Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 13, 2021
Open Peer Review Period: Mar 12, 2021 - May 7, 2021
Date Accepted: Jun 14, 2021
Date Submitted to PubMed: Aug 3, 2021
(closed for review but you can still tweet)
Physiologic Response to the Pfizer-BioNTech COVID-19 Vaccine Measured Using Wearable Devices: A Prospective Observational Study
ABSTRACT
Background:
The Pfizer-BioNTech COVID-19 vaccine employs a novel messenger Ribonucleic Acid (mRNA) technology to elicit a protective immune response. Short-term physiologic responses to the vaccine have not been studied using wearable devices.
Objective:
We aim to characterize physiologic changes in response to COVID-19 vaccination in a small cohort of subjects using a wearable device (WHOOP Strap 3.0). This is a proof-of-concept for using consumer-grade wearable devices to monitor response to COVID-19 vaccines.
Methods:
In this prospective observational study, physiologic data from 19 Internal Medicine residents at a single institution that received both doses of the Pfizer-BioNTech COVID-19 vaccine was collected using the WHOOP Strap 3.0. The primary outcomes were percent change from baseline in heart rate variability (HRV), resting heart rate (RHR) and respiratory rate (RR). Secondary outcomes were percent change from baseline in total, rapid eye movement (REM) and deep sleep. Exploratory outcomes included local and systemic reactogenicity following each dose, and prophylactic analgesic use.
Results:
In 19 individuals, mean age 28.8 (+/- 2.2), 53% female, HRV was decreased on Day 1 following administration of the first vaccine dose (-13.44% +/- 13.62%), and second vaccine dose (-9.25% +/- 22.6%). RHR and RR showed no change from baseline after either vaccine dose. Sleep duration was increased up to four days post vaccination, after an initial decrease on Day 1. Increased sleep duration prior to vaccination was associated with a greater change in HRV. Local and systemic reactogenicity was more severe after dose two.
Conclusions:
This is the first observational study of the physiologic response to any of the novel COVID-19 vaccines, as measured using wearable devices. Using this relatively small, healthy cohort, we provide evidence that HRV decreases in response to both vaccine doses, with no significant changes in RHR or RR. Sleep duration initially decreased following each dose with a subsequent increase thereafter. Future studies with a larger sample size and comparison to other inflammatory and immune biomarkers, such as antibody response, will be needed to determine the true utility of this type of continuous wearable monitoring in regards to vaccine responses. Our data raises the possibility that increased sleep prior to vaccination may impact physiologic responses and may be a modifiable way to increase vaccine response. These results may inform future studies using wearables for monitoring vaccine responses. Clinical Trial: NCT04304703: https://www.clinicaltrials.gov/ct2/show/NCT04304703
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