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American College of Physicians

Vaccination not associated with worsening symptoms or quality of life in patients with persisting symptoms after acute COVID-19
Findings may help those experiencing vaccine hesitancy after infection

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A small case series of patients who received one dose of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccine found that vaccination was not associated with worsening symptoms or quality of life in patients with persisting symptoms after acute COVID-19. These findings may help to assuage vaccine hesitancy in patients with persistent symptoms. A case report is published in Annals of Internal Medicine.

Researchers from North Bristol NHS Trust, Bristol, United Kingdom, studied 163 patients from a single U.K. hospital to describe quality of life and symptoms after vaccination in a series of patients with persistent symptoms 8 months after hospitalization with COVID-19. Prior to vaccination, the patients reported a total of 159 symptoms across organ systems, including fatigue (75%), breathlessness (61%), and insomnia (53%). In addition, quality of life was markedly reduced from the norm.

All participants were reassessed at approximately 1 month after receiving the vaccine, and quality-of-life questionnaires and review of symptoms were repeated, with specific questions on whether symptoms had improved, stayed the same, or worsened. Participants were only asked to confirm vaccination status after symptom assessment to minimize bias due to a perceived association between the assessment and vaccination. They were subsequently asked about adverse effects temporally related to the vaccine.

Among the 44 participants who had received 1 dose of vaccine, 82% reported at least 1 persistent symptom. Among the 159 symptoms reported before vaccination, 23.2% had improved, 5.6% had worsened, and 71.1% had stayed the same. There was no significant worsening in quality-of-life metrics before versus after vaccination. No difference in any outcome measure was identified between the two different vaccines.

According to the researchers, these observations are important because they may provide reassurance to the increasing number of persons experiencing persistent symptoms after acute SARS-CoV-2 infection that receipt of a messenger RNA or adenoviral vector vaccine is not associated with a decrease in quality of life or worsening of symptoms.


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