Journal
VACCINE
Volume 33, Issue 29, Pages 3360-3366Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.vaccine.2015.05.008
Keywords
Influenza virus vaccine; Inflammatory response; Cytokines; Side effects; Inflammation, local reactions, systemic reactions; Flu shot
Categories
Funding
- NCATS NIH HHS [UL1 TR000090, UL1 TR001070, 8UL1TR000090-05] Funding Source: Medline
- NCRR NIH HHS [UL1RR025755, UL1 RR025755] Funding Source: Medline
- NIAID NIH HHS [HHSN266200700005C] Funding Source: Medline
- NICHD NIH HHS [HD067670, R21 HD061644, R21 HD067670, HD061644] Funding Source: Medline
- NINR NIH HHS [R01 NR01366, R01 NR013661, NR01366] Funding Source: Medline
- PHS HHS [HHSN266200700005C] Funding Source: Medline
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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 or 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-alpha 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 degrees F versus 98.0-98.1 degrees). 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. (C) 2015 Elsevier Ltd. All rights reserved.
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