Lisa M Christian1, Kyle Porter2, Erik Karlsson3, Stacey Schultz-Cherry3. 1. Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: Lisa.Christian@osumc.edu. 2. Center for Biostatistics, The Ohio State University, Columbus, OH, USA. 3. Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.
Abstract
BACKGROUND: Though typically mild, side effects to the influenza virus vaccine are common and may contribute to negative perceptions including the belief that the vaccine can cause the flu. However, the extent to which subjective symptoms correspond with biological response indicators is poorly understood. METHODS: This study examined associations among subjective side effects (soreness at the site of injection and illness-like symptoms), serum proinflammatory cytokines and body temperature a baseline, 1, 2, and 3 days following receipt of trivalent inactivated influenza vaccine (IIV3) in a sample of 56 women 18-40 years in age. RESULTS: In relation to local reactions, women reporting being very sore at the injection site at 1 day post-vaccination exhibited greater increases in serum TNF-α and MIF in the days following vaccination compared to those with no or mild soreness. In addition, higher basal body temperature was observed in this group compared to other groups (98.7°F versus 98.0-98.1°). In relation to systemic reactions, women endorsing illness-like symptoms (headache, fatigue, nausea, sore throat, dizziness, achiness, or mild fever) exhibited marginally higher IL-6 at baseline (p=0.055) and greater increases in serum MIF at 2 days post-vaccination than those reporting no systemic symptoms. Associations of systemic symptoms with inflammatory responses were not accounted for by concomitant local reactions. As expected, antibody responses to the vaccine were highly similar in women regardless of local or systemic symptoms. CONCLUSIONS: These results are consistent with the notion that subjective reports of local and systemic reactions following vaccination may be predicted by and correspond with biological indicators of inflammatory status, but are not meaningful predictors of antibody responses. To improve adherence to vaccine recommendations, clinicians should provide assurance that such symptoms may be related to normal mild inflammatory responses to the vaccine and do not reflect immunogenicity.
BACKGROUND: Though typically mild, side effects to the influenza virus vaccine are common and may contribute to negative perceptions including the belief that the vaccine can cause the flu. However, the extent to which subjective symptoms correspond with biological response indicators is poorly understood. METHODS: This study examined associations among subjective side effects (soreness at the site of injection and illness-like symptoms), serum proinflammatory cytokines and body temperature a baseline, 1, 2, and 3 days following receipt of trivalent inactivated influenza vaccine (IIV3) in a sample of 56 women 18-40 years in age. RESULTS: In relation to local reactions, women reporting being very sore at the injection site at 1 day post-vaccination exhibited greater increases in serum TNF-α and MIF in the days following vaccination compared to those with no or mild soreness. In addition, higher basal body temperature was observed in this group compared to other groups (98.7°F versus 98.0-98.1°). In relation to systemic reactions, women endorsing illness-like symptoms (headache, fatigue, nausea, sore throat, dizziness, achiness, or mild fever) exhibited marginally higher IL-6 at baseline (p=0.055) and greater increases in serum MIF at 2 days post-vaccination than those reporting no systemic symptoms. Associations of systemic symptoms with inflammatory responses were not accounted for by concomitant local reactions. As expected, antibody responses to the vaccine were highly similar in women regardless of local or systemic symptoms. CONCLUSIONS: These results are consistent with the notion that subjective reports of local and systemic reactions following vaccination may be predicted by and correspond with biological indicators of inflammatory status, but are not meaningful predictors of antibody responses. To improve adherence to vaccine recommendations, clinicians should provide assurance that such symptoms may be related to normal mild inflammatory responses to the vaccine and do not reflect immunogenicity.
Authors: Mark C Steinhoff; Saad B Omer; Eliza Roy; Shams E Arifeen; Rubhana Raqib; Mekibib Altaye; Robert F Breiman; Khalequ Zaman M B B S Journal: N Engl J Med Date: 2010-04-29 Impact factor: 91.245
Authors: Roman Prymula; Claire-Anne Siegrist; Roman Chlibek; Helena Zemlickova; Marie Vackova; Jan Smetana; Patricia Lommel; Eva Kaliskova; Dorota Borys; Lode Schuerman Journal: Lancet Date: 2009-10-17 Impact factor: 79.321
Authors: Alexander N Larcombe; Rachel E Foong; Elizabeth M Bozanich; Luke J Berry; Luke W Garratt; Rosa C Gualano; Jessica E Jones; Lovisa F Dousha; Graeme R Zosky; Peter D Sly Journal: Influenza Other Respir Viruses Date: 2011-03-21 Impact factor: 4.380
Authors: Carcia S Carson; Kyle W Becker; Kyle M Garland; Hayden M Pagendarm; Payton T Stone; Karan Arora; Lihong Wang-Bishop; Jessalyn J Baljon; Lorena D Cruz; Sebastian Joyce; John T Wilson Journal: J Control Release Date: 2022-03-15 Impact factor: 11.467
Authors: Gabriela Maria Wiedemann; Severin Johannes Jacobi; Michael Chaloupka; Angelina Krächan; Svetlana Hamm; Stefan Strobl; Roland Baumgartner; Simon Rothenfusser; Peter Duewell; Stefan Endres; Sebastian Kobold Journal: Oncoimmunology Date: 2016-05-31 Impact factor: 8.110
Authors: Wivine Burny; Andrea Callegaro; Viviane Bechtold; Frédéric Clement; Sophie Delhaye; Laurence Fissette; Michel Janssens; Geert Leroux-Roels; Arnaud Marchant; Robert A van den Berg; Nathalie Garçon; Robbert van der Most; Arnaud M Didierlaurent Journal: Front Immunol Date: 2017-08-14 Impact factor: 7.561
Authors: Kawsar R Talaat; Neal A Halsey; Amber B Cox; Christian L Coles; Anna P Durbin; Amritha Ramakrishnan; Jay H Bream Journal: Influenza Other Respir Viruses Date: 2018-01-04 Impact factor: 4.380