Health behaviors are largely not predictive of adverse events following influenza vaccination

ABSTRACT

Background

Identifying health behaviors associated with adverse events following immunization (AEFI) could identify intervention targets for AEFI prevention.

Methods

University employees receiving an influenza vaccination (n = 1301) completed a series of online surveys for health behaviors including sleep, exercise, dietary intake, and smoking habits, and emotional state (baseline), and for indications of AEFI (three days post-vaccination) and influenza-like illness (ILI) symptoms (fortnightly follow-up for 4 months).

Results

29.9% of participants reported an AEFI and 46.0% reported experiencing ILI during follow-up. Multivariate logistic regression revealed usual sleep duration was associated with AEFI (odds ratio 1.20, 95% confidence interval 1.03–1.41), increasing with each hour of sleep. ILI was associated with reporting AEFI (1.70, 1.24–2.33), increasing BMI (1.03, 1.00–1.06) and survey response frequency (1.13, 1.04–1.22), and decreased with better usual sleep quality (0.96, 0.92–1.00) and with increasing age (0.98, 0.96–1.00). Sex stratification revealed no significant predictors of AEFI for either sex; in women, experiencing AEFI increased likelihood of ILI (1.88, 1.25–2.85) and in men, survey completion frequency increased ILI likelihood (1.19, 1.05–1.36).

Conclusions

Our study suggests modifying health behaviors would not alter AEFI risk and reactogenicity may signal weaker immunogenicity but confirmation through objective measures is warranted.

KEYWORDS:

• Injection site reaction
• health behaviors
• immunogenicity
• influenza
• sleep
• vaccination

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or mending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have received/receive investigator initiated grant funding form Sanofi and Merck.

Data availability

The data that support the findings of this study are available on request from the corresponding author.

Author contributions

E Goldbaum and KM Edwards co-conceived and co-designed the study; E Goldbaum acquired data; E Goldbaum and YS Bin led the analysis and, with authors R Booy and KM Edwards, the interpretation of data. E Goldbaum drafted the article, and all authors critically revised it for intellectual content before approving the final version for submission.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2022.2143350

Additional information

Funding

This paper was not funded.