Symptomology following mRNA vaccination against SARS-CoV-2

• Published in: Preventive medicine Vol. 153; p. 106860
• Main Authors: Ebinger, Joseph E., Lan, Roy, Sun, Nancy, Wu, Min, Joung, Sandy, Botwin, Gregory J., Botting, Patrick, Al-Amili, Daniah, Aronow, Harriet, Beekley, James, Coleman, Bernice, Contreras, Sandra, Cozen, Wendy, Davis, Jennifer, Debbas, Philip, Diaz, Jacqueline, Driver, Matthew, Fert-Bober, Justyna, Gu, Quanquan, Heath, Mallory, Herrera, Ergueen, Hoang, Amy, Hussain, Shehnaz K., Huynh, Carissa, Kim, Linda, Kittleson, Michelle, Liu, Yunxian, Lloyd, John, Luong, Eric, Malladi, Bhavya, Merchant, Akil, Merin, Noah, Mujukian, Angela, Nguyen, Nathalie, Nguyen, Trevor-Trung, Pozdnyakova, Valeriya, Rashid, Mohamad, Raedschelders, Koen, Reckamp, Karen L., Rhoades, Kylie, Sternbach, Sarah, Vallejo, Rocío, White, Shane, Tompkins, Rose, Wong, Melissa, Arditi, Moshe, Figueiredo, Jane C., Van Eyk, Jennifer E., Miles, Peggy B., Chavira, Cynthia, Shane, Rita, Sobhani, Kimia, Melmed, Gil Y., McGovern, Dermot P.B., Braun, Jonathan G., Cheng, Susan, Minissian, Margo B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2021; The Authors. Published by Elsevier Inc
• Subjects: COVID-19; COVID-19 Vaccines; Female; Humans; RNA, Messenger; SARS-CoV-2; Vaccination; Vaccine-associated symptoms; Vaccine-associated symptoms; SARS-CoV-2; Vaccination
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2021.106860

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. •Female sex was associated with a >70% increased odds of substantial symptoms following each vaccine dose.•Prior SARS-CoV-2 infection was associated with a doubling of the odds of symptoms following dose 1.•Younger age and a history of hypertension were also associated with increased odds of substantial symptoms following dose 2.