Analgesic use after COVID-19 vaccination does not negatively affect antibody responses

By Bhavana KunkalikarReviewed by Emily Henderson, B.Sc.Oct 20 2022

In a recent study posted to the medRxiv* preprint server, University of Arizona researchers assessed the relationship between antibody responses and analgesic usage after coronavirus disease 2019 (COVID-19) vaccination.

Study: No evidence that analgesic use after COVID-19 vaccination negatively impacts antibody responses. Image Credit: Natalia Dolgosheeva / Shutterstock

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Background

COVID-19 vaccines have shown high efficacy against clinical disease elicited by the ancestor strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, emerging variants, like SARS-CoV-2 Omicron and its sublineages, largely evade neutralizing antibodies produced by vaccination. Therefore, bivalent messenger ribonucleic acid (mRNA) booster vaccinations have been updated to better neutralize the BA.4/5 lineages. However, the reactogenicity observed in response to these vaccines may have a detrimental effect on a patient's willingness to accept a booster shot.

However, COVID-19 animal models have shown that non-steroidal anti-inflammatory drugs (NSAIDs) significantly reduce antiviral antibody responses, which serve as accurate correlates for protection against SARS-CoV-2 infection. These mild adverse events may be mitigated to some extent by over-the-counter analgesics. However, it is still uncertain if mRNA immunization causes the same inhibitory effects in humans.

About the study

In the present study, researchers surveyed COVID-19 vaccinees regarding their usage of analgesics and compared the results to SARS-CoV-2 spike (S)-specific antibody levels.

The team assessed the survey data related to analgesic usage between 15 March 2021 and 22 March 2022. The survey was answered by 2,354 COVID-19-vaccinated people included in a statewide antibody testing program performed by the University of Arizona. Self-reported vaccination history, analgesic usage within 48 hours following either two mRNA-1273 or BNT162b2 vaccine doses, and antibodies elicited against SARS-CoV-2 S-receptor binding domain (RBD) were examined. A one-way Analysis of Variance (ANOVA) was also carried out using the t-test statistic.

Results

Compared to individuals who took NSAIDs or acetaminophen, those who did not consume an analgesic had significantly lower levels of RBD-specific antibodies. Notably, the cohorts that use NSAID and acetaminophen did not differ statistically from one another. Interestingly, analgesic use was linked to increased levels of anti-Spike antibodies rather than lower ones.

RBD levels were statistically considerably higher in individuals who chose not to respond to the survey than in those who did. Fatigue, headaches, and muscular pains were the most typical vaccine-related adverse effects and were most prevalent in people receiving NSAIDs. After vaccination, 95% of subjects were seropositive, but a small proportion of persons fell below this cutoff. Compared to people who did not consume analgesics, seropositivity was higher among people who were taking NSAIDs and experiencing these three symptoms.

A significantly larger proportion of NSAID users and people who did not use analgesics reported exhaustion and muscle aches. Additionally, the team found that NSAID users experienced headaches at a greater rate than non-users and at a lower rate than acetaminophen users. Unfortunately, the observational design of this study prevented a direct assessment. However, the most reasonable interpretation for the increase in antibody levels was that inflammation and adverse events were related to antibody increase instead of analgesic usage.

Overall, the study findings showed no evidence that the use of analgesics following COVID-19 vaccination had a negative effect on antibody responses.

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.