What is the association between self-reported post-vaccination symptoms and anti-SARS-CoV-2 antibody responses?

In a recent study published in JAMA network openresearchers investigated the association between symptoms after coronavirus disease 2019 (COVID-19) vaccination and antibody responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Background

SARS-CoV-2 mRNA vaccines such as Pfizer-BioNTech’s BNT162b2 and Moderna’s mRNA-1273 are associated with systemic and local manifestations. However, it remains unclear whether post-vaccination symptoms are associated with vaccination-induced antibody responses. Previous studies on the immunogenicity and reactogenicity of COVID-19 vaccines were restricted to convenient samples limiting generalizability.

Research and Findings

In this study, investigators evaluated the association between post-vaccination symptoms and antibody responses to SARS-CoV-2 in participants of the Framingham Heart Study (FHS), a cohort of cohorts for COVID-19 research ( C4R). The participant was invited in his February 2021 to complete his C4R questionnaire on SARS-CoV-2 vaccination and associated symptoms.

Subjects also provided dried blood spots (DBS) to test for antibodies to SARS-CoV-2. FHS participants who received two doses of COVID-19 mRNA vaccine two weeks prior to DBS collection were included in the analysis. Post-vaccination symptoms were classified as local or systemic.

Local symptoms included pain and rash at the injection site, and systemic symptoms included fever, nausea, chills, vomiting, muscle pain, headache, and malaise. Anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies were quantified using a microsphere immunoassay. The association between post-vaccination symptoms and antibody responses was assessed using the chi-square test and multivariate linear regression.

Analyzes were adjusted for clinical and sociodemographic characteristics and time from vaccination. Of the over 3200 participants eligible for C4R, 928 completed the questionnaire and collection of his DBS. Of these, 55% received the mRNA-1273 vaccine and 45% received the BNT162b2 vaccine. Participants had an average age of 65 years and were mostly female (61%) and non-Hispanic white (96%).

Eighty-four participants self-reported previous COVID-19 infection. Approximately 48% of participants experienced systemic symptoms, 109 reported local symptoms, and 373 were asymptomatic after either vaccination. Bivariate analysis showed an association between symptoms and female sex, younger age, mRNA-1273 vaccine, and her previous COVID-19 history.

Antibody reactivity was found in 98% of asymptomatic individuals and 99% of participants with systemic or local symptoms. In adjusted models, there was an association between systemic symptoms and greater antibody responses. In the past, when he excluded individuals infected with COVID-19 and repeated the analysis, the results were similar.

Conclusion

In this study, we found that self-reported post-vaccination systemic symptoms were associated with greater anti-SARS-CoV-2 antibody responses. These findings are consistent with reports of U.S. health care workers, who found higher post-vaccination antibody responses among symptomatic people after receiving mRNA vaccines.

The authors identified mRNA-1273 vaccine, age, and gender as factors associated with vaccine immunogenicity and reactogenicity. Comorbidities, BMI, and race/ethnicity were not associated with post-vaccination symptoms. Nearly all participants had positive antibody responses to the doubled dose of mRNA vaccine.

Still, systemic symptoms are associated with greater antibody responses in multivariable models, highlighting inter-individual variability. should be investigated.Altogether, these findings highlight the reconstruction of post-vaccination symptoms as an indicator of vaccine Effectiveness Strengthen guidance on vaccine boosters.