chuka_lis (chuka_lis) wrote,

Физиологический ответ на вакцину

Препринт на основе данных показателей сердечного ритма в покое. Около 4 тыс человек, которые регулярно мониторили свой пульс (цифровые датчики, Fitbit device (76%) and an Apple watch (20%) соединенные с телефонами), из которых часть привлась файзером, часть модерной (44%), некоторые болели ковидом до (5%).
После прививки у большинства (70% после 1 дозы, 76% после 2 дозы) наблюдалось учащение ритма сердца- на 0.5 удара в минуту после первой дозы, на 1.6- после второй, с пиком на 2 день после прививки, и возвращением в норму примерно к 4 дню после 1 дозы и 6 дню после второй. Наиболее выраженные изменения у тех, кто старше (больше 40, и особенно больше 60, после 2 дозы); у тех, кто получил модерну, и у тех, кто уже болел ковидом.
Так же, после прививки, особенно после 2 дозы, в первый день люди спали дольше, чем обычно ( в среднем на 40 минут) и активничали меньше.
С точки зрения авторов, изменения сердечного ритма свидетельствуют о течении воспалительной реакции в организме, которая, вреоятно, может использоваться как маркер, показывающий работу иммунитета в ответ на привику. Особенно с учетом того, что на антитела после никто не проверяет, но если был физиологический ответ- то, скорее всего, есть и антитела (ну и защита).

though it is known that there is substantial variability in individuals’ immune  response to vaccines, and that some fully vaccinated individuals can still become infected,1054there is currently no routinely available method to objectively identify a specific person’s response to a vaccine beyond self-reported side-effects, which are common. The Centers for Disease Control and Prevention’s (CDC) V-safe program found a majority(69%)of the 1.957million enrolled individuals receiving the second dose of a mRNA vaccine reported some systemic side effects.Many of the reported symptoms were consistent with systemic inflammation including fatigue, myalgias, chills, fever and joint pain being report in the range of 6025.6% to 53.9% of individuals the day following their 2nd dose.
In this analysis from the Digital Engagement and Tracking for Early Control and Treatment (DETECT) study, we collected daily wearable sensor data from the two-weeks before and after 63each vaccination dose from 4,110 volunteers who documented receiving at least one dose of the  vaccine (2,366received both dosesof a mRNA vaccine). We hypothesized that there are digital  biomarkers of vaccine-induced inflammatory responses via subtle deviations from an individual’s normal resting heart rate (RHR),as well as changes in a person’s routine sleep and  activity behaviors in the days surrounding a vaccine dose
For each individual, we calculated the average of the absolute changes of RHR, sleep and  activity with respect to their individual baseline, which we have previously shown to be  relatively stable for an individual over time, but to vary substantially between individuals.14,15A 95single daily value is considered valid only if the device was worn for more than 15 hours during 96the day. The sleep and activity metrics were calculated accordingly using the total time asleep and the106number of steps recorded by the sensor in the 24 hours, respectively.
t least one vaccination to date was reported by 4,110 participants in the DETECT study.After  applying the exclusion criteria discussed in Methods, we included a total of 3,312(80%) individuals for the analysis of changes in their RHR. Of them, 165(5.0%)reported having been 130previously diagnosed with COVID-19 infection, 1,465(44%)received the Moderna vaccine and  1,847(56%)received the Pfizer-BioNTech vaccine.3,421(83%) and 2,675(65%) participants  contributed adequate data -as discussed in Methods -to evaluate changes in activity and sleep,  respectively.
We observed that the average RHR significantly increased the day following vaccination,  reaching a peak on day 2with a population mean increaseof +0.49  and +1.59 beats per minute (BPM) with respect to  baseline, following the first and second dose, respectively. We found that the average RHR did 138not return to baseline until day 4after the first dose and day 6 after the second. The majority of vaccinated individuals, 70% and 76% after first and second dose, respectively,140experienced an increase in their RHRin the two days following the vaccine. (Figure 1c & d) We explored several participant and vaccine characteristics that could impact immune response.  (Table 1) We found that average RHR changes with respect to baseline in the 5 days following  vaccination did not vary by gender  In contrast, we found that RHR responses vary by age, with individuals age 145< 40 years having the greatest increase in RHR. We showed that < 60 years was  associated with a significantly higher RHR increase than 60+ years, but only after the second  dose of the vaccine (average 0.78 versus 0.53 BPM, p = 0.03).  We found that prior COVID-19 infection was associated with a significantly higher RHR  increase after the first vaccine dose relative to those without prior infection (average 0.75 versus  0.22 BPM, p = 0.02), but no significant difference after the second dose(0.28 versus 0.68)
The changes in RHR for individuals who received the Moderna vaccine were significantly greater than those who received the Pfizer-BioNTech vaccine, after  both the first (0.39 versus 0.22, p= 0.04) and second doses (0.88 versus 0.46, p<0.01).
Prior COVID- 19 infection was independently associated with a higher RHR increase after the first dose, with  estimated marginal mean of 0.770  versus 0.293  ;and no significant difference after the second dose, 0.275 versus 0.731
Similarly, the Moderna vaccine was also independently associated with a higher RHR increase after both doses(with respect to Pfizer-BioNTech), with estimated marginal mean of 0.6  versus 0.4 for first dose,and 0.7 versus 0.285  for second dose
Age was also associated with RHR response, but only after the second vaccine dose
We also observed that normal activity and sleep patterns among participants were minimally affected by the first dose of the vaccine. However, a significant decrease in activity and increase in sleep (40 minutes ) relative to baseline were observed on day 1 after the second vaccine dose, both of which returned to baseline by day 2.
while vaccines against COVID-19 are remarkably effective, they are not  100% effective, as recently highlighted by reports of “vaccine breakthrough” in fully vaccinated  people. Many individuals are concerned about their lack of any symptoms after getting vaccinated.The present study demonstrates the ability, through widely available wearable sensors, to recognize individual physiologic changes associated with a systemic vaccine-induced  inflammatory response.
Individual response to vaccination is remarkably complex, incorporating components of innate,  humoral and cell-based immune system.
There are no commercially  available tests for neutralizing antibodies to the spike protein or its components S1, S2, RBD,  that would provide quantitative evidence of an immune response. Beyond humoral immunity, the  early T-cell spike-specific response has recently been shown to be important, yet is only rarely  assessed in academic research settings. Accordingly,it is currently impossible to identify, at sensors, to recognize individual physiologic changes associated with a systemic vaccine-induced  nflammatory response.
Beyond humoral immunity, the early T-cell spike-specific response has recently been shown to be important, yet is only rarely  assessed in academic research settings. it is currently impossible to identify, at  scale,the level of protection an individual acquires after vaccination. Currently available mRNA vaccines (Pfizer-BioNTech and Moderna) and adenovirus vaccine  (Janssen) elicit an inflammatory response through immune cell activation leading to the  production of Type 1 interferon and the release of multiple inflammatory mediators. Vaccination has been shown to stimulate the production of neutralizing antibodies, activate virus-specific CD4+ and CD8+ T cells, and lead to the robust release of immune-modulatory  cytokines in the days that follow a first, and especially a second dose of the mRNA vaccines. Beyond rapid stimulation of innate immunity via adjuvant stimulation, prior studies of mRNA  vaccines have shown peak production of the vaccine-induced antigen protein to occur as soon as   hours after vaccination, suggesting that an inflammatory response begins within hours of  vaccination.
Consistent with that, we identified a rapid rise in heart rate the day after vaccination, and one that was more robust after the second dose, unless the participant had prior COVID-19 infection, mirroring the significantly higher incidence of systemic symptoms  following the second dose found in V-safe. We also observed a more pronounced increase after  a Moderna vaccine, in accordance to a recent analysis of V-safe data that identified a higher 209incidence of side effects relative to those receiving the Pfizer-BioNTech vaccine, especially after  the second dose.This may be related to a possible unnecessary excess dose and consequent side-effects, supporting the finding of a randomized trial of full (100 ml) versus half (50 ml)dose  of the Moderna vaccine with lack of differences in immune response. Immunosenescence or waning response to vaccination as someone ages has been described for  many vaccines and is a concern for COVID-19.25We found that individuals in the younger age  group(<40 years) had a significantly higher RHR response to the second dose compared toolder216individuals. Overall, women also reported more side effects to V-Safe compared to men
It is possible that with  further investigation it may be found that RHR response to vaccines may correlate with ndividual immune response and therefore wearables may offer a way to easily quantify  someone’s protection.  The presence of a fever has previously been shown to be associated with an increase in heart  rate, with an ~8.5 BPM increase for every degree Celsius increase in body temperature. While  ~30% of V-safe participants reported having a fever after their second dose and ~9% after the  first, we showed that the vast majority of participants experienced an increase in RHR after both  vaccination doses, suggesting that inflammation unassociated with an elevated temperature also  influences heart rate, albeit much more subtly. Similarly, inflammation has also been shown to lead to increase in sleep and a decrease in activity, with a more rapid return to normal with treatment.
By taking advantage  of wearable sensors we were able to recognize subtle, but significant deviations from an individual’s unique, normal resting heart rate due to vaccination. We were able to also  demonstrate substantial inter-individual variability in that heart rate increase that was only related  to the mRNA vaccine type andprior COVID-19 infection in our population.The significantly  greater heart rate response at the time of vaccination, especially the first dose,in those with prior 243infectionis consistent with a greater immune response for these individuals.
Fitness bands and smartwatches are owned by approximately 1 in 3 American adults and appear to provide, through passive data capture, meaningful data to track the physiologic response to 270COVID-19vaccines at the individual level. Not only might this provide reassurance for 271vaccinees who do not experience any symptoms, but correlation with the humoral and cellular  immune response may indicate digital tracking as a useful surrogate.
Tags: вакцина, здоровье, коронавирус, статьи

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