TY - JOUR
T1 - An Analysis of SARS-CoV-2 Vaccine Reactogenicity
T2 - Variation by Type, Dose, and History, Severity, and Recency of Prior SARS-CoV-2 Infection
AU - EPICC COVID-19 Cohort Study Group
AU - Scher, Ann I
AU - Berjohn, Catherine M
AU - Byrne, Celia
AU - Colombo, Rhonda E
AU - Colombo, Christopher J
AU - Edwards, Margaret Sanchez
AU - Ewers, Evan C
AU - Ganesan, Anuradha
AU - Jones, Milissa
AU - Larson, Derek T
AU - Libraty, Daniel
AU - Lindholm, David A
AU - Madar, Cristian S
AU - Maldonado, Carlos J
AU - Maves, Ryan C
AU - Mende, Katrin
AU - Richard, Stephanie A
AU - Rozman, Julia S
AU - Rusiecki, Jennifer
AU - Smith, Alfred
AU - Simons, Mark
AU - Tribble, David
AU - Agan, Brian
AU - Burgess, Timothy H
AU - Pollett, Simon D
N1 - Published by Oxford University Press on behalf of Infectious Diseases Society of America 2022.This work is written by (a) US Government employee(s) and is in the public domain in the US.
PY - 2022/7
Y1 - 2022/7
N2 - BACKGROUND: There is limited information on the functional consequences of coronavirus disease 2019 (COVID-19) vaccine side effects. To support patient counseling and public health messaging, we describe the risk and correlates of COVID-19 vaccine side effects sufficient to prevent work or usual activities and/or lead to medical care ("severe" side effects).METHODS: The EPICC study is a longitudinal cohort study of Military Healthcare System beneficiaries including active duty service members, dependents, and retirees. We studied 2789 adults who were vaccinated between December 2020 and December 2021.RESULTS: Severe side effects were most common with the Ad26.COV2.S (Janssen/Johnson and Johnson) vaccine, followed by mRNA-1273 (Moderna) then BNT162b2 (Pfizer/BioNTech). Severe side effects were more common after the second than first dose (11% vs 4%;
P < .001). First (but not second) dose side effects were more common in those with vs without prior severe acute respiratory syndrome coronavirus 2 infection (9% vs 2%; adjusted odds ratio [aOR], 5.84; 95% CI, 3.8-9.1), particularly if the prior illness was severe or critical (13% vs 2%; aOR, 10.57; 95% CI, 5.5-20.1) or resulted in inpatient care (17% vs 2%; aOR, 19.3; 95% CI, 5.1-72.5). Side effects were more common in women than men but not otherwise related to demographic factors.
CONCLUSIONS: Vaccine side effects sufficient to prevent usual activities were more common after the second than first dose and varied by vaccine type. First dose side effects were more likely in those with a history of COVID-19-particularly if that prior illness was severe or associated with inpatient care. These findings may assist clinicians and patients by providing a real-world evaluation of the likelihood of experiencing impactful postvaccine symptoms.
AB - BACKGROUND: There is limited information on the functional consequences of coronavirus disease 2019 (COVID-19) vaccine side effects. To support patient counseling and public health messaging, we describe the risk and correlates of COVID-19 vaccine side effects sufficient to prevent work or usual activities and/or lead to medical care ("severe" side effects).METHODS: The EPICC study is a longitudinal cohort study of Military Healthcare System beneficiaries including active duty service members, dependents, and retirees. We studied 2789 adults who were vaccinated between December 2020 and December 2021.RESULTS: Severe side effects were most common with the Ad26.COV2.S (Janssen/Johnson and Johnson) vaccine, followed by mRNA-1273 (Moderna) then BNT162b2 (Pfizer/BioNTech). Severe side effects were more common after the second than first dose (11% vs 4%;
P < .001). First (but not second) dose side effects were more common in those with vs without prior severe acute respiratory syndrome coronavirus 2 infection (9% vs 2%; adjusted odds ratio [aOR], 5.84; 95% CI, 3.8-9.1), particularly if the prior illness was severe or critical (13% vs 2%; aOR, 10.57; 95% CI, 5.5-20.1) or resulted in inpatient care (17% vs 2%; aOR, 19.3; 95% CI, 5.1-72.5). Side effects were more common in women than men but not otherwise related to demographic factors.
CONCLUSIONS: Vaccine side effects sufficient to prevent usual activities were more common after the second than first dose and varied by vaccine type. First dose side effects were more likely in those with a history of COVID-19-particularly if that prior illness was severe or associated with inpatient care. These findings may assist clinicians and patients by providing a real-world evaluation of the likelihood of experiencing impactful postvaccine symptoms.
U2 - 10.1093/ofid/ofac314
DO - 10.1093/ofid/ofac314
M3 - Article
C2 - 35899278
SN - 2328-8957
VL - 9
SP - ofac314
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 7
ER -