• Joseph E Ebinger, Roy Lan, Nancy Sun, Min Wu, Sandy Joung, Gregory J Botwin, Patrick Botting, Daniah Al-Amili, Harriet Aronow, James Beekley, Bernice Coleman, Sandra Contreras, Wendy Cozen, Jennifer Davis, Philip Debbas, Jacqueline Diaz, Matthew Driver, Justyna Fert-Bober, Quanquan Gu, Mallory Heath, Ergueen Herrera, Amy Hoang, Shehnaz K Hussain, Carissa Huynh, Linda Kim, Michelle Kittleson, Yunxian Liu, John Lloyd, Eric Luong, Bhavya Malladi, Akil Merchant, Noah Merin, Angela Mujukian, Nathalie Nguyen, Trevor-Trung Nguyen, Valeriya Pozdnyakova, Mohamad Rashid, Koen Raedschelders, Karen L Reckamp, Kylie Rhoades, Sarah Sternbach, Rocío Vallejo, Shane White, Rose Tompkins, Melissa Wong, Moshe Arditi, Jane C Figueiredo, Jennifer E Van Eyk, Peggy B Miles, Cynthia Chavira, Rita Shane, Kimia Sobhani, Gil Y Melmed, McGovernDermot P BDPBF. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai, USA., Jonathan G Braun, Susan Cheng, and Margo B Minissian.
• Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
• Prev Med. 2021 Dec 1; 153: 106860106860.

AbstractDespite demonstrated efficacy of vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease-2019 (COVID-19), widespread hesitancy to vaccination persists. Improved knowledge regarding frequency, severity, and duration of vaccine-associated symptoms may help reduce hesitancy. In this prospective observational study, we studied 1032 healthcare workers who received both doses of the Pfizer-BioNTech SARS-CoV-2 mRNA vaccine and completed post-vaccine symptom surveys both after dose 1 and after dose 2. We defined appreciable post-vaccine symptoms as those of at least moderate severity and lasting at least 2 days. We found that symptoms were more frequent following the second vaccine dose than the first (74% vs. 60%, P < 0.001), with >80% of all symptoms resolving within 2 days. The most common symptom was injection site pain, followed by fatigue and malaise. Overall, 20% of participants experienced appreciable symptoms after dose 1 and 30% after dose 2. In multivariable analyses, female sex was associated with greater odds of appreciable symptoms after both dose 1 (OR, 95% CI 1.73, 1.19-2.51) and dose 2 (1.76, 1.28-2.42). Prior COVID-19 was also associated with appreciable symptoms following dose 1, while younger age and history of hypertension were associated with appreciable symptoms after dose 2. We conclude that most post-vaccine symptoms are reportedly mild and last <2 days. Appreciable post-vaccine symptoms are associated with female sex, prior COVID-19, younger age, and hypertension. This information can aid clinicians in advising patients on the safety and expected symptomatology associated with vaccination.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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