Soreness, fatigue and headaches common for first dose of AstraZeneca, second of Pfizer

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Most Australians are reporting side effects such as a sore arm, fatigue and headaches from the first dose of AstraZeneca and the second dose of Pfizer, but experts say this is normal and could be a sign the vaccines are doing their job.

AusVaxSafety, a collaboration led by the National Centre for Immunisation Research and Surveillance, reports weekly on adverse reactions to the COVID-19 vaccinations. The side effects are self-reported in a survey sent three days after the jab, with hundreds of thousands of responses so far.

Sholto Macpherson, 45, from Maroubra, in Sydney’s eastern suburbs, had his second Pfizer vaccination last week and experienced typical side effects. He had no reaction to the first jab and experienced minor fatigue and headaches after the second dose.

Sholto Macpherson experienced fatigue and headaches from the second Pfizer dose but says it was worth it.Credit:Rhett Wyman

He said the side effects were not enough to stop him from working and looking after his children, and he considered it well worth it.

“I felt completely relieved after getting that second shot – I high-fived the nurses out of there, I was just ecstatic,” Mr Macpherson said. “I’m removing myself as a link in the chain – or making it much less likely.”

The AusVaxSafety figures reveal 62.4 per cent of people did not have a reaction to the first Pfizer dose, the vaccine currently recommended for people under 60.

More than nine out of 10 were able to continue work, study and routine duties. The most common reaction was injection-site pain, followed by fatigue and headaches.

But for the follow-up dose three weeks later, this was flipped – 58.5 per cent had an adverse reaction. Nearly one in four felt so unwell they missed work, study or routine duties, though most for less than a day.

The most common reaction to the second jab is fatigue, closely followed by injection-site pain, with both experienced by almost half of respondents. Headaches, muscle pain, joint pain, chills and fever were also reasonably common.

Meanwhile, for people who received the AstraZeneca vaccine, currently only recommended for people over 60, the side effects mostly occurred with the first dose.

More than half of people who received the first AstraZeneca jab had some combination of fatigue, headache, muscle/body aches, injection site pain, chills and fever.

It was much less common to get side effects from the second AstraZeneca dose, with only one in three reporting any adverse event.

AusVaxSafety also reported how many Indigenous Australians experienced side effects and the results were similar to the general population.

Professor Robert Booy, infectious disease specialist and epidemiologist at the University of Sydney and chair of the scientific committee of the Immunisation Coalition, said the major COVID-19 vaccines were more closely studied than any other vaccine, both in clinical trials and also real-world scrutiny.

“We have more confidence about the safety of the COVID vaccines than any other vaccine we currently use,” Professor Booy said.

He said most side effects were normal and would usually last only a couple of days. The sore injection site and systemic reaction could even be a sign of the vaccine doing its job to provoke a reaction from the immune system.

Researchers have previously found that people who get a fever from the influenza vaccine have a stronger immune response and greater protection from the virus but this is still being studied for the COVID-19 vaccine, he said.

However, people should be alert to possible symptoms of thrombosis with thrombocytopenia syndrome (TTS), the rare clotting disorder that has afflicted some recipients of the AstraZeneca vaccine as well as Johnson & Johnson overseas.

The symptoms include persistent headaches that are unresponsive to painkillers, abdominal or chest pain and neurological symptoms such as double vision and movement or sensation changes. Professor Booy said TTS symptoms would not occur until at least four days after the vaccination and up to four weeks later.

Professor Booy said the risk of TTS was one in 100,000 people in the general population and one in a million for people over 60.

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