Disentangling post-vaccination symptoms from early COVID-19.
AUC, Area under the curve
BMI, Body mass index
CI, Confidence interval
COVID-19 detection
COVID-19, Coronavirus disease 2019
CSS, COVID Symptoms Study
DI, Data invalid
Early detection
IQR, inter quartile range
KCL, King's College London
LFAT, Lateral flow antigen test
LR, Logistic Regression
Mobile technology
NHS UK, National Health Service of the United Kingdom
O-AZ, Oxford-AstraZeneca adenovirus-vectored vaccine
PB, Pfizer-BoiNTech mRNA vaccine
RF, Random forest
ROC, Receiver operating curve
SARS-CoV-2, Severe acute respiratory syndrome-related coronavirus-2
Self-reported symptoms
Side-effects
UK, United Kingdom of Great Britain and Nothern Ireland
Vaccination
bMEM, Bayesian mixed-effect model
rtPCR, Reverse transcription polymerase chain reaction
severe acute respiratory syndrome‐related coronavirus 2 (SARS-CoV-2)
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
30
08
2021
revised:
28
10
2021
accepted:
08
11
2021
entrez:
7
12
2021
pubmed:
8
12
2021
medline:
8
12
2021
Statut:
ppublish
Résumé
Identifying and testing individuals likely to have SARS-CoV-2 is critical for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 infection globally. Some individuals experience systemic symptoms post-vaccination, which overlap with COVID-19 symptoms. This study compared early post-vaccination symptoms in individuals who subsequently tested positive or negative for SARS-CoV-2, using data from the COVID Symptom Study (CSS) app. We conducted a prospective observational study in 1,072,313 UK CSS participants who were asymptomatic when vaccinated with Pfizer-BioNTech mRNA vaccine (BNT162b2) or Oxford-AstraZeneca adenovirus-vectored vaccine (ChAdOx1 nCoV-19) between 8 December 2020 and 17 May 2021, who subsequently reported symptoms within seven days (N=362,770) (other than local symptoms at injection site) and were tested for SARS-CoV-2 (N=14,842), aiming to differentiate vaccination side-effects Differentiating post-vaccination side-effects alone from early COVID-19 was challenging, with a sensitivity in identification of individuals testing positive of 0.6 at best. Most of these individuals did not have fever, persistent cough, or anosmia/dysosmia, requisite symptoms for accessing UK testing; and many only had systemic symptoms commonly seen post-vaccination in individuals negative for SARS-CoV-2 (headache, myalgia, and fatigue). Post-vaccination symptoms UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK National Institute for Health Research, UK Medical Research Council and British Heart Foundation, Chronic Disease Research Foundation, Zoe Limited.
Sections du résumé
BACKGROUND
BACKGROUND
Identifying and testing individuals likely to have SARS-CoV-2 is critical for infection control, including post-vaccination. Vaccination is a major public health strategy to reduce SARS-CoV-2 infection globally. Some individuals experience systemic symptoms post-vaccination, which overlap with COVID-19 symptoms. This study compared early post-vaccination symptoms in individuals who subsequently tested positive or negative for SARS-CoV-2, using data from the COVID Symptom Study (CSS) app.
METHODS
METHODS
We conducted a prospective observational study in 1,072,313 UK CSS participants who were asymptomatic when vaccinated with Pfizer-BioNTech mRNA vaccine (BNT162b2) or Oxford-AstraZeneca adenovirus-vectored vaccine (ChAdOx1 nCoV-19) between 8 December 2020 and 17 May 2021, who subsequently reported symptoms within seven days (N=362,770) (other than local symptoms at injection site) and were tested for SARS-CoV-2 (N=14,842), aiming to differentiate vaccination side-effects
FINDINGS
RESULTS
Differentiating post-vaccination side-effects alone from early COVID-19 was challenging, with a sensitivity in identification of individuals testing positive of 0.6 at best. Most of these individuals did not have fever, persistent cough, or anosmia/dysosmia, requisite symptoms for accessing UK testing; and many only had systemic symptoms commonly seen post-vaccination in individuals negative for SARS-CoV-2 (headache, myalgia, and fatigue).
INTERPRETATION
CONCLUSIONS
Post-vaccination symptoms
FUNDING
BACKGROUND
UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK National Institute for Health Research, UK Medical Research Council and British Heart Foundation, Chronic Disease Research Foundation, Zoe Limited.
Identifiants
pubmed: 34873584
doi: 10.1016/j.eclinm.2021.101212
pii: S2589-5370(21)00493-4
pmc: PMC8635464
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101212Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
CJS report grants from the Chronic Disease Research Foundation (CDRF), Medical Research Council (MRC) and Wellcome Trust during the conduct of the study. ELD reports being a co-lead of the KCL COVID Symptom Study Biobank, a research-supported biobank of individuals with Long COVID, administered through King's College London, during this study.EM reports grants from the MRC, as a personal fellowship. CHS reports grant from Alzheimer's Society. CH, SS, LP, AM report other from ZOE Limited and are employed by ZOE Limited, during the conduct of the study. TS is a scientific advisor to ZOE Limited. CHS reports grants from Alzheimer's Society, during the conduct of the study. SO reports grants from the Wellcome Trust, Innovate UK (UKRI), and Chronic Disease Research Foundation (CDRF), during the conduct of the study. All the other authors have no conflicts.
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