Systemic adverse effects induced by the BNT162b2 vaccine are associated with higher antibody titers from 3 to 6 months after vaccination

  1. Ryousuke Koike
  2. Michiru Sawahata
  3. Yosikazu Nakamura
  4. Yushi Nomura
  5. Otohiro Katsube
  6. Koichi Hagiwara
  7. Seiji Niho
  8. Norihiro Masuda
  9. Takaaki Tanaka
  10. Kumiya Sugiyama
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Abstract

Objective

We aimed to determine the relationship between vaccine-related adverse effects and antibody (Ab) titers from 3 to 6 months after the second dose of the BNT162b2 coronavirus disease 2019 (COVID-19) mRNA vaccine (Pfizer/BioNTech) in Japan.

Methods

We enrolled 378 healthcare workers (255 women, 123 men) whose Ab titers 3 and 6 months after the second dose were analyzed in our previous study and whose characteristics and adverse effects were collected previously using a structured self-report questionnaire.

Results

Median age was 44 years. While injection-site symptoms occurred with almost equal frequency between the first and second doses, systemic adverse effects, such as general fatigue and fever, were significantly more frequent after the second dose than after the first. Multivariate analysis showed that fever was significantly correlated with female sex for the second dose (odds ratio [OR], 2.139; 95% confidence interval [95%CI], 1.185–3.859), older age for the first dose (OR, 0.962; 95%CI, 0.931–0.994) and second dose (OR, 0.957; 95%CI, 0.936–0.979), and dyslipidemia for the first dose (OR, 8.750; 95%CI, 1.814–42.20). Age-adjusted Ab titers at 3 months after vaccination were 23.7% and 23.4% higher in patients with fever than in those without fever after first and second dose, respectively. In addition, age-adjusted Ab titers at 3 and 6 months after the second dose were respectively 21.7% and 19.3% higher in the group with anti-inflammatory agent use than in the group without anti-inflammatory agent use.

Conclusion

Participants with systemic adverse effects tend to have higher Ab titers from 3 to 6 months after the second dose of the BNT162b2 vaccine. Our results may encourage vaccination, even among people with vaccine hesitancy related to relatively common systemic adverse effects.

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