Effect of SARS-CoV-2 Vaccination on Symptoms from Post-Acute Sequelae of COVID-19: Results from the Nationwide VAXILONG Study
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Abstract
Introduction: Few data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, also called long-COVID or post-acute sequelae of COVID-19 (PASC). Patients and methods: We conducted a nationwide online study among adult patients with PASC as defined by symptoms persisting over 4 weeks following a confirmed or probable COVID-19, without any identified alternative diagnosis. Information concerning PASC symptoms, vaccine type and scheme and its effect on PASC symptoms were studied. Results: 620 questionnaires were completed and 567 satisfied the inclusion criteria and were analyzed. The respondents’ median age was 44 (IQR 25–75: 37–50) and 83.4% were women. The initial infection was proven in 365 patients (64%) and 5.1% had been hospitalized to receive oxygen. A total of 396 patients had received at least one injection of SARS-CoV-2 vaccine at the time of the survey, after a median of 357 (198–431) days following the initially-reported SARS-CoV-2 infection. Among the 380 patients who reported persistent symptoms at the time of SARS-CoV-2 vaccination, 201 (52.8%) reported a global effect on symptoms following the injection, corresponding to an improvement in 21.8% and a worsening in 31%. There were no differences based on the type of vaccine used. After a complete vaccination scheme, 93.3% (28/30) of initially seronegative patients reported a positive anti-SARS-CoV-2 IgG. A total of 170 PASC patients had not been vaccinated. The most common reasons for postponing the SARS-CoV-2 vaccine were fear of worsening PASC symptoms (55.9%) and the belief that vaccination was contraindicated because of PASC (15.6%). Conclusion: Our study suggests that SARS-CoV-2 vaccination is well tolerated in the majority of PASC patients and has good immunogenicity. Disseminating these reassuring data might prove crucial to increasing vaccine coverage in patients with PASC.
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The symptomatic worsening following vaccination was mostly driven by fever/chills, fatigue, and muscle/joint pain.
“In another study, the symptomatic worsening following vaccination was mostly driven by fever/chills, fatigue, and muscle/joint pain [28].”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [28]
The Results (p. 3) identify fever/chills and arthralgia (joint pain) among the symptoms that mostly represented worsening after vaccination. They do not identify fatigue or muscle pain in that group; instead, they also name gastrointestinal symptoms and paresthesia. The finding concerns patients with persistent post-COVID symptoms at vaccination. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe symptomatic improvement following vaccination was mainly driven by brain fog and anosmia, which has been associated with disability in long COVID.
“while the symptomatic improvement following vaccination was mainly driven by brain fog and anosmia, which has been associated with disability in long COVID [28].”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [28]
Long COVID patients without confirmed diagnoses of acute SARS-CoV2 infection (defined by RT-PCR or serology test) were more likely to report symptomatic worsening, possibly suggesting increased nocebo effects in the population without biological proof.
“In addition, long COVID patients without confirmed diagnoses of acute SARS-CoV2 infection (defined by RT-PCR or serology test) were more likely to report symptomatic worsening, possibly suggesting increased nocebo effects in the population without biological proof [28,39].”
From Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis (2023) · cites this paper as [28]
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- Authors
- Scherlinger, M., Pijnenburg, L., Chatelus, E., Arnaud, L., Gottenberg, J.-E., Sibilia, J., & Felten, R.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Hôpitaux Universitaires de Strasbourg (FR)
- Inserm (FR)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- Scherlinger, Marc
- Felten, Renaud
- ORCID
- Venue
- Vaccines
- Publisher
- MDPI AG
- Published
- 2021-12-30
- Volume
- 10
- Issue
- 1
- Pages
- 46
- ISSN
- 2076-393X (ISSN-L)
- PMC
- PMC8781023
- OpenAlex
- W4206039474
- Cited by
- 45
- References
- 14
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 11 · 2023: 11 · 2022: 19
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Vaccines (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 vaccination, post-COVID-19 sequelae, long COVID, persistent symptoms, vaccine tolerability, vaccine immunogenicity, anti-SARS-CoV-2 IgG, vaccine hesitancy, vaccination coverage
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