Lack of symptoms after COVID-19 mRNA vaccination does not mean that the vaccine does not work

A study conducted by researchers in Maryland, USA, found symptoms that occur after vaccination against coronavirus disease (COVID-19) in 2019 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

An analysis of a team of 206 adults vaccinated with the Pfizer-BioNTech BNT162b2 showed a correlation between the severity score of vaccine-related symptoms and the magnitude of the vaccine-induced antibody response to SARS-CoV-2. I couldn’t see it.

Bethesda’s Uniformed Services Uniformed Services Universities of Health Sciences, Silver Spring Naval Medical Research Center, Frederick National Cancer Institute researchers frequently mention the presence of post-immunity symptoms in some media and medical professionals As a sign that the COVID-19 vaccine is “working”.

This falsely means that the lack of symptoms means that the vaccine has not elicited a proper antibody response.

However, Edward Mitre et al. State that current research results suggest that asymptomatic individuals can rest assured that this does not mean that the vaccine “did not work.”

The team also reports that symptoms were inversely correlated with age and weight, were more common among women, and occurred more frequently after the second vaccination.

The preprinted version of the research paper is medRxiv* Servers and articles have been peer reviewed.

Study: Side effects and antibody titers in response to the BNT162b2 mRNA COVID-19 vaccine in a prospective healthcare professional study. Image credit: NIAID

The relationship between post-vaccination symptoms and antibody response is unknown

Mass deployment of vaccines to prevent SARS-CoV-2 infection is currently the most promising approach to controlling the COVID-19 pandemic.

One feature common to both the Pfizer-BioNTech BNT162b2 and Modern RNA-1273 vaccines is a high level of immunogenicity. The majority of participants in the Phase 1 to Phase 3 studies reported both local and systemic responses.

Coggins and his team say it’s commonplace for media and medical professionals to state that the onset of symptoms indicates that the vaccine is “working.”

“This statement is basically true because the vaccine” acts “by inducing an inflammatory response, but the lack of post-vaccination symptoms may indicate a lack of an appropriate antiviral antibody response. It also falsely suggests that, “the researchers say.

“In particular, there are few data showing a correlation between vaccine-induced symptoms and antibody titers on vaccine platforms,” ​​they add.

What was included in the current study?

The team found that the side effects induced by the first and second doses of the Pfizer-BioNTech BNT162b2 vaccine were the magnitude of the anti-SARS-CoV-2 antibody response of participants enrolled in the prospective assessment of the SARS-CoV-2 study. Evaluated whether it is related to (pass).

PASS is an observational longitudinal cohort study of healthcare professionals initiated in August 2020 to assess clinical and immunological responses to SARS-CoV-2 infection and vaccination.

Participants completed a vaccine-related symptomatology questionnaire one month after receiving each vaccination.In addition, immunoglobulin G (IgG) antibody against SARS-CoV-2 Spike protein Spike receptor binding domain (RBD) was measured using a microsphere-based multiplex immunoassay.

Peplomers mediate the early stages of the infectious process when their RBD binds to the host cell receptor angiotensin converting enzyme 2 (ACE2). This spike RBD is the primary target for antibodies after SARS-CoV-2 infection or vaccination.

The severity of symptoms after the first vaccination of BNT162b2 correlates with the severity of symptoms after the second vaccination. (A) Total symptom severity score (range 0-48), (B) Symptom duration, (C) Systemic symptom severity score (range 0-32), and (D) Local symptom severity score (range 0) ~ 12) First (orange) and second (blue) vaccinations. (E) Correlation of symptom scores of vaccination 1 and vaccination 2. (F) Classified as low (≤10, turquoise) or high (> 10, red) total symptom score after vaccination showing symptom scores of 0-2, 3-4, 5-7, 8-10 Percentage of subjects who were vaccinated, or> 10 2 after vaccination (N = 206, **** = p <0.0001, NS = not significant in all panels, Wilcoxon signed rank test for panel AD and Spearman correlation for panel E Significance assessed by analysis. Represents the mean and standard deviation of Bar Panel AD).

What did the study find?

Vaccine-related symptom severity scores and vaccine-induced IgG titers among 206 of the 271 PASS participants (median 41.5 years) who were serum negative for SARS-CoV-2 prior to vaccination. Correlation is the first or second vaccination.

Individuals with high or low symptom scores had similar levels of both spike-specific and RBD-specific IgG antibodies.

Coggins and colleagues state that this lack of correlation was maintained even after adjusting for age, weight, and gender.

“The lack of post-vaccination symptoms after BNT162b2 vaccination is not the same as the lack of vaccine-induced antibodies one month after vaccination,” the team wrote.

High symptom scores were more common among women

Researchers also found that high post-vaccination symptom scores were more common among women and were inversely associated with age and weight.

“Young age, female gender, and weight loss were all associated with higher symptom scores,” they write.

Coggins and the team point out that women evaluated in a large UK-based study also showed more symptoms than men after BNT162b2 vaccination.

“The determination of whether women and / or underweight individuals have larger BNT162b2-related adverse events may be informed by additional cohort studies,” they suggest.

The study found that the mean symptom score reported after the second vaccination was significantly higher than that of the first vaccination, 10.6 vs. 7.3.

In addition, there was a positive correlation between the symptom scores after the first and second vaccinations.

Individuals with a high symptom score after the first dose were almost twice as likely to have substantial symptoms after the second dose as individuals with a low symptom score after the first dose.

What did the author conclude?

Researchers say the study shows that the BNT162b2 vaccine is generally associated with the development of symptoms.

However, “symptoms increase after the second vaccination, are common in young people, and do not correlate with vaccine-induced antiviral IgG titers,” they write.

“These findings suggest that patients receiving the BNT162b2 vaccine need to be reassured that lack of symptoms is not necessarily equivalent to the lack of desired vaccine function,” the team concludes. I will.

*Important Notices

medRxiv Publish preliminary scientific reports that should not be considered definitive as they are not peer-reviewed, guide clinical practice / health-related behaviors, and should not be treated as established information.