Why Some People Are Suffering from Vaccine Side Effects More Than Others
By Miranda Levy
Wander into any of our (increasingly busy) parks and high streets, and chances are that snippets of conversation will float your way. “AstraZeneca,” you might hear people say as they congregate in small, socially-distanced groups. “Oxford jab”... “Pfizer”… “side effects”.
We are now in week 11 of the great Covid vaccination rollout. More than 23 million people in the UK have received at least their first jab; a population percentage beaten only by Israel, the Seychelles, the UAE and the Maldives. As I write, the 56 and overs are now being invited to book their jabs online , as well as younger people with underlying health conditions. Some are going back for their second. By July 31 all adults will have received their first vaccine.
I turn 53 in May but I had my Oxford/AstraZeneca jab on February 27. I got it early because I volunteer at a vaccination clinic in North London, inputting data and asking people about their medical history. One day, there were three shots left at the end of play and I (sorry) muscled in with my sleeve rolled up.
The following morning, I was smug. “I don’t even have a sore arm,” I posted on Facebook. As more than 100 friends added their Pfizer v Astra stories throughout the course of the day, I started to feel worse. By bedtime on Sunday, I had a fever that came and went (I didn’t take my temperature), chills, sweats, a headache, sore throat – and a lingering fatigue.
Now, I am absolutely pro-vaccination, as are my friends, but we are full of questions too. Does the Oxford AstraZeneca vaccine really have worse side effects than Pfizer? Is it tougher if you’ve had Covid? “I’ve heard it’s worse in people under 60,” said one friend. “And in women, too.”
Hard data is now being collected that will provide the answer to these questions, thanks to the Covid Symptom Study app, a not-for-profit initiative launched at the end of March 2020 to support vital Covid research.
The app was launched by health science company ZOE alongside scientific analysis provided by King’s College London (KCL). With over four million contributors globally, the Covid Symptom Study – led by Prof Tim Spector, a professor of genetic epidemiology at KCL – this is the world’s largest ongoing study of Covid-19. People sign up to the app and report daily their experiences of everything from suffering coronavirus itself, to their responses to the vaccination.
It’s the ZOE app that has largely told us how Covid is spreading, who gets it, what their symptoms are and how they are reacting to the vaccination. ZOE’s findings on the rollout have been overwhelmingly positive and reassuring.
“We see around a 70 per cent reduction in mild disease after the vaccine, which is what we’d expect,” said Prof Spector at the end of February (A subsequent study by Public Health England showed that a single dose of the AstraZeneca vaccine prevents hospitalisations in over-80s by more than 80 per cent). “Both the Pfizer and the AstraZeneca vaccine induce really high levels of antibodies and T cells, both of which components may play a role in protecting you from a subsequent infection,” says the KCL team.
In the analysis that reported on data collected up to February 15, some early conclusions were drawn from the 400,000 or so people who had had either the Pfizer jab or the AstraZeneca vaccine.
Around one in 10 people who had the Pfizer jab reported “systemic” after-effects, similar to mild flu symptoms. But this rose to three in 10 who had the Oxford AstraZeneca. This was the one I had; it uses a disabled cold virus to smuggle the coronavirus message into the body. Dr Chris Smith, a virologist at the University of Cambridge and Addenbrooke's Hospital, describes it as like being injected with a “spiky meatball” (Dr Smith had Pfizer – the jabs have different mechanisms).
It’s important to mention here that a lack of side effects or symptoms does not mean you aren’t having an adequate immune response.
At the end of last month, there were rumors that several French hospitals were slowing down AstraZeneca vaccination programs for their staff because side effects – albeit temporary – meant people were calling in sick, causing logistical problems.
“There is evidence that the AstraZeneca jab may produce a more ‘rounded’ antibody response, and more of a response from our T-cells, which are another part of the body’s natural immune response,’ says Dr Claire Steves. “This can mean you get symptoms such as fever, tiredness and aches as your body adjusts. But, reassuringly, our data shows that 98.3 per cent of people feel better within a week.”
I still feel tired, with the hint of a headache I haven’t been able to kick for 10 days: in the unlucky 1.7 per cent, then. According to the experts, there could be a couple of reasons for this.
For starters, there is evidence to suggest that women report more vaccine side effects than men. Research from the Center For Disease Control and Prevention in the US revealed that 79.1 per cent of side effects were reported by women, despite the fact that only 61.2 per cent of the vaccines had been given to women. “Women in general have more reactions to a variety of vaccines, including influenza,” says Dr Julianne Gee at the CDC’s immunization office. A very few women have even reported lumps in their breasts due to swollen lymph nodes as the body fights infection. “These are signs you are mounting a very robust immune response,” says Dr Gee.
Individuals who have had Covid-19 already appear to have more symptoms just after the first dose than those who haven’t. Dr Steves says: “If you’ve had Covid-19 before, your memory B and T cells are primed to fight a new infection with a stronger, faster response – and this can be the case even if you have a negative antibody test.
“This is because we know that circulating antibodies – at least in some people – can become undetectable over time, but the memory B cells are still there, ready to jump into action and fight a new infection.”
Dr Smith is unsure: “We don’t really know the answer to this. Some evidence shows that, among those people who have caught Covid for a second time, the symptoms are much milder or even absent the second time. The same may well apply to a second jab vaccination.”
In fact, says Dr Smith, some of these symptoms may not be down to the vaccine at all. “Just because you are feeling s-----y, it might not be because of the jab. It could be down to something else entirely,” he says. “We have a tendency to attach significance to coincidence.” Hence, that headache might be because of one glass of wine too many last night, that tiredness due to an extra-long run.
Dr Smith points to what is termed as the “nocebo” effect. “You might be expecting side effects so, when you experience a symptom that might be relevant, you blame the vaccine.”
Whatever the nuances of minor side effects, this shouldn’t be a reason not to go for vaccinations. The long-term gain of protection against this virus, which for some could have consequences that are life-changing, far outweighs any short-term pain. But we do need an honest conversation about side effects. “Most of all to explain that these are not effects to be afraid of,” says Dr Steves. “The majority of symptoms are mild and short-lived. Most people are back normal within three days.” – The Telegraph
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