Gender differences in adverse effects following the second dose of AstraZeneca COVID-19 vaccine: a cross-sectional study among healthcare workers

Background: Vaccination in pandemic diseases, in addition to positive effects on controlling the prevalence and reducing the resulting socioeconomic effects, can have adverse effects with different intensity based on gender, type and dose of vaccine. We aimed to investigate gender differences in adverse effects following the second dose of AstraZeneca Covid-19 vaccine among healthcare workers (HWs).

Method: This cross-sectional study was conducted on 780 HWs who worked in two educational hospitals in Kermanshah city, western Iran, and had received the second dose of AstraZeneca vaccine. The duration of the investigation of the adverse effects was a maximum of one month after receiving the second dose of AstraZeneca vaccine.

Results: The overall proportion of adverse effects following the second dose of the AstraZeneca Covid-19 vaccine was higher in female participants, but it was not significant (OR=1.83, p=0.056). The results of adjusted logistic regression showed that the odds of chills (OR=2.17, p=0.001), nausea (OR=2.98, p=0.012), and gastrointestinal symptoms (OR=2.1, p=0.001), runny nose (OR=1.5, p=0.047), fever (OR=1.64, p=0.002), body pain (OR=1.4, p=0.04), and fatigue (OR=1.85, p=0.001) were significantly higher in females than in males. The maximum gap of 15% (attributable risk) was shown for fever adverse between genders.

Conclusion: The higher occurrence rate of side effects after second dose of AstraZeneca Covid-19 vaccine in women, indicates that gender factors influence the response to the vaccine, consequently, it is imperative that women undergo further examination to mitigate the risk of complications arising from injection procedures.