TY - JOUR

T1 - High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine—an Observational Study in Adults from Ronneby, Sweden

AU - Andersson, Axel G.

AU - Lundgren, Anna

AU - Xu, Yiyi

AU - Nielsen, Christel

AU - Lindh, Christian H.

AU - Pineda, Daniela

AU - Cederlund, Julia

AU - Pataridou, Elisavet

AU - Tøttenborg, Sandra Søgaard

AU - Petersen, Kajsa Ugelvig

AU - Fletcher, Tony

AU - Lagging, Martin

AU - Bemark, Mats

AU - Jakobsson, Kristina

AU - Li, Ying

N1 - Publisher Copyright: © 2023, Public Health Services, US Dept of Health and Human Services. All rights reserved.

PY - 2023

Y1 - 2023

N2 - 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 water-works 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.

AB - 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 water-works 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.

U2 - 10.1289/EHP11847

DO - 10.1289/EHP11847

M3 - Journal article

C2 - 37578904

AN - SCOPUS:85168190915

VL - 131

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 8

M1 - 087007

ER -