Why are the side effects more intense with the second dose of COVID-19 vaccine?



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You may experience mild to moderate side effects from the COVID-19 vaccine, and if you receive an injection of two doses, the side effects after the second vaccine may be more severe than those after the first.

This is normal and should not deter people from completing their vaccine series, experts say.

In the Moderna and Pfizer vaccine trials, more people experienced side effects after the second dose.

“The first piece of advice we gave to people who were getting vaccinated was that when you get your second injection you can say to your employer, ‘Hey, I’m going to get my second injection, I might call in sick’, so you anticipate it and you are not afraid of it, ”said Dr Peter Chin-Hong, infectious disease specialist at UCSF.


About twice as many participants in the Pfizer clinical trial developed chills and joint pain after their second dose than after the first. With Moderna, approximately five times as many second dose recipients experienced chills compared to first dose recipients. Redness and swelling at the injection site and fevers were also more common with the second dose compared to the first for both vaccines.

Dr Melanie Swift, co-chair of the COVID-19 vaccine allocation and distribution working group at the Mayo Clinic, said the side effects are the body’s development of immunity to the virus.

Swift said that with the first dose, your immune system kicks in and recognizes the spike protein that COVID-19 vaccines produce for the first time.

“Your body builds this immune memory,” she says. “It’s like your body is going, ‘COVID, now I have your number, now I’m ready for you.'”

With the second dose, your body makes the spike protein and releases antibodies.

“Your immune memory cells haven’t forgotten, they’re ready to mount a robust immune response,” she said.

Chin-Hong compared the experience of getting a two-dose COVID vaccine to turning on a computer.

“With the first dose, you turn on the computer, then it goes to sleep,” Chin-Hong explained. “Then with the second hit, he’s immediately activated and he’s ready to fight that invader and he thinks the spike protein is the invader. You get that big boost of the high, which is a good one. thing in general, because it just means your immunity. the system is working. “

It is normal for the body to respond to vaccines. With the Moderna and Pfizer two-dose vaccines and the Johnson & Johnson single-dose vaccine, the most common reaction in recipients in the trials was pain at the injection site. Throughout the rest of your body, you may experience fatigue, headaches, muscle aches, chills, fever, and nausea with all vaccines.

“Side effects are a good sign,” Swift said. “But it confuses people because a lot of these symptoms are symptoms of COVID, but the difference is there is no respiratory system like you can get with COVID. With the vaccine, you don’t cough, you don’t get a runny nose, you don’t lose your sense of taste or smell. “

Side effects usually go away on their own after one to two days.

Trials for all vaccines have shown that side effects are more common in women and young people according to research, Chin-Hong said.

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