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High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine-an Observational Study in Adults from Ronneby, Sweden

Andersson, Axel G ; Lundgren, Anna ; Xu, Yiyi LU ; Nielsen, Christel LU orcid ; Lindh, Christian H LU orcid ; Pineda, Daniela LU orcid ; Cederlund, Julia ; Pataridou, Elisavet ; Søgaard Tøttenborg, Sandra and Ugelvig Petersen, Kajsa , et al. (2023) In Environmental Health Perspectives 131(8). p.1-11
Abstract

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS.

OBJECTIVES: Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and... (More)

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS.

OBJECTIVES: Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and antibody responses in adults 5 wk and 6 months after a two-dose vaccination regime against SARS-CoV-2.

METHODS: Adults age 20-60 y from Ronneby (n=309, median PFOS serum level 47 ng/mL, fifth to 95th percentile 4-213 ng/mL) and a group with background exposure (n=47, median PFOS serum level 4 ng/mL) received two doses of the Spikevax (Moderna) mRNA vaccine. The levels of seven PFAS were measured in serum before vaccination. Serum immunoglobulin G antibodies against the SARS-CoV-2 spike antigen (S-Abs) were measured before vaccination and at 5 wk (n=350) and 6 months (n=329) after the second vaccine dose. Linear regression analyses were fitted against current, historical, and prenatal exposure to PFAS, adjusting for sex, age, and smoking, excluding individuals with previous SARS-CoV-2-infection.

RESULTS: PFAS exposure, regardless of how it was estimated, was not negatively associated with antibody levels 5 wk [current PFOS: -0.5% S-Abs/PFOS interquartile range (IQR); 95% confidence interval (CI): -8, 7] or 6 months (current PFOS: 3% S-Abs/PFOS IQR; 95% CI: -6, 12) after COVID-19 vaccination.

DISCUSSION: Following a strict study protocol, rigorous study design, and few dropouts, we found no indication that PFAS exposure negatively affected antibody responses to COVID-19 mRNA vaccination for up to 6 months after vaccination. https://doi.org/10.1289/EHP11847.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, Humans, Adult, Young Adult, Middle Aged, COVID-19 Vaccines, SARS-CoV-2, Sweden/epidemiology, Antibody Formation, COVID-19/prevention & control, Alkanesulfonic Acids, Vaccines, Fluorocarbons
in
Environmental Health Perspectives
volume
131
issue
8
article number
087007
pages
1 - 11
publisher
National Institute of Environmental Health Sciences
external identifiers
  • scopus:85168190915
  • pmid:37578904
ISSN
1552-9924
DOI
10.1289/EHP11847
language
English
LU publication?
yes
id
c542c9c5-6022-480c-bb98-180a01435633
date added to LUP
2023-08-16 15:33:37
date last changed
2025-01-26 05:00:11
@article{c542c9c5-6022-480c-bb98-180a01435633,
  abstract     = {{<p>BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS.</p><p>OBJECTIVES: Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and antibody responses in adults 5 wk and 6 months after a two-dose vaccination regime against SARS-CoV-2.</p><p>METHODS: Adults age 20-60 y from Ronneby (n=309, median PFOS serum level 47 ng/mL, fifth to 95th percentile 4-213 ng/mL) and a group with background exposure (n=47, median PFOS serum level 4 ng/mL) received two doses of the Spikevax (Moderna) mRNA vaccine. The levels of seven PFAS were measured in serum before vaccination. Serum immunoglobulin G antibodies against the SARS-CoV-2 spike antigen (S-Abs) were measured before vaccination and at 5 wk (n=350) and 6 months (n=329) after the second vaccine dose. Linear regression analyses were fitted against current, historical, and prenatal exposure to PFAS, adjusting for sex, age, and smoking, excluding individuals with previous SARS-CoV-2-infection.</p><p>RESULTS: PFAS exposure, regardless of how it was estimated, was not negatively associated with antibody levels 5 wk [current PFOS: -0.5% S-Abs/PFOS interquartile range (IQR); 95% confidence interval (CI): -8, 7] or 6 months (current PFOS: 3% S-Abs/PFOS IQR; 95% CI: -6, 12) after COVID-19 vaccination.</p><p>DISCUSSION: Following a strict study protocol, rigorous study design, and few dropouts, we found no indication that PFAS exposure negatively affected antibody responses to COVID-19 mRNA vaccination for up to 6 months after vaccination. https://doi.org/10.1289/EHP11847.</p>}},
  author       = {{Andersson, Axel G and Lundgren, Anna and Xu, Yiyi and Nielsen, Christel and Lindh, Christian H and Pineda, Daniela and Cederlund, Julia and Pataridou, Elisavet and Søgaard Tøttenborg, Sandra and Ugelvig Petersen, Kajsa and Fletcher, Tony and Lagging, Martin and Bemark, Mats and Jakobsson, Kristina and Li, Ying}},
  issn         = {{1552-9924}},
  keywords     = {{Child; Humans; Adult; Young Adult; Middle Aged; COVID-19 Vaccines; SARS-CoV-2; Sweden/epidemiology; Antibody Formation; COVID-19/prevention & control; Alkanesulfonic Acids; Vaccines; Fluorocarbons}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{1--11}},
  publisher    = {{National Institute of Environmental Health Sciences}},
  series       = {{Environmental Health Perspectives}},
  title        = {{High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine-an Observational Study in Adults from Ronneby, Sweden}},
  url          = {{http://dx.doi.org/10.1289/EHP11847}},
  doi          = {{10.1289/EHP11847}},
  volume       = {{131}},
  year         = {{2023}},
}