Self-reported real-world safety and reactogenicity of covid-19 vaccines: A vaccine recipient survey

Alexander G. Mathioudakis, Murad Ghrew, Andrew Ustianowski, Shazaad Ahmad, Raymond Borrow, Lida Pieretta Papavasileiou, Dimitrios Petrakis, Nawar Diar Bakerly*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


An online survey was conducted to compare the safety, tolerability and reactogenicity of available COVID-19 vaccines in different recipient groups. This survey was launched in February 2021 and ran for 11 days. Recipients of a first COVID-19 vaccine dose ≥ 7 days prior to survey completion were eligible. The incidence and severity of vaccination side effects were assessed. The survey was completed by 2002 respondents of whom 26.6% had a prior COVID-19 infection. A prior COVID-19 infection was associated with an increased risk of any side effect (risk ratio 1.08, 95% confidence intervals (1.05–1.11)), fever (2.24 (1.86–2.70)), breathlessness (2.05 (1.28–3.29)), flu-like illness (1.78 (1.51–2.10)), fatigue (1.34 (1.20–1.49)) and local reactions (1.10 (1.06–1.15)). It was also associated with an increased risk of severe side effects leading to hospital care (1.56 (1.14–2.12)). While mRNA vaccines were associated with a higher incidence of any side effect (1.06 (1.01–1.11)) compared with viral vector-based vaccines, these were generally milder (p < 0.001), mostly local reactions. Importantly, mRNA vaccine recipients reported a considerably lower incidence of systemic reactions (RR < 0.6) including anaphylaxis, swelling, flu-like illness, breathlessness and fatigue and of side effects requiring hospital care (0.42 (0.31–0.58)). Our study confirms the findings of recent randomised controlled trials (RCTs) demonstrating that COVID-19 vaccines are generally safe with limited severe side effects. For the first time, our study links prior COVID-19 illness with an increased incidence of vaccination side effects and demonstrates that mRNA vaccines cause milder, less frequent systemic side effects but more local reactions.

Original languageEnglish
Article number249
Issue number3
Publication statusPublished - Mar 2021

Bibliographical note

Funding Information:
Acknowledgments: AGM was supported by the NIHR Manchester Biomedical Research Centre (NIHR Manchester BRC). We are thankful to Matthew Snape (Oxford Vaccine Group, University of Oxford) for his advice regarding vaccine safety and reactogenicity tracking and to the Coronavirus Medical Group Greece for disseminating our survey among Greek health professionals.

Publisher Copyright:
© 2021 by the authors.


  • Adverse events
  • COVID-19
  • COVID-19 vaccine
  • Coronavirus disease 2019
  • Reactogenicity
  • Safety
  • Tolerability


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