Frequency, Severity of Adverse Events in Older Adults After COVID-19 Vaccine Booster

Among adults aged 60 years and older, the most common adverse events (AEs) following a third dose of the BNT162b2 COVID-19 vaccine were mild, including injection site pain, fatigue, and malaise, according to survey results published in JAMA Network Open.

Researchers in Israel contacted adults (N=66,098) aged 60 years and older who received a booster dose of the BNT162b2 vaccine. Participants aged between 60 and 79 were asked to complete an online survey regarding the occurrence of AEs following vaccination. For participants aged 80 and older, the survey was conducted via telephone interview. The researchers used data captured from electronic health records to assess participants’ demographic and clinical characteristics.

Among participants who completed the survey (n=27,046), the median age was 71 (IQR, 66-75) years, 45.3% were women, and 49.2% were at increased risk for severe COVID-19 infection.

Following receipt of a COVID-19 vaccine booster dose, 30% of participants reported at least 1 AE, 16.6% reported systemic reactions, and injection site pain (23.5%), fatigue (9.7%), and malaise (7.2%) were the most commonly reported AEs. The rate of systemic reactions decreased with age as 20.5% of reactions occurred in participants aged between 60 and 69 and 13.6% occurred among those 70 and older.

The researchers found that women were more likely to report an AE vs men (39.0% vs 22.6%). Similar findings were noted for systemic reactions (22.9% vs 11.4%).

Approximately 67.8% of participants reported that their response to the booster dose did not differ from that of the second vaccine dose. However, 18.7% of participants reported a milder response to the COVID-19 booster dose and 11.1% reported a worse response. Adverse events requiring medical care occurred among only 1.2% of participants.

This study was limited by the use of different surveys for participants aged between 60 and 79 vs those 80 and older.

“We found that AEs after the BNT162b2 mRNA vaccine booster dose were generally mild and usually did not require medical care,” the researchers concluded.

Disclosure: Several authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Auster O, Finkel U, Dagan N, et al. Short-term adverse events after the third dose of the BNT162b2 mRNA COVID-19 vaccine in adults 60 years or older. JAMA Netw Open. 2022;5(4):e227657. doi:10.1001/jamanetworkopen.2022.7657