Symptomology following mRNA vaccination against SARS-CoV-2

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-associat...

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Published inPreventive 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
LanguageEnglish
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
Online AccessGet full text

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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. •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.
AbstractList 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.
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.
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.
ArticleNumber 106860
Author Luong, Eric
Shane, Rita
Braun, Jonathan G.
Cheng, Susan
White, Shane
Merchant, Akil
Debbas, Philip
Minissian, Margo B.
Hoang, Amy
Nguyen, Nathalie
Nguyen, Trevor-Trung
Figueiredo, Jane C.
Reckamp, Karen L.
Vallejo, Rocío
Arditi, Moshe
Fert-Bober, Justyna
Herrera, Ergueen
Davis, Jennifer
Wong, Melissa
Kim, Linda
Lan, Roy
Miles, Peggy B.
Huynh, Carissa
Hussain, Shehnaz K.
Pozdnyakova, Valeriya
Botting, Patrick
Contreras, Sandra
Melmed, Gil Y.
Van Eyk, Jennifer E.
Coleman, Bernice
Sobhani, Kimia
Aronow, Harriet
Diaz, Jacqueline
Driver, Matthew
Kittleson, Michelle
Rhoades, Kylie
Joung, Sandy
Merin, Noah
Heath, Mallory
Lloyd, John
Liu, Yunxian
Wu, Min
Al-Amili, Daniah
McGovern, Dermot P.B.
Cozen, Wendy
Malladi, Bhavya
Sun, Nancy
Rashid, Mohamad
Raedschelders, Koen
Sternbach, Sarah
Ebinger, Joseph E.
Botwin, Gregory J.
Tompkins, Rose
Beekley, James
Gu, Quanquan
Chavira, Cynthia
Mujukian, Angela
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ISSN 0091-7435
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IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Keywords Vaccine-associated symptoms
SARS-CoV-2
Vaccination
Language English
License This is an open access article under the CC BY-NC-ND license.
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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MergedId FETCHMERGED-LOGICAL-c459t-137fc22115a60e15818a8e336d60eaaddf61b458b9c3d489fd6bc89440aa02623
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ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
Drs. Braun, Cheng, and Minissian share joint correspondence in this work.
Contributed equally to this paper.
OpenAccessLink https://www.sciencedirect.com/science/article/pii/S0091743521004291
PMID 34687733
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  text: 2021-12-01
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Snippet Despite demonstrated efficacy of vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease-2019...
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StartPage 106860
SubjectTerms COVID-19
COVID-19 Vaccines
Female
Humans
RNA, Messenger
SARS-CoV-2
Vaccination
Vaccine-associated symptoms
Title Symptomology following mRNA vaccination against SARS-CoV-2
URI https://dx.doi.org/10.1016/j.ypmed.2021.106860
https://www.ncbi.nlm.nih.gov/pubmed/34687733
https://search.proquest.com/docview/2585359942
https://pubmed.ncbi.nlm.nih.gov/PMC8527734
Volume 153
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