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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 4  |  Page : 238-241

Online survey for symptoms following COVID-19 postvaccination in Karnataka: A cross-sectional study


1 Department of General Medicine, Jawaharlal Nehru Medical College, KAHER, Belgavi, Karnataka, India
2 Department of Hospital Administration, Jawaharlal Nehru Medical College, KAHER, Belgavi, Karnataka, India
3 Department of Public Health, Jawaharlal Nehru Medical College, KAHER, Belgavi, Karnataka, India
4 Department of Medical Under Graduate Student Researcher, Jawaharlal Nehru Medical College, KAHER, Belgavi, Karnataka, India

Date of Submission18-Sep-2021
Date of Decision23-Jan-2022
Date of Acceptance23-Jan-2022
Date of Web Publication25-Oct-2022

Correspondence Address:
Ass Prof. A B Kudachi
Department of Hospital Administration, Jawaharlal Nehru Medical College, KAHER, Belgavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajim.ajim_97_21

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  Abstract 


Background: While the protective efficacy of vaccine is frequently discussed, little is known about the real-world postvaccination experience outside of clinical trial conditions. The objective of the study was to assess the immediate response to the first and second dose of COVID-19 vaccine and to study the spectrum of postvaccination symptom profile for individuals' vaccines. Materials and Methods: A cross-sectional online survey was done using Google Forms. It was circulated via electronic media to the people who had taken COVID-19 vaccine from July 1 to July 30, 2021. Data were analyzed using SPSS version 20.00. Results: A total of 610 people responded to the online survey. Majority (29%) of respondents belonged to the 20–30 years' age group, followed by 30–40 years' age group (24%). The respondents were predominantly males (82%) and belonging to urban area (57%). Almost 57% of the people had taken Covishield, with the rest having received Covaxin. About 53% of the people had taken the first dose of vaccine. The respondents reported postvaccination symptoms as follows: fever (56%), muscle pain (47%), headache (45%), redness (35%), tiredness (33%), itching (30%), joint pain (30%), and swelling (27%). A total of 45% of participants experienced some health problems and 69% had taken medications after vaccination to relieve the symptoms. A statistically significant association was observed between first dose of COVID-19 vaccine and gender of the participants (P = 0.0024). A similar association was also observed between the dose of COVID-19 vaccine and presence of postvaccination symptoms, namely, fever (P = 0.0001), headache (P = 0.0001), muscle pain (P = 0.0010), tiredness (P = 0.029), breathlessness (P = 0.001), and joint pains (P = 0.012). Conclusion: Post-COVID vaccination symptoms are very common in the community irrespective of age and gender.

Keywords: Adverse events, COVID-19, morbidity, postvaccination, vaccination


How to cite this article:
Kotiwale V A, Kudachi A B, Rajashree S K, Kotiwale V V. Online survey for symptoms following COVID-19 postvaccination in Karnataka: A cross-sectional study. APIK J Int Med 2022;10:238-41

How to cite this URL:
Kotiwale V A, Kudachi A B, Rajashree S K, Kotiwale V V. Online survey for symptoms following COVID-19 postvaccination in Karnataka: A cross-sectional study. APIK J Int Med [serial online] 2022 [cited 2022 Dec 4];10:238-41. Available from: https://www.ajim.in/text.asp?2022/10/4/238/359450




  Introduction Top


Since its emergence in December 2019, SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), has taken a tremendous toll globally; as of February 28, 2021, there have been over 110 million cases and 2.5 million deaths worldwide from COVID-19. Although most COVID-19 deaths occur among older adults and persons with chronic comorbid medical conditions, deaths have occurred in persons of all ages. Moreover, the pandemic has caused widespread morbidity and necessitated control measures that have devastated economies worldwide. In response to the pandemic, the global efforts to develop multiple vaccines to protect against COVID-19 disease have been unrivalled in the history of public health. By the end of 2020, three COVID-19 vaccines have received emergency use approval/listing.[1]

COVID-19 vaccines have been rolled out recently in several parts of the world. Although the protective efficacy is frequently discussed, little is known about the real-world postvaccination experience outside of clinical trial conditions.[2] Effective vaccines against COVID-19 are urgently needed to control the global pandemic. More than 280 candidate vaccines are in development worldwide, 23 of which are already in phase 3 trials using different platforms.[3] COVID-19 vaccination will help protect from getting COVID-19. One may experience some side effects, which is indictive of body's reaction. These side effects may affect one's ability to do daily activities, but they should go away in a few days. Some people have no side effects.[4] Knowledge about what to expect after vaccination will help educate the public, dispel misinformation, and reduce vaccine hesitancy.[1] Common side effects on the arm are pain, redness, and swelling and other symptoms throughout the rest of your body are tiredness, headache, muscle pain, chills, fever, and nausea.

COVID vaccination with any of the approved vaccination has shown to protect from infections, severe disease, and decreased risk of mortality. However, some minor symptoms are common after vaccination. Although serious adverse events are very rare, the fear of postvaccination symptoms could be responsible for initial vaccine hesitancy among public. Hence, the study was planned to assess the immediate response to the first and second dose of COVID-19 vaccine and to study the spectrum of postvaccination symptom profile for individuals' vaccines.


  Materials and Methods Top


A cross-sectional study was performed from July 1, to July 30, 2021 among Belagavi inhabitants who received COVID-19 vaccines, regardless of their nationalities, ethnicities, occupations, and places of residence. Adults (18 years and older) were asked to take part in a self-administered online survey (generated in Google Forms) that was circulated via social media platforms (WhatsApp) and electronic mail.

The primary objective of this cross-sectional study was to assess the immediate response to the first and second dose of COVID-19 vaccine and to study the spectrum of postvaccination symptom profile for individuals' vaccines. Questions were formatted in binary manner to the extent possible, with descriptive features added to the section on symptom profile. The data presented in the study were exclusively obtained through the online survey. People who had taken first and both doses of vaccines are included. The ethical clearance was obtained from the institutional ethical committee. The data were analyzed using SPSS version 20.00. The data were entered in Microsoft Excel and analyzed using SPSS version 20.00. Descriptive Statistics were used to assess the baseline data. All quantitative variables were presented in frequency and percentages and mean. Continuous variables were expressed as mean (standard deviation) and categorical variables were expressed frequency and percentage. For the comparison of categorical variables, Chi-square test was used. P < 0.05 was considered statistically significant.


  Results Top


A total of 610 people responded to the survey over a 1-month period from July 1, to July 31, [Table 1]. Majority (29%) of respondents belonged to the 20–30 years' age group, followed by 30–40 years' age group (24%). Their mean age was 39 years. The respondents were predominantly males (82%) and belonging to urban area (57%). Almost 57% of respondents had taken Covishield, whereas the rest of the participants had received Covaxin. Among the respondents, 33.4% were government employee and 23% were students. About 53% of the people had taken the first and 47% had the second dose of vaccine.
Table 1: Demographic profile of participants taken coronavirus disease-2019 vaccination (n=610)

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The respondents reported postvaccination symptoms as follows: fever (56%), muscle pain (47%), headache (45%), redness (35%), tiredness (33%), itching (30%), joint pain (30%), and swelling (27%). [Table 2] shows that among these prevalent symptoms, redness, swelling (96%); diarrhea (95%); giddiness, breathlessness, itching (94%); fever and headache (93%) were developed in less than 24 hours. 45% of study participants had health problems, majority 36% were hypertensive, 19% were diabetics, followed by 12% thyroid, and other health problems were reported in 28% of people. Out of 610 people, 421 (69%) participants had taken oral medication after vaccination to relieve the nonserious symptoms. Of these, 93% of participants had taken oral medication paracetamol tablet in home and 5% were hospitalized after vaccination with serious problem diarrhea, insomnia, and recovered.
Table 2: Distribution of participants according to time of onset of symptoms following coronavirus disease-2019 vaccine

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Prevalence of general side effects according to the age group

A total of 610 (69%) participants reported having at least one side effect following COVID-19 vaccine. The prevalence of side effects was higher (58%) in <40-year-old age group than the >40-year-old age group (42%). The most common side effect was fever (56%) and all the reported side effects were prevalent in the >40-year-old age group than the <40-year-old age group. A statistically significant association was observed between the first dose of COVID-19 vaccine and gender of the participants (0.0024). [Table 3] presents the association between dose of vaccine with various symptoms seen after post vaccination. It clearly shows that a significant reduction was observed in the prevalence in redness from first dose (39.5%) to second dose (31.6%) (P=0.0420), in itching from 34.0% to 26.7% with P=0.0490. But a significant changes in prevalence of fever from 47.9% to 63.6% with p=0.0001, headache changes from 32.9% to 57.4% with P=0.0001, muscle pain changes from 39.9% to 53.4% with P=0.0010, tenderness changes from 27.7% to 36.0% with P=0.0290, Breathlessness changes from 12.5% to 22.6% with P=0.0010, Joint pain changes from 25.6% to 35.0% with p=0.0120, anaphylactic reaction changes from 11.4% to 17.3% with P=0.0380, swollen lymph nodes changes from 13.5% to 19.8% with P=0.0370, giddiness changes from 18.7% to 27.9% with P=0.0080 and lastly, insomnia changes from 12.8% to 20.1% with p=0.0150 in the study concern. It concludes clearly that, the prevalence in most and majority of symptoms significantly increased.
Table 3: Association between dose of vaccine with various postvaccination symptoms present

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  Discussion Top


In this community-based study in the Belagavi, we have investigated adverse effect rates following administration of the two COVID-19 vaccines that are frequently in use in the Karnataka. The mean age of the people vaccinated is 39 years. The prospective observational study in the UK also showed that the mean age of the participants was <40.3 years.[5]

Side effects were significantly more prevalent (82.3%) in men. Furthermore, our study showed that COVID-19 postvaccination adverse effects were higher in 58% in <40 years people compared to 42% in more than 40 years. The prospective observational study conducted in the UK reported that side effects were more prevalent in people aged <55 years compared to older than 55 years.[5]

The frequency of experiencing side effects following vaccine was more in those taking Covaxin compared to those receiving Covishield (89% vs. 78%). In contrast to this, Indian study showed that, people had taken Covishield (66% ) and Covaxin (53%) vaccine and experienced some adverse events following covid-19 vacciantion.[2] The differences between the present study and above-mentioned study could be due to differences in frequencies of different vaccines. In the present study, 43% of participants had taken Covaxin, whereas in the other study, only 3% of participants had taken Covaxin.

Overall, 83.4% of respondents reported at least one postvaccination symptom. The most prevalent symptoms were fever, muscle pain, headache, redness, tiredness, itching, joint pain, and swelling. Fever was most prevalent and swelling was less. The chance of having symptoms decreased with advancing age. The Indian study showed most prevalent postvaccination symptoms such as tiredness, myalgia, fever, headache, local pain at injection site, joint pain, nausea, and diarrhea. Among these, tiredness was more prevent and diarrhea was the least.[2]

In an Indian study, it is reported that frequency of symptoms was 81% in 20–29 years, followed by 80% (30–39 years) and 7% (80–90 years), and 56% of the respondents were male and 44% were female.[2] In the present study, major symptoms after COVID 19 vaccination such as swelling (96%), redness (96%), diarrhea (95%), and itching (94%) were developed within 24 hours of vaccination, the Indonesia study reported postvaccination side effects tiredness (66%), muscle pain (64%) headache (51%) developed in medical staff within 24 hours and in nonmedical staff most common side effects were same tiredness (58%), muscle pain (65%) headache (38%) developed after 24 h of vaccination.[6]

Strength

Our data could be used to inform people on the likelihood of side effects on the basis of their age and sex and the type of vaccine being administered.

Limitation

Survey questions were in English, which might have posed some difficulty among those with limited proficiency in that language. There is a delay between vaccination and survey timing that may result in recall bias. The study evaluated only short-term adverse effects, and long-term surveillance in the general population will be required to investigate possible future effects. The importance of this survey of symptoms is this survey can pick up many smaller or minor adverse events which may not be reported as adverse events following immunization (AEFI). The frequency of these symptoms is much more than reported AEFIs.


  Conclusion Top


The survey reported that short-term adverse effects of both vaccines are moderate in frequency, short lived, and developed several mild postvaccination symptoms. Adverse events are more frequently reported in younger individuals and men. The postvaccine symptoms both systemic and local often last 1–2 days from the injection. These symptoms were consistent with an immune response commonly associated with vaccines. No serious events were reported. Nevertheless, follow-up after vaccination is needed to prevent immunologic responses that may occur in some people. Our data could be used to inform people on the likelihood of side effects on the basis of their age and sex and the type of vaccine being administered.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
2.
Jayadevan R, Shenoy R, Anithadevi TS. Survey of Symptoms Following COVID-19 Vaccination in India. Available from: https://doi.org/10.1101/20210.02.08.21251366. [Last accessed on 2021 Feb 12].  Back to cited text no. 2
    
3.
Al Kaabi N, Zhang Y, Xia S, Yang Y, Al Qahtani MM, Abdulrazzaq N, et al. Effect of 2 inactivated SARS-CoV-2 vaccines on symptomatic COVID-19 infection in adults: A randomized clinical trial. JAMA 2021;326:35-45.  Back to cited text no. 3
    
4.
Available from: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html. [Last accessed on 2022 Jan 23].  Back to cited text no. 4
    
5.
Menni C, Klaser K, May A, Polidori L, Capdevila J, Louca P, et al. Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID symptom study app in the UK: A prospective observational study. Lancet Infect Dis 2021;21:939-49.  Back to cited text no. 5
    
6.
Djanas D, Yusirwan, Martini RD, Rahmadian, Putra H, Adriani. Survey data of COVID-19 vaccine side effects among hospital staff in a national referral hospital in Indonesia. Data Brief 2021;36:107098.  Back to cited text no. 6
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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