Self-Reported and Physiologic Reactions to Third BNT162b2 mRNA COVID-19 (Booster) Vaccine Dose

Merav Mofaz, Matan Yechezkel, Grace Guan, Margaret L. Brandeau, Tal Patalon, Sivan Gazit, Dan Yamin, Erez Shmueli

Research output: Contribution to journalArticlepeer-review


Despite extensive technological advances in recent years, objective and continuous assessment of physiologic measures after vaccination is rarely performed. We conducted a prospective observational study to evaluate short-term self-reported and physiologic reactions to the booster BNT162b2 mRNA (Pfizer-BioNTech, vaccine dose. A total of 1,609 participants were equipped with smartwatches and completed daily questionnaires through a dedicated mobile application. The extent of systemic reactions reported after the booster dose was similar to that of the second dose and considerably greater than that of the first dose. Analyses of objective heart rate and heart rate variability measures recorded by smartwatches further supported this finding. Subjective and objective reactions after the booster dose were more apparent in younger participants and in participants who did not have underlying medical conditions. Our findings further support the safety of the booster dose from subjective and objective perspectives and underscore the need for integrating wearables in clinical trials.

Original languageEnglish
Pages (from-to)1375-1383
Number of pages9
JournalEmerging Infectious Diseases
Issue number7
StatePublished - 1 Jul 2022


  • BNT162b2
  • COVID-19
  • SARS-CoV-2
  • adverse effects
  • booster vaccine
  • coronavirus disease
  • coronaviruses
  • heart rate variability
  • mRNA
  • physiologic reactions
  • respiratory infections
  • self-reported reactions
  • severe acute respiratory syndrome coronavirus 2
  • smartwatch
  • third COVID-19 dose
  • vaccine
  • viruses
  • wearables
  • zoonoses


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