TY - JOUR
T1 - Association of Self-reported Systemic Reactions Following SARS-CoV-2 Vaccination With Immunological Response in the Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 Vaccines (ENFORCE)
AU - Bannister, Wendy P.
AU - Raben, Dorthe
AU - Valentiner-Branth, Palle
AU - Tolstrup, Martin
AU - Larsen, Lykke
AU - Tarp, Britta
AU - Iversen, Mette Brouw
AU - Søgaard, Ole Schmeltz
AU - Ostrowski, Sisse Rye
AU - Breinholt Stærke, Nina
AU - Jakobsen, Marie Louise
AU - Olaf Lindvig, Susan
AU - Ruwald Juhl, Maria
AU - Somuncu Johansen, Isik
AU - B. Mustafa, Ahmed
AU - Østergaard, Lars
AU - Dam Larsen, Fredrikke
AU - Knudsen, Lene Surland
AU - Klastrup, Vibeke
AU - Wiese, Lothar
AU - Benfield, Thomas
AU - Toft Petersen, Kristine
AU - Iversen, Kasper K.
AU - Nielsen, Henrik
AU - Reekie, Joanne
AU - Lundgren, Jens
AU - ENFORCE Study Group
A2 - Bodilsen, J.
A2 - Petersen, K. T.
A2 - Thisted, R. K.
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023/6
Y1 - 2023/6
N2 - Background: Side effects to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are a key concern contributing to vaccine hesitancy, but more individuals may be encouraged if SARS-CoV-2 vaccines were known to lead to a stronger immune response. Methods: Included were adult participants from the Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 Vaccines (ENFORCE) who completed a questionnaire to assess systemic reactions following SARS-CoV-2 vaccination (BTN162b2, mRNA-1273, ChAdOx1) and had SARS-CoV-2 spike immunoglobulin G (IgG) levels measured at baseline and post-vaccine. A symptom score was developed to measure severity of systemic adverse reactions (+1 for each moderate, +2 for each severe). Post-vaccination SARS-CoV-2 spike IgG levels were compared between participants with different scores using multivariable linear regression. Results: A total of 6528 participants were included (56.3% females; median age [interquartile range], 64 [54-75] years). After the first vaccination, no association was found between symptom score and post-vaccine dose spike IgG level (P =. 575). Following the second vaccination, significantly higher spike IgG levels were observed according to higher symptom scores (P <. 001); adjusted geometric mean ratios were 1.16 (95% CI, 1.04-1.30), 1.24 (95% CI, 1.09-1.41), 1.25 (95% CI, 1.06-1.46), and 1.21 (95% CI, 1.08-1.35), for scores of 2, 3, 4, and ≥5, respectively, compared with a score of 0. After adjustment for pre-vaccine dose spike IgG, this association was attenuated. Conclusions: An association was found between more severe adverse reactions and stronger antibody response after the second vaccination but not the first, likely attributed to higher levels of preexisting immunity gained from response to first vaccination. Regardless of side effects, most people experienced an effective immune response following vaccination.
AB - Background: Side effects to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are a key concern contributing to vaccine hesitancy, but more individuals may be encouraged if SARS-CoV-2 vaccines were known to lead to a stronger immune response. Methods: Included were adult participants from the Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 Vaccines (ENFORCE) who completed a questionnaire to assess systemic reactions following SARS-CoV-2 vaccination (BTN162b2, mRNA-1273, ChAdOx1) and had SARS-CoV-2 spike immunoglobulin G (IgG) levels measured at baseline and post-vaccine. A symptom score was developed to measure severity of systemic adverse reactions (+1 for each moderate, +2 for each severe). Post-vaccination SARS-CoV-2 spike IgG levels were compared between participants with different scores using multivariable linear regression. Results: A total of 6528 participants were included (56.3% females; median age [interquartile range], 64 [54-75] years). After the first vaccination, no association was found between symptom score and post-vaccine dose spike IgG level (P =. 575). Following the second vaccination, significantly higher spike IgG levels were observed according to higher symptom scores (P <. 001); adjusted geometric mean ratios were 1.16 (95% CI, 1.04-1.30), 1.24 (95% CI, 1.09-1.41), 1.25 (95% CI, 1.06-1.46), and 1.21 (95% CI, 1.08-1.35), for scores of 2, 3, 4, and ≥5, respectively, compared with a score of 0. After adjustment for pre-vaccine dose spike IgG, this association was attenuated. Conclusions: An association was found between more severe adverse reactions and stronger antibody response after the second vaccination but not the first, likely attributed to higher levels of preexisting immunity gained from response to first vaccination. Regardless of side effects, most people experienced an effective immune response following vaccination.
KW - COVID-19 vaccines
KW - SARS-CoV-2
KW - adverse drug reactions
KW - antibody response
UR - http://www.scopus.com/inward/record.url?scp=85164243150&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofad248
DO - 10.1093/ofid/ofad248
M3 - Journal article
C2 - 37351453
SN - 2328-8957
VL - 10
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 6
M1 - ofad248
ER -