Abstract
Background: The effect of post-vaccination adverse events on immunogenicity is unknown. We aimed to explore relationship between post-vaccination adverse reactions and antibody levels during 6-month follow-up. Methods: Blood was serially drawn from healthcare workers after the second dose of BNT162b2 mRNA vaccine (Day 12, 30, 60, 90, 120, 150, and 180) and anti-SARS-CoV-2 spike IgG (S-IgG) levels were measured. Following each vaccine dose, volunteers completed a questionnaire regarding adverse reactions (symptomatic vs. asymptomatic groups). Results: A total of 395 subjects received the second dose of the vaccine. The main results were as follows: (i) fever after the 2nd dose was independently associated with the median S-IgG level at all follow-up time points; (ii) significantly higher S-IgG levels were observed in the symptomatic group of patients without prior COVID-19 infection throughout the entire follow-up period; (iii) prior COVID-19 positivity resulted in higher S-IgG levels only in the asymptomatic group from Day 90 of the follow-up period; (iv) both prior COVID-19 disease with asymptomatic status and symptomatic status without prior COVID-19 infection resulted in similar S-IgG antibody levels; (v) significantly lower serum S-IgG levels were observed in smokers. Conclusion: Fever may play an important role in the post-vaccination immune response in the long term.
Highlights
According to the WHO database [1], more than 390 million confirmed SARS-CoV-2 infections worldwide since 2019 with more than 5.5 million deaths
Between 10 February and 13 June 2021, a total of 395 people received the second dose of Pfizer-BioNTech vaccine (BNT162b2) and provided informed consent for study enrollment
383 individuals completed the questionnaire on post-vaccination adverse reactions (AR) and gave post-vaccination blood samples at Day 12, 323 at Day 30, 320 at Day 60, 303 at Day 90, 268 at Day 120, 220 at Day 150, and 279 at Day 180
Summary
According to the WHO database [1], more than 390 million confirmed SARS-CoV-2 infections worldwide since 2019 with more than 5.5 million deaths. A two-dose regimen of BNT162b2 and mRNA-1273 were found to be safe and more than 90% effective against COVID-19 [2,3]. Several systemic adverse reactions (AR) were observed during vaccination, mainly after the second dose. The rapid pace of vaccine development and the uncertainty of potential long-term adverse effects raised some level of hesitation against mRNA vaccines in the global community [4]. The main objective of the present study was to elucidate the long-term effect of such ARs on antibody production in healthcare workers with and without prior COVID-19 infection. We aimed to explore relationship between post-vaccination adverse reactions and antibody levels during 6-month follow-up. Methods: Blood was serially drawn from healthcare workers after the second dose of BNT162b2 mRNA vaccine (Day 12, 30, 60, 90, 120, 150, and 180) and anti-SARS-CoV-2 spike IgG (S-IgG) levels were measured. Conclusion: Fever may play an important role in the post-vaccination immune response in the long term
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