Despite a continuing high death toll from COVID-19 - 23,000 so far this year in the USA - only 25% of Americans had the booster last Autumn. This year, so far in the UK under 60% of 75+ age group invited have taken up the offer of a booster.
One of the reasons often cited is that the boosters make you feel rough for a day or two with flu-like symptoms of headache, aches and pains and general malaise, although, speaking from personal experience, I have never had anything like that, and I have had every booster offered. The worst I've had has been a slightly sore arm for a day or two with a little stiffness which is only there when I think about it. However, even the reported adverse reactions pass within a day or two. Now a new study has shown that this is a good sign because it shows the vaccine is working well to produce a high yield of antibodies.
Headache, chills, tiredness may be evidence of a supercharged defense, according to UCSF-led study.
Fewer than 1 in 4 people in the U.S. have received last year’s updated COVID-19 vaccine, despite a death toll of more than 23,000 Americans this year.
One of the most common reasons for bypassing the COVID vaccine is concern about side effects like tiredness, muscle and joint pain, chills, headache, fever, nausea and feeling generally unwell. But a new study, led by UC San Francisco, has found that the symptoms indicate a robust immune response that is likely to lessen the chances of infection.
The study, which appears online June 10 in Annals of Internal Medicine, is based on symptom reports and antibody responses from 363 people, who had the Pfizer-BioNTech or Moderna mRNA vaccines when they were first introduced.
After the second dose of the vaccine, the researchers found that those with seven or more symptoms had nearly double the antibody levels of those who did not have symptoms. The participants were mainly in their forties to sixties and had not had the virus.
About 40% of the people in the study also wore a device to monitor their temperature, breathing and heart rate. The researchers found that those whose skin temperature increased by 1 degree Celsius after the second dose had three times the antibody levels six months later, compared to those whose temperature did not increase.
An absence of side effects does not mean the vaccine is not working
As the virus has evolved and fatality rates have fallen, many people are underestimating its impact.Generally, we found that the higher the number of side effects, the higher the level of antibodies. But this wasn’t a hard rule: some people without side effects had better antibodies than some people with side effects.
Dr Ethan Dutcher, MD, PhD, first author
Department of Psychiatry and Behavioral Sciences
University of California San Francisco, CA, USA.
And the Weill Institute for Neurosciences.The toll of COVID is still high for some – sickness, lost work, lasting fatigue and the dreaded long COVID. While the symptoms from vaccination can be very unpleasant, it’s important to remember that they don’t come close to the disease’s potential complications.
Dr Elissa Epel, PhD, co-senior author
Department of Psychiatry and Behavioral Sciences
University of California San Francisco, CA, USA.The latest recommendations from the Centers for Disease Control and Prevention are that everyone 6 months and older should receive the updated vaccine, and those 65 and older should receive an additional dose.With COVID-19 vaccines likely here to stay, identifying what predicts a strong antibody response will remain important.
Professor Aric Prather, PhD, co-senior author
Department of Psychiatry and Behavioral Sciences
University of California San Francisco, CA, USA.
Co-Authors: Ashley Mason, PhD, and Frederick Hecht, MD, of UCSF; James E. Robinson, MD, of Tulane University; and Stacy Drury, MD, PhD, of Tulane University and Boston Children’s Hospital.
Abstract
Background:
Concern about side effects is a common reason for SARS-CoV-2 vaccine hesitancy.
Objective:
To determine whether short-term side effects of SARS-CoV-2 messenger RNA (mRNA) vaccination are associated with subsequent neutralizing antibody (nAB) response.
Design:
Prospective cohort study.
Setting:
San Francisco Bay Area.
Participants:
Adults who had not been vaccinated against or exposed to SARS-CoV-2, who then received 2 doses of either BNT162b2 or mRNA-1273.
Measurements:
Serum nAB titer at 1 month and 6 months after the second vaccine dose. Daily symptom surveys and objective biometric measurements at each dose.
Results:
363 participants were included in symptom-related analyses (65.6% female; mean age, 52.4 years [SD, 11.9]), and 147 were included in biometric-related analyses (66.0% female; mean age, 58.8 years [SD, 5.3]). Chills, tiredness, feeling unwell, and headache after the second dose were each associated with 1.4 to 1.6 fold higher nAB at 1 and 6 months after vaccination. Symptom count and vaccination-induced change in skin temperature and heart rate were all positively associated with nAB across both follow-up time points. Each 1 °C increase in skin temperature after dose 2 was associated with 1.8 fold higher nAB 1 month later and 3.1 fold higher nAB 6 months later.
Limitations:
The study was conducted in 2021 in people receiving the primary vaccine series, making generalizability to people with prior SARS-CoV-2 vaccination or exposure unclear. Whether the observed associations would also apply for neutralizing activity against non-ancestral SARS-CoV-2 strains is also unknown.
Conclusion:
Convergent self-report and objective biometric findings indicate that short-term systemic side effects of SARS-CoV-2 mRNA vaccination are associated with greater long-lasting nAB responses. This may be relevant in addressing negative attitudes toward vaccine side effects, which are a barrier to vaccine uptake.
Ethan G. Dutcher, Elissa S. Epel, Ashley E. Mason, et al.
COVID-19 Vaccine Side Effects and Long-Term Neutralizing Antibody Response: A Prospective Cohort Study. Ann Intern Med. [Epub 11 June 2024]. doi:10.7326/M23-2956
Copyright: © 2024 The authors.
Published by American College of Physicians. Open access.
Reprinted under a Creative Commons Attribution 4.0 International license (CC BY 4.0)
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