No evidence that analgesic use after COVID-19 vaccination negatively impacts antibody responses

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Uptake of mRNA vaccines, especially booster immunizations, against COVID-19 has been lower than hoped, perhaps in part due to their reactogenicity. Analgesics might alleviate symptoms associated with vaccination, but studies to measure their impact on immune responses have been limited to relatively small cohorts. We semi-quantitatively measured antibody responses following COVID-19 vaccination in 2354 human participants surveyed about analgesic use. Participants who used non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen after vaccination showed elevated antibody levels against the receptor binding domain of Spike protein relative to those who did not use analgesics. This pattern was observed for both mRNA-1273 and BNT162b2 and across age groups. Participants who used analgesics more frequently reported fatigue, muscle aches, and headaches than those who did not use painkillers. Amongst participants who reported these symptoms, we observed no statistically significant differences in antibody levels irrespective of analgesic use. These data suggest that antibody levels are elevated as a function of symptoms and inflammatory processes rather than painkiller use per se. Taken together, we find no evidence that analgesic use reduces antibody responses after COVID-19 vaccination. Recommendation of their use to alleviate symptoms might improve uptake of booster immunizations.

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