 days. The most common symptom was injection site pain, followed by fatigue and malaise. Overall, 20% of participants experienced appreciable symptoms after dose 1 and 30% after dose 2. In multivariable analyses, female sex was associated with greater odds of appreciable symptoms after both dose 1 (OR, 95% CI 1.73, 1.19–2.51) and dose 2 (1.76, 1.28–2.42). Prior COVID-19 was also associated with appreciable symptoms following dose 1, while younger age and history of hypertension were associated with appreciable symptoms after dose 2. We conclude that most post-vaccine symptoms are reportedly mild and last <2 days. Appreciable post-vaccine symptoms are associated with female sex, prior COVID-19, younger age, and hypertension. This information can aid clinicians in advising patients on the safety and expected symptomatology associated with vaccination.

Message in a bottle: mRNA vaccination for influenza

“…The vaccines were well-tolerated and elicited high, long-lasting antibody titres, comparable to existing vaccines. The reported adverse events from that 2019 study, which included injection site pain and swelling, myalgia, and fatigue, are similar to those reported since for coronavirus mRNA vaccines [87].…”

Serological response to vaccination in post-acute sequelae of COVID

“…We examined humoral responses specific only to COVID vaccination, and the extent to which similar findings would be seen following other vaccine or immune challenges is unknown. We had collected postvaccination reactogenicity data for a proportion of study participants [18] but these same data were not available for all participants; thus future work is needed to examine how post-vaccine sequelae may be related to differences in post-vaccine immune responses across PASC and non-PASC phenotypes. Given our focus on humoral immune activation, additional studies are needed to determine whether similar results would be seen for cellular responses including T cell activity.…”

Is the Pandemic Wearing Us Out? A Cross-Sectional Study of the Prevalence of Fatigue in Adult Twins without Previous SARS-CoV-2 Infection

“…Other researchers report that the mRNA-based vaccines are more likely associated with local adverse effects, while viral vector-based vaccines are more likely to cause systemic side effects such as fatigue [ 48 ]. Patients also reported persistent fatigue at 7 days [ 49 , 50 , 51 ], 14 days [ 52 ] and 3 months [ 53 ] after vaccination. Our results are inconsistent with these reports: We found no significant correlation between the occurrence of pandemic-associated fatigue and vaccination status nor between the severity of the different fatigue dimensions and vaccination status.…”