Association between perfluoroalkyl and polyfluoroalkyl substances and response to the COVID-19 vaccine in a paediatric prospective observational cohort in Arizona
James Hollister, Cynthia Porter, Boqi Xiang, Shawn C Beitel, Patrick Rivers, Karen Lutrick, Jefferey L Burgess, Katherine D EllingsonBackground
Previous research has shown a significant association between increased serum perfluoroalkyl and polyfluoroalkyl substances (PFAS) concentration and reduced antibody response to vaccinations in children, but this association has not yet been studied for COVID-19 vaccinations. We explored this relationship using data from the Arizona Healthcare, Emergency Response and Other Essential Workers Surveillance (AZ-HEROES) Kids study, a prospective cohort that began recruiting participants in July 2021 and followed through April 2023.
Methods
AZ-HEROES Kids participants aged 6 months to 17 years were eligible for this study if they received a full primary mRNA COVID-19 BNT-162b2 (Pfizer-BioNTech) vaccine series, voluntarily submitted a blood specimen 14–60 days following the second vaccine dose and had no evidence of SARS-CoV-2 infection prior to vaccination. 13 PFAS chemicals were measured in serum samples, including branched and linear isomers of perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid. A semi-quantitative ELISA was used to measure antibody binding to the SARS-CoV-2 spike protein receptor binding domain (RBD) and S2 subunit domain (S2). An area under the serial dilution curve (AUC) was calculated for RBD and S2. Regression models were fit for each PFAS chemical to assess the relationship between antibody binding (RBD and S2 AUC) and serum PFAS concentration with adjustments for age, sex, geographic region in Arizona and presence of chronic conditions.
Results
The final sample included 120 individuals between 1 and 16 years old. An SD increase in total log-PFOS concentration was significantly associated with a 5.0% decrease in RBD AUC (95% CI −8.1% to −1.8%). The linear and branched isomers of PFOS were also significantly associated with a 4.8% (−7.9% to −1.6%) and 4.9% (−8.0% to −1.7%) decrease in RBD AUC, respectively.
Conclusions
This study contributes to the growing evidence of the negative effects of PFAS exposure on humoral response to vaccination in children.