Immunogenicity after Second ChAdOx1 nCoV-19 (AZD1222) Vaccination According to the Individual Reactogenicity, Health Status and Lifestyle
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Measurement of Adverse Events
2.3. Measurements of Individual Health Status
2.4. Measurement of Cellular and Humoral Immune Responses
2.4.1. Humoral Immunity
2.4.2. Cellular Immunity
2.5. Statistical Analysis
3. Results
3.1. Characteristics of the Study Participants
3.2. Humoral and Cellular Immunogenicity
3.3. Reactogenicity
3.4. Association between Immunogenicity, Reactogenicity, and Individual Health Status
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Anti-S1 Antibody (S/co) | sVNT (%) | T-Spot (/250,000 PMCs) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Positive Symptom | Negative Symptom | p | Positive Symptom | Negative Symptom | p | Positive Symptom | Negative Symptom | p | ||
1st dose | Fever (58.2%) | 5.2 (±1.5) | 5.6 (±1.8) | 0.26 | 74.9 (±17.7) | 75.1 (±21.4) | 0.97 | 10.4 (±8.1) | 9.7 (±7.0) | 0.69 |
Chills (62.0%) | 5.2 (±1.5) | 5.67 (±1.81) | 0.17 | 74.0 (±18.3) | 76.6 (±30.8) | 0.60 | 10.8 (±1.6) | 9.1 (±7.1) | 0.34 | |
Headache (54.4%) | 5.1 (±1.3) | 5.61 (±1.9) | 0.20 | 74.9 (±17.6) | 75.0 (±21.2) | 0.97 | 10.5 (±7.9) | 9.7 (±7.4) | 0.68 | |
Muscle pain (72.2%) | 5.3 (±1.4) | 5.52 (±2.11) | 0.62 | 76.0 (±17.6) | 72.2 (±23.0) | 0.49 | 9.9 (±7.1) | 10.9 (±9.1) | 0.59 | |
Fatigue (79.7%) | 5.3 (±1.4) | 5.6 (±2.32) | 0.61 | 75.6 (±17.7) | 72.6 (±24.8) | 0.66 | 10.4 (±7.9) | 8.9 (±6.2) | 0.51 | |
Nausea & Vomiting (12.7%) | 5.9 (±1.4) | 5.27 (±1.64) | 0.27 | 80.8 (±14.8) | 74.1 (±19.7) | 0.31 | 14.4 (±11.1) | 9.5 (±6.8) | 0.21 | |
Rash (5.1%) | 6.0 (±0.8) | 5.31 (±1.64) | 0.41 | 89.4 (±7.7) | 74.2 (±19.3) | 0.02 | 13.9 (±15.3) | 9.9 (±7.1) | 0.64 | |
Anaphylactoid reaction (1.3%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A) | N/A | |
Tenderness (84.8%) | 5.5 (±1.6) | 4.72 (±1.91) | 0.15 | 76.5 (±17.9) | 66.4 (±24.4) | 0.09 | 10.4 (±8) | 9.0 (±5.4) | 0.58 | |
Pain (53.2%) | 10.2 (±8.5) | 10.08 (±6.54) | 0.32 | 74.1 (±18.5) | 75.9 (±20.2) | 0.68 | 10.2 (±1.3) | 10.1 (±1.1) | 0.95 | |
Redness (20.3%) | 5.1 (±1.1) | 5.4 (±1.74) | 0.42 | 72.4 (±17.3) | 75.6 (±19.7) | 0.55 | 7.8 (±5.0) | 10.7 (±8.1) | 0.19 | |
Swelling (30.4%) | 5.3 (±1.2) | 5.38 (±1.77) | 0.73 | 73.6 (±17.0) | 75.5 (±20.2) | 0.66 | 8.5 (±7.0) | 10.9 (±7.8) | 0.20 | |
2nd dose | Fever (20.3%) | 5.4 (±1.9) | 5.32 (±1.55) | 0.81 | 76.1 (±20.3) | 74.7 (±19.1) | 0.79 | 10.2 (±10) | 10.1 (±7.0) | 0.96 |
Chills (20.3%) | 6.2 (±1.7) | 5.16 (±1.55) | 0.03 | 85.1 (±14.7) | 72.8 (±19.4) | 0.03 | 13.0 (±9.6) | 9.6 (±7.1) | 0.15 | |
Headache (36.7%) | 5.1 (±1.5) | 5.47 (±1.71) | 0.37 | 75.4 (±17.8) | 74.7 (±20.1) | 0.88 | 11.4 (±6.9) | 9.3 (±6.6) | 0.27 | |
Muscle pain (43.0%) | 5.5 (±1.6) | 5.21 (±1.65) | 0.41 | 78.0 (±17.7) | 72.7 (±20.1) | 0.23 | 10.2 (±8.9) | 10.1 (±6.6) | 0.98 | |
Fatigue (59.5%) | 5.4 (±1.5) | 5.26 (±1.85) | 0.71 | 77.6 (±16.5) | 71.0 (±22.2) | 0.16 | 10.8 (±8.4) | 9.1 (±6.2) | 0.37 | |
Nausea & Vomiting (3.8%) | 6.1 (±1.3) | 5.31 (±1.63) | 0.40 | 83.7 (±14.1) | 74.6 (±19.4) | 0.43 | 16.3 (±16) | 9.9 (±7.2) | 0.56 | |
Rash (1.3%) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
Anaphylactoid reaction (0.0%) | N/A | N/A) | N/A | N/A | N/A | N/A | N/A | N/A | N/A | |
Tenderness (67.1%) | 5.4 (±1.5) | 5.18 (±1.88) | 0.52 | 77.8 (±16.4) | 69.3 (±23.3) | 0.10 | 9.5 (±7.3) | 11.5 (±8.3) | 0.29 | |
Pain (36.7%) | 5.3 (±1.5) | 5.39 (±1.7) | 0.72 | 75.1 (±17.9) | 74.9 (±20.1) | 0.97 | 8.7 (±7.4) | 11.0 (±7.7) | 0.22 | |
Redness (17.7%) | 5.1 (±1.3) | 5.4 (±1.68) | 0.48 | 71.2 (±18.4) | 75.8 (±19.4) | 0.42 | 7.8 (±5.4) | 10.6 (±8.0) | 0.23 | |
Swelling (16.5%) | 5.1 (±1.1) | 5.38 (±1.71) | 0.63 | 71.2 (±16.3) | 75.7 (±19.7) | 0.44 | 7.0 (±5.2) | 10.7 (±7.9) | 0.12 |
Anti-S1 Antibody | sVNT | T-Spot | ||||||
---|---|---|---|---|---|---|---|---|
Variables (N) | Mean (SD) | p | Mean (SD) | p | Mean (SD) | p | ||
Sex | Male (21) | 5.2 (±1.9) | 0.73 | 73.7 (±20.9) | 0.73 | 12.9 (±7.8) | 0.08 | |
Female (58) | 5.4 (±1.5) | 75.4 (±18.7) | 9.3 (±7.4) | |||||
Age | <40 (55) | 5.4 (±1.6) | 0.47 | 76.6 (±17.7) | 0.31 | 9.8 (±7.6) | 0.58 | |
≥40 (24) | 5.1 (±1.8) | 71.2 (±22.2) | 10.9 (±7.7) | |||||
Smoking | No (70) | 5.3 (±1.7) | 0.26 | 74.0 (±19.5) | 0.23 | 10.1 (±7.9) | 0.83 | |
Yes (9) | 5.9 (±1.3) | 82.2 (±16.1) | 10.7 (±4.8) | |||||
Alcohol consumption | Mild to moderate (45) | 5.3 (±1.5) | 0.98 | 75.5 (±18.6) | 0.78 | 8.9 (±5.9) | 0.13 | |
Heavy or binge (34) | 5.3 (±1.7) | 74.2 (±20.2) | 11.9 (±9.3) | |||||
BMI | <25 (57) | 5.2 (±1.5) | 0.44 | 74.2 (±18.3) | 0.51 | 10.1 (±7.9) | 0.08 | |
25–30 (18) | 5.7 (±0.4) | 78.7 (±19.8) | 11.8 (±6.7) | |||||
>30 (4) | 6.1 (±0.8) | 68.8 (±31.4) | 4.0 (±5.0) | |||||
Pulmonary tuberculosis | No (75) | 5.3 (±1.6) | 0.43 | 74.4 (±19.3) | 0.27 | 10.2 (±7.7) | 0.92 | |
Yes(4) | 6.0 (±0.8) | 85.4 (±15.7) | 7.8 (±6.0) | |||||
HTN | No (76) | 5.3 (±1.6) | 0.90 | 75.2 (±19.0) | 0.50 | 10.3 (±7.7) | 0.47 | |
Yes (3) | 5.5 (±2.8) | 67.7 (±26.4) | 7.0 (±3.5) | |||||
Dyslipidemia | No (76) | 5.3 (±1.6) | 0.94 | 74.7 (±19.0) | 0.62 | 10.1 (±7.7) | 0.78 | |
Yes (3) | 5.4 (±1.8) | 80.4 (±28.5) | 11.3 (±5.8) | |||||
DM | No (78) | 5.4 (±1.6) | 0.24 | 75.3 (±19.1) | 0.15 | 10.2 (±7.6) | 0.50 | |
Yes (1) | 3.5 (±NA) | 47.5 (±NA) | 5.0 (±NA) | |||||
Abnormal LFT | No (71) | 5.4 (±1.7) | 0.90 | 75.1 (±18.7) | 0.84 | 10.3 (±7.8) | 0.67 | |
Yes (8) | 5.3 (±1.4) | 73.7 (±24.5) | 9.1 (±5.9) | |||||
Abnormal RFT | No (72) | 5.3 (±1.6) | 0.25 | 74.7 (±19.5) | 0.75 | 9.6 (±7.0) | 0.19 | |
Yes (7) | 6.0 (±1.4) | 77.1 (±16.8) | 15.7 (±11.0) | |||||
Physical activity | Lack (42) | 5.2 (±1.6) | 0.52 | 73.1 (±21.2) | 0.36 | 10.6 (±7.4) | 0.60 | |
Adequate (37) | 5.5 (±1.6) | 77.0 (±16.7) | 9.6 (±7.9) | |||||
Muscle exercise | Lack (52) | 5.3 (±1.4) | 0.80 | 74.0 (±18.7) | 0.55 | 9.1 (±7.0) | 0.09 | |
Adequate (27) | 5.4 (±1.9) | 76.8 (±20.4) | 12.4 (±8.6) | |||||
1st dose | Antipyretics | No (8) | 5.4 (±1.5) | 0.68 | 76.2 (±17.9) | 0.14 | 10.1 (±7.7) | 0.97 |
Yes (69) | 5.0 (±2.5) | 66.5 (±26.1) | 10.3 (±7.3) | |||||
Antipyretics intake | Prophylactic (30) | 5.4 (±1.5) | 0.58 | 75.1 (±17.5) | 0.62 | 10.5 (±7.4) | 0.76 | |
After symptom onset (39) | 5.4 (±1.5) | 77.4 (±18.4) | 9.9 (±8.1) | |||||
2nd dose | Antipyretics | No (28) | 5.4 (±1.5) | 0.83 | 76.1 (±17.6) | 0.46 | 10.6 (±8.4) | 0.51 |
Yes (51) | 5.3 (±1.8) | 72.8 (±21.9) | 9.3 (±5.7) | |||||
Antipyretics intake | Prophylactic (24) | 5.5 (±1.8) | 0.51 | 76.3 (±17.2) | 0.85 | 11.9 (±8.9) | 0.33 | |
After symptom onset (27) | 5.2 (±1.3) | 75.4 (±18.3) | 9.5 (±8.3) | |||||
SRI | <13 (37) | 5.3 (±1.8) | 0.81 | 72.9 (±21.0) | 0.38 | 10.8 (±7.8) | 0.49 | |
≥13 (42) | 5.4 (±1.5) | 76.8 (±17.5) | 9.6 (±7.5) | |||||
SRID | <29 (40) | 5.4 (±1.8) | 0.75 | 74.6 (±20.8) | 0.88 | 11.3 (±7.7) | 0.21 | |
≥29 (39) | 5.3 (±1.5) | 75.3 (±17.6) | 9.1 (±7.5) |
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Male (n = 21) | Female (n = 58) | Total | p | ||
---|---|---|---|---|---|
Age | Age (years) | 40.4 ± 7.5 | 35.5 ± 6.3 | 36.8 ± 7 | 0.01 |
Days between 1st and 2nd shot | 77.8 ± 13.4 | 78.9 ± 8.6 | 78.6 ± 10.0 | 0.65 | |
Days after 2nd shot | 16.8 ± 4.8 | 15.3 ± 2.4 | 15.7 ± 3.2 | 0.20 | |
Immunogenicity | S1 antibody (S/Co value) | 5.2 ± 1.9 | 5.4 ± 1.5 | 5.3 ± 1.6 | 0.73 |
S1 antibody positive | 21/21 (100%) | 58/58 (100%) | 79/79 (100%) | N/A | |
T-spot (spots) | 12.9 ± 7.8 | 9.3 ± 7.4 | 10.1 ± 7.6 | 0.08 | |
T-spot positive | 10/17 (52.9%) | 22/46 (19.3%) | 32/74 (43.2%) | 0.14 | |
sVNT (%) | 73.7 ± 20.9 | 75.4 ± 18.7 | 75.0 ± 19.2 | 0.73 | |
sVNT positive | 20/21 (95.2%) | 58/58 (100%) | 78/79 (98.7%) | 0.09 | |
Blood pressure | SBP (mmHg) | 123.7 ± 13.0 | 112.8 ± 10.1 | 115.7 ± 11.9 | <0.01 |
DBP (mmHg) | 80.5 ± 8.5 | 72 ± 8.4 | 74.2 ± 9.2 | <0.01 | |
Anthropometrics | BMI (kg/m²) | 26.8 ± 7.1 | 22.5 ± 3.3 | 23.7 ± 5 | <0.01 |
WC (cm) | 77.5 ± 8.5 | 73.6 ± 13.1 | 74.7 ± 12.1 | <0.01 | |
Physical activities | Lack | 9 (42.9%) | 33 (56.9%) | 42 (53.2%) | 0.28 |
Adequate | 12 (57.1%) | 25 (43.1%) | 37 (46.8%) | ||
Weight training | Lack | 8 (38.1%) | 44 (75.9%) | 52 (65.8%) | <0.01 |
Adequate | 13 (61.9%) | 14 (24.1%) | 27 (34.2%) | ||
Smoking | No | 9/21 (42.9%) | 58/58 (100%) | 70/79 (88.6%) | <0.01 |
Yes | 12/21 (57.1%) | 0/58 (0%) | 9/79 (11.4%) | ||
Alcohol consumption | Mild to moderate | 6/21 (28.6%) | 39/58 (67.2%) | 45/79 (57.0%) | 0.02 |
Heavy or binge | 15/21 (71.4%) | 19/58 (32.8%) | 34/79 (43.0%) | ||
Comorbidity | Pulmonary tuberculosis | 2/21 (9.5%) | 2/58 (3.4%) | 4/79 (5.1%) | 0.28 |
Hypertension | 2/21 (9.5%) | 1/58 (1.7%) | 3/79 (3.8%) | 0.11 | |
Dyslipidemia | 2/21 (9.5%) | 1/58 (1.7%) | 3/79 (3.8%) | 0.11 | |
Diabetes mellitus | 1/21 (4.8%) | 0/58 (0.0%) | 1/79 (1.3%) | 0.09 | |
Laboratory analysis | Hb (g/dL) | 15.0 ± 0.8 | 13.1 ± 1.05 | 13.6 ± 1.3 | <0.01 |
FBG (mg/dL) | 102.2 ± 14.4 | 91.5 ± 13.1 | 94.4 ± 13.1 | <0.01 | |
Cr (mg/dL) | 0.8 ± 0.1 | 0.6 ± 0.1 | 0.7 ± 0.1 | <0.01 | |
eGFR (mL/min/1.73 m2) | 85.0 ± 15.7 | 92.6 ± 20.4 | 90.6 ± 19.4 | 0.13 | |
AST (IU/L) | 23.7 ± 5.8 | 21.8 ± 13.7 | 22.3 ± 12.1 | 0.55 | |
ALT (IU/L) | 32.4 ± 18.6 | 19.4 ± 31.9 | 22.8 ± 29.4 | 0.08 | |
GGT (IU/L) | 32.5 ± 24.0 | 16.6 ± 11.1 | 20.8 ± 16.9 | <0.01 | |
TC (mg/dL) | 225.6 ± 41.9 | 198.1 ± 35.2 | 205.4 ± 38.8 | <0.01 | |
HDL-C (mg/dL) | 54.7 ± 8.8 | 62.1 ± 9.9 | 60.2 ± 10.1 | <0.01 | |
LDL-C (mg/dL) | 134.9 ± 37.5 | 116.3 ± 36.1 | 121.3 ± 35 | 0.04 | |
TG (mg/dL) | 172.7 ± 82.5 | 98.9 ± 53.9 | 118.6 ± 70.3 | <0.01 | |
Reactogenicity | SIR | 9.3 ± 8.5 | 14.9 ± 9.3 | 13.4 ± 9.3 | 0.02 |
SIRD | 19.1 ± 22.9 | 39.9 ± 32.8 | 34.4 ± 31.7 | 0.01 |
T-Spot Negative | T-Spot Positive | Total | p | ||
---|---|---|---|---|---|
Sex | Female | 35 (61.4%) | 22 (38.6%) | 57 | 0.14 |
Male | 7 (41.2%) | 10 (58.8%) | 17 | ||
Age | (years) | 35.5 ± 6.7 | 37.4 ± 5.8 | 36.8 ± 7.0 | 0.18 |
Occupation | Doctor | 3 (50.0%) | 3 (50.0%) | 6 | 0.45 |
Nurse | 25 (58.1%) | 18 (41.9%) | 43 | ||
Researchers | 1 (50%) | 1 (50%) | 2 | ||
Medical technologist | 7 (43.8%) | 9 (56.3%) | 16 | ||
Hospital administrative assistant | 6 (85.7%) | 1 (14.3%) | 7 | ||
Physical activities | Lack | 22 (53.7%) | 19 (46.3%) | 41 | 0.55 |
Adequate | 20 (60.6%) | 13 (39.4%) | 33 | ||
Weight training | Lack | 31 (60.8%) | 20 (39.2%) | 51 | 0.30 |
Adequate | 11 (47.8%) | 12 (52.2%) | 23 | ||
Smoking | No | 38 (57.6%) | 28 (42.4%) | 66 | 0.68 |
Yes | 4 (50%) | 4 (50%) | 8 | ||
Alcohol consumption | Mild to moderate | 26 (60.5%) | 17 (39.5%) | 43 | 0.45 |
Heavy | 16 (51.6%) | 15 (48.4%) | 31 | ||
Anthropometrics | BMI | 23.4 ± 3.5 | 23.2 ± 3.2 | 23.7 ± 5.0 | 0.72 |
WC | 74.7 ± 9.3 | 73.8 ± 15.6 | 74.7 ± 12.1 | 0.76 | |
SBP | 114.26 ± 10.6 | 117.6 ± 13.7 | 115.7 ± 11.9 | 0.25 | |
DBP | 73.1 ± 8.7 | 75.6 ± 9.2 | 74.2 ± 9.2 | 0.24 | |
Pulmonary tuberculosis | No | 40 (57.1%) | 30 (42.9%) | 70 | 0.78 |
Yes | 2 (50.0%) | 2 (50.0%) | 4 | ||
Hypertension | No | 40 (56.3%) | 31 (43.7%) | 71 | 0.74 |
Yes | 2 (66.7%) | 1 (33.3%) | 3 | ||
Dyslipidemia | No | 41 (57.7%) | 30 (42.3%) | 71 | 0.40 |
Yes | 1 (33.3%) | 2 (66.7%) | 3 | ||
Diabetes mellitus | No | 41 (56.2%) | 32 (43.8%) | 73 | 0.38 |
Yes | 1 (100.0) | 0 (0.0%) | 1 | ||
Laboratory analysis | Hb (g/dL) | 13.4 ± 1.3 | 13.8 ± 1.3 | 13.6 ± 1.3 | 0.29 |
FBG (mg/dL) | 94.9 ± 11.8 | 93.2 ± 15.3 | 94.4 ± 13.1 | 0.60 | |
Cr (mg/dL) | 0.6 ± 0.1 | 0.7 ± 0.2 | 0.7 ± 0.2 | 0.01 | |
eGFR (mL/min/1.73 m2) | 95.4 ± 19.8 | 83.8 ± 16.7 | 90.6 ± 19.5 | <0.01 | |
AST (IU/L) | 20.5 ± 5.7 | 24.8 ± 17.7 | 22.3 ± 12.1 | 0.14 | |
ALT (IU/L) | 19.1 ± 14.8 | 28.1 ± 42.7 | 22.8 ± 29.5 | 0.21 | |
GGT (IU/L) | 19.4 ± 13.5 | 22.7 ± 21.6 | 20.8 ± 17.0 | 0.42 | |
TC (mg/dL) | 205.7 ± 36.6 | 204.1 ± 43.6 | 205.4 ± 38.8 | 0.87 | |
HDL-C (mg/dL) | 61.5 ± 10.4 | 59.0 ± 9.7 | 60.2 ± 10.1 | 0.30 | |
LDL-C (mg/dL) | 120.5 ± 35.4 | 122.1 ± 35.3 | 121.4 ± 35.0 | 0.86 | |
TG (mg/dL) | 118.3 ± 72.8 | 117.6 ± 72.0 | 118.6 ± 70.4 | 0.97 | |
Reactogenicity | SIR | 14.5 ± 10.0 | 13.4 ± 8.4 | 13.4 ± 9.3 | 0.61 |
SIRD | 38.1 ± 31.3 | 34.0 ± 32.9 | 34.4 ± 31.7 | 0.58 |
Anti-S1 Antibody | sVNT | T-Spot | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Univariate Model | Multivariate Model | Univariate Model | Multivariate Model | Univariate Model | Multivariate Model | |||||||
Coefficient (SE) | p | Coefficient (SE) | p | Coefficient (SE) | p | Coefficient (SE) | p | Coefficient (SE) | p | Coefficient (SE) | p | |
Men | −0.20(0.51) | 0.7 | −1.78(6.28) | 0.77 | 3.63 (2.07) | 0.08 | 5.94 (2.24) | 0.01 | ||||
Age | −0.07(0.03) | 0.02 | −0.06(0.03) | 0.02 | −0.60(0.34) | 0.09 | −0.61(0.31) | 0.05 | 0.16 (0.14) | 0.27 | ||
BMI | 0.10(0.06) | 0.12 | 0.10(0.05) | 0.06 | 0.42(0.73) | 0.57 | −0.32 (0.27) | 0.24 | −0.69 (0.29) | 0.02 | ||
Muscle exercise | 0.02(0.42) | 0.97 | 3.25(5.07) | 0.52 | 3.30 (1.88) | 0.09 | ||||||
SRI | −0.04(0.03) | 0.22 | 0.19(0.41) | 0.65 | 0.08 (0.04) | 0.59 | −0.25 (0.15) | 0.11 | ||||
SRID | 0.01(0.01) | 0.52 | −0.08(0.12) | 0.50 | −0.13 (0.06) | 0.89 | 0.07 (0.04) | 0.10 |
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Choi, H.; Lee, S.-M.; Lim, S.; Shin, K.-H.; Kim, T.; Kim, W.-j.; Yun, M.; Oh, S.-H. Immunogenicity after Second ChAdOx1 nCoV-19 (AZD1222) Vaccination According to the Individual Reactogenicity, Health Status and Lifestyle. Vaccines 2021, 9, 1473. https://doi.org/10.3390/vaccines9121473
Choi H, Lee S-M, Lim S, Shin K-H, Kim T, Kim W-j, Yun M, Oh S-H. Immunogenicity after Second ChAdOx1 nCoV-19 (AZD1222) Vaccination According to the Individual Reactogenicity, Health Status and Lifestyle. Vaccines. 2021; 9(12):1473. https://doi.org/10.3390/vaccines9121473
Chicago/Turabian StyleChoi, Hyunji, Sun-Min Lee, Seungjin Lim, Kyung-Hwa Shin, Taeyun Kim, Won-joo Kim, Misook Yun, and Seung-Hwan Oh. 2021. "Immunogenicity after Second ChAdOx1 nCoV-19 (AZD1222) Vaccination According to the Individual Reactogenicity, Health Status and Lifestyle" Vaccines 9, no. 12: 1473. https://doi.org/10.3390/vaccines9121473
APA StyleChoi, H., Lee, S. -M., Lim, S., Shin, K. -H., Kim, T., Kim, W. -j., Yun, M., & Oh, S. -H. (2021). Immunogenicity after Second ChAdOx1 nCoV-19 (AZD1222) Vaccination According to the Individual Reactogenicity, Health Status and Lifestyle. Vaccines, 9(12), 1473. https://doi.org/10.3390/vaccines9121473