The association between adverse reactions and immune response against SARS-CoV-2 spike protein after vaccination with BNT162b2 among healthcare workers in a single healthcare system: a prospective observational cohort study

Abstract

Adverse reactions after vaccination with COVID-19 mRNA vaccines are common; however, the association between adverse reactions and humoral responses is uncertain. To determine whether humoral immune responses after BNT162b2 vaccine administration were associated with local and systemic adverse reactions, we conducted a prospective observational cohort study in a single tertiary referral center. Healthcare workers who received the first dose of BNT162b2 vaccine were recruited. SARS-CoV-2 anti-spike IgG antibody titers were measured three weeks after the second dose and information about adverse reactions after vaccination was collected. Among the 887 participants, 641 (72.3%) were women. The median age was 38 (range, 22–74) years. All but one showed anti-spike IgG levels well above the cutoff, with a median level of 13,600 arbitrary units/mL. Overall, 800 (92.2%) participants reported some reactions after the first dose and 822 (96.3%) after the second dose. Significantly more participants reported systemic reactions after the second dose than after the first dose (P < .01), and 625 (73.6%) reported that reactions were stronger after the second dose. Factors positively associated with elevation of anti-spike IgG levels were history of asthma (24% higher if present, P = .01) and stronger reactions after the second dose (19% higher if experienced, P = .02). The majority of participants showed good humoral responses and reported some adverse reactions after vaccination. Anti-spike IgG levels were significantly higher if adverse reactions after the second dose were stronger than those after the first dose. These findings may help inform current and future vaccine recipients.

Incidence of COVID-19 Vaccination-Related Uveitis and Effects of Booster Dose in a Tertiary Uveitis Referral Center

“…Two patients had more than on COVID-19 related uveitis events (Patient #3 after the second dose; and Patient #1 after the third booster dose). The precise mechanisms for higher reactogenicity after the second or subsequent doses of Covid-19 mRNA vaccine are still unclear, but several studies have shown that systemic adverse reactions after the second dose are associated with higher levels of anti-spike IgG protein in the serum post-vaccination (41)(42)(43)(44). This higher levels of anti-spike IgG protein has been reported to correlate with increased naïve and transitional B cells and activated CD8+ T cells (45).…”

Inhaled corticosteroids do not affect the antibody titer against the SARS-CoV-2 spike protein in BNT162b2 mRNA vaccinated patients

“…The antibody titers of ICSs can be affected by age, sex, and smoking. Jubishi et al reported that self-reported asthma was correlated with elevated anti-Spike IgG levels [ 11 ]. In our study, we did not show the increase of antibody titer in asthma patients.…”

mRNA vaccines in the prevention and treatment of diseases

“…First among them is the strong immunogenic nature of ionizable cationic phospholipids 94,137 . For example, after injection of the Pfizer‐BioNTech or Moderna COVID‐19 mRNA vaccines, various symptoms including swelling, pain, chills, and fever have been reported 138–140 . These are suspected to be the consequence of the production of pro‐inflammatory cytokines such as IL‐1β and IL‐6 141–143 .…”

“…94,137 For example, after injection of the Pfizer-BioNTech or Moderna COVID-19 mRNA vaccines, various symptoms including swelling, pain, chills, and fever have been reported. [138][139][140] These are suspected to be the consequence of the production of pro-inflammatory cytokines such as IL-1β and IL-6. [141][142][143] Second, an increasing number of studies has verified the immunogenicity of PEG; therefore, repeated administration of PEG can induce allergic reactions.…”