Abstract

Adults receiving heterologous prime-boost COVID-19 immunisation schedules with mRNA (Pfizer-BioNTech) or adenoviral-vector (ChAdOx1-S/nCOV-19) vaccines had higher reactogenicity rates and were more likely to seek medical attention after their second dose than homologous schedules. Reactogenicity rates were generally higher among ≤50 than >50 year-olds and in adults with prior symptomatic or confirmed COVID-19. Adults receiving heterologous schedules because of severe first-dose reactions had lower reactogenicity after the second dose following ChAdOx1-S/Pfizer-BioNTech (93.4%[90.5-98.1] vs. 48%[41.0-57.7]) but not Pfizer-BioNTech/ChAdOx1-S (91.7%[77.5-98.2] vs. 75.0%[57.8-87.9]).

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