Infectious Disease

“No unexpected patterns of side effects” among thousands who received a third injection

September 28, 2021

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Walensky and the authors do not report any relevant financial information.

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The safety surveillance found “no unexpected patterns of side effects,” researchers at the MMWR reported in the thousands of Americans who received a third dose of a COVID-19 messenger RNA vaccine.

For their study, the CDC epidemiologist My mother. Home, PhD, and colleagues on the CDC’s COVID-19 Response Team included a total of 22,191 registrants who used v-safe – a smartphone-based surveillance system – to receive a third dose of a COVID-19 vaccine from August 12 to September 19 .

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Source: Adobe Stock.

They surveyed participants 0 to 7 days after receiving a third dose and reported about local injection sites, systemic reactions, and health effects.

Of the 22,191 registrants, 63.3% were women and approximately 30%, respectively, were 18 to 49 years old, 50 to 64 years old, and 65 to 74 years old. Of the registrants, 58.1% completed at least one health check-up the week after taking a third dose.

Among those who received three doses of the Pfizer-BioNTech COVID-19 vaccine (n = 6,308) – the only COVID-19 vaccine approved for booster doses for all but immunocompromised patients – local reactions became more common after the third dose than after the second reported dose (74.1% vs. 71.7%). Systemic reactions were reported less frequently after the third dose than after the second (69.2% vs. 71.7%).

Among those who received three doses of the Moderna COVID-19 vaccine (n = 6,283), local reactions were also reported more frequently after the third dose than after the second dose (84.7% vs. 83.5%). As with the Pfizer vaccine, systemic reactions were reported less frequently (79% vs. 81.3%).

Local (74.9%) and systemic (69.9%) reactions were common among all registrants in the week after receiving a third dose of the COVID-19 vaccine, and most occurred the day after. Commonly reported reactions included injection site pain (71%), fatigue (56%), and headache (43.4%).

Of all registrants, 31.8% reported health effects, while 28.3% reported being unable to perform their normal daily activities. Medical care was used by 1.8% of the registrants, while 0.1% were hospitalized.

“This report includes some of the data from our early third-dose experience that the FDA and CDC reviewed when making their recommendations for boosters,” CDC Director Rochelle P. Walensky, MD, MPHsaid during a COVID-19 White House press conference on Tuesday. “The frequency and type of side effects were similar to those after the second vaccination and were mostly mild or moderate and of short duration.”

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Amesh A. Adalja, MD

Amesh A. Adalja

The COVID-19 vaccines have been shown to be very safe and have been given to hundreds of millions of people. It is not surprising that a third dose does not have a safety signal of concern. For those at high risk of serious illness, e.g. For those over 65 years of age, booster vaccination is a safe and appropriate intervention.

It is also important to note that most of the people in this study were over the age of 50. Hence, it is important to solidly assess safety in younger age groups, as the benefit they get from a booster vaccination if they do not have any high-risk comorbidities is marginal.

Amesh A. Adalja, MD

Senior scholarship holder

Johns Hopkins Center for Health Safety

Disclosure: Adalja does not report any relevant financial information.

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