{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:50:27Z","timestamp":1791528627741,"version":"4.3.4"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Side effects to SARS-CoV-2 vaccines are a key concern contributing to vaccine hesitancy, but more individuals may be encouraged if they were known to lead to a stronger immune response.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Adult participants were included from the Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 Vaccines (ENFORCE), who completed a questionnaire to assess systemic reactions following SARS-CoV-2 vaccination (BTN162b2, mRNA-1273, ChAdOx1) and had SARS-CoV-2 spike IgG levels measured at baseline and post-vaccine. A symptom score was developed to measure severity of systemic adverse reactions (+1 for each moderate, +2 for each severe). Post-vaccination SARS-CoV-2 spike IgG levels were compared between participants with different scores using multivariable linear regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 6528 participants were included (56.3% females, median age 64 years [IQR 54-75]). After first vaccination, no association was found between symptom score and post-vaccine dose spike IgG level (p-value=0.575). Following second vaccination, significantly higher spike IgG levels were observed according to higher symptom score (p&amp;lt;0.001); adjusted geometric mean ratios (95% CIs) were 1.16 (1.04-1.30), 1.24 (1.09-1.41), 1.25 (1.06-1.46), and 1.21 (1.08-1.35), for scores of 2, 3, 4, \u22655, respectively, compared to a score of 0. After adjustment for pre-vaccine dose spike IgG, this association was attenuated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>An association was found between more severe adverse reactions and stronger antibody response after the second vaccination but not the first, likely attributed to higher levels of pre-existing immunity gained from response to first vaccination. Regardless of side effects, most people experienced an effective immune response following vaccination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofad248","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T11:59:25Z","timestamp":1683547165000},"source":"Crossref","is-referenced-by-count":6,"title":["Association of Self-Reported Systemic Reactions Following SARS-CoV-2 Vaccination With Immunological Response in The Danish National Cohort Study of Effectiveness and Safety of SARS-CoV-2 Vaccines (ENFORCE)"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4780-3364","authenticated-orcid":false,"given":"Wendy P","family":"Bannister","sequence":"first","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorthe","family":"Raben","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palle","family":"Valentiner-Branth","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Tolstrup","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lykke","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britta","family":"Tarp","sequence":"additional","affiliation":[{"name":"Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital , Silkeborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Brouw Iversen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Zealand University Hospital , Roskilde , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole","family":"Schmeltz S\u00f8gaard","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisse","family":"Rye Ostrowski","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark"},{"name":"Department of Clinical Immunology, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Breinholt St\u00e6rke","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Louise","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan Olaf","family":"Lindvig","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ruwald","family":"Juhl","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aalborg University Hospital , Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isik","family":"Somuncu Johansen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research, University of Southern Denmark , Odense C , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed B","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark"},{"name":"Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre , Hvidovre , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2459-0511","authenticated-orcid":false,"given":"Lars","family":"\u00d8stergaard","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrikke","family":"Dam Larsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark"},{"name":"Department of Clinical Medicine, Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lene","family":"Surland Knudsen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Zealand University Hospital , Roskilde , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke","family":"Klastrup","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2719-1743","authenticated-orcid":false,"given":"Lothar","family":"Wiese","sequence":"additional","affiliation":[{"name":"Department of Medicine, Zealand University Hospital , Roskilde , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0698-9385","authenticated-orcid":false,"given":"Thomas","family":"Benfield","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark"},{"name":"Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre , Hvidovre , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Toft Petersen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aalborg University Hospital , Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper K","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Department of Emergency Medicine, Herlev-Gentofte Hospital , Herlev , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0841-8255","authenticated-orcid":false,"given":"Henrik","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aalborg University Hospital , Aalborg , Denmark"},{"name":"Department of Clinical Medicine, Aalborg University , Aalborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-3559","authenticated-orcid":false,"given":"Joanne","family":"Reekie","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8901-7850","authenticated-orcid":false,"given":"Jens","family":"Lundgren","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen , Copenhagen , Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ENFORCE Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,8]]},"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofad248\/50242142\/ofad248.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofad248\/50242142\/ofad248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T11:59:26Z","timestamp":1683547166000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article\/doi\/10.1093\/ofid\/ofad248\/7156824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,8]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofad248","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,8]]},"article-number":"ofad248"}}