Abstract
Reports have emerged on changes in length and amount of menstrual flow after COVID-19 mRNA vaccination.1 While there is documentation of serum immune marker elevations with COVID-19 infection,2 similar menstrual symptom changes after infection have not been reported. To evaluate this discrepancy in symptoms, we examined differences in menstrual cytokine expression in women who have had COVID-19 and/or mRNA vaccination. Menstrual blood from the first heavy day of menses was collected using a modified menstrual pad with an embedded dried blood sample collection strip. Women 20-40 years old with no gynecologic conditions, use of intrauterine birth control or smoking history, were included. Samples were collected from four groups: 1) controls (COV-/Vax-) who provided samples prior to The Pandemic, 2) vaccinated with no known COVID-19 (Cov-/Vax+), 3) unvaccinated with a history of COVID-19 (Cov+/Vax-), and 4) vaccinated with a history of COVID-19 (Cov+/Vax+). Samples were extracted and run on a H48 plex immune assay and analyzed for cytokine expression. We found notable trends in the expression of nine cytokines when compared to cytokines from control women with no infection or vaccination (table below). Notably, vaccination-only is associated with upregulation of EGF, IL-1ra, Il-2, MDC, and MIP-1b and downregulation of IL-1b and Il-6. Cov+ patients shared similar cytokine profiles whether they received the vaccine or not, with the exception of EGF, IL-6 and VEGF.Tabled 1Differential expression compared to controls (COV-/Vax-)COV-/Vax+COV+/Vax-COV+/Vax+EGF↑↑=↑IL-1b↓↓↓↓↓IL-6↓↑↓MIP-1b↑↑↑↑↑VEGF=↑↑=IL-1ra↑↑↑IL-2↑↑↑MDC↑↑↑↑↑IP-10=↑↑ Open table in a new tab Both COVID-19 infection-only and vaccination-only groups presented with differential cytokine profiles compared to the control (COV-/Vax -) group. The cytokine profile of these two groups showed similar trends in five out of the nine cytokines that were differentially expressed suggesting that the vaccine may be inducing COVID-like immune responses that can be detected in menstrual blood. Increased expression of EGF, a cytokine involved in the regulation of endometrial angiogenesis, in the vaccinated groups may be associated with the transient changes in quality of menstrual flow.
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