Most Common COVID Vaccine Side Effects in Older Adults

The likely reason has to do with a declining immune response that comes with age, experts say. However, a lack of reaction or a diminished one doesn't mean the body isn't building protection against COVID-19. Large-scale clinical trials and real-world data show that the three federally authorized vaccines — from Moderna, Pfizer-BioNTech and Johnson & Johnson (J&J) — are highly effective at preventing severe illness from a coronavirus infection across all age groups. “So these are very strong vaccines,” Schaffner says.

COVID-19 vaccine side effects by age

Data is for systemic reactions, collected from the clinical trials

    
For those who did have symptoms, pain at the injection site, fatigue, headache and muscle pain — the majority of which were mild to moderate — were the most common among older adults in clinical trials for the Moderna, Pfizer and J&J vaccines. Data collected by the Centers for Disease Control and Prevention's (CDC) v-safe surveillance system also lists these as the top symptoms experienced by people 65 and older who received the Moderna and Pfizer vaccines between Dec. 14, 2020, and Feb. 28, 2021.

Joint pain, fever, nausea and chills have also been reported among older adults after their shots. And CDC data collected during the first month of U.S. vaccinations found that dizziness was one of the most frequently noted symptoms, across all age groups.

Another key finding: The second shot tends to hit a little harder. Older adults reported more frequent and more intense side effects after their second dose of the Pfizer and Moderna vaccines, compared to the first dose. What's more, if you've already had COVID-19 “the inclination at the moment” is that you could feel stronger side effects from the vaccines, since your “immune system has been somewhat primed,” Schaffner says.

Side effects a result of ‘revved up’ immune system

However irritating and uncomfortable they may be, these short-lived side effects “are normal signs that your body is building protection,” the CDC says.

The headache, fatigue, aches and chills are a result of an inflammatory response that happens “as the immune system sends the soldiers in to encounter the vaccine and begin to respond to it,” Schaffner explains. So the systemic reactions “are already your immune system starting to rev up,” he adds.

Over-the-counter medications, such as ibuprofen, acetaminophen, aspirin or antihistamines can help with any post-vaccine pain or discomfort. The CDC says individuals can take these medications as long as there's no other medical reason that would prevent them from taking them normally, although it's always a good idea to check with your doctor.

Just be sure to wait until symptoms — if any — set in before you seek relief. Schaffner says there's some data that suggest taking a pain-relieving medication before your shot can weaken your immune response, so “out of an excess of caution” it's best to wait. And any irritation or discomfort in the arm where you got the shot can be eased with a clean, cool, wet washcloth, the CDC says.

Preparing for possible side effects

If you are prone to dizzy spells or have trouble with balance, go to your appointment with “someone who can hold your arm,” Schaffner says, referring to the CDC report that listed dizziness as a common side effect from the shots. Making sure you're well hydrated before your vaccine can also help offset any lightheadedness.

"And remember, one of the good things is you will be observed for at least 15 minutes afterward. So you'll be sitting down in an area just beyond where you were vaccinated, and you can compose yourself and relax,” he adds.

In most cases, vaccine-related side effects fade after a few days — typically one to three days after onset. However, if they linger or worry you, contact your doctor. The same goes if the redness or tenderness where you got the shot gets worse after 24 hours, the CDC advises.

An important thing to keep in mind: In comparison to COVID, any side effects from the vaccines “are really very trivial,” Schaffner says. “It is a very modest price to pay if you do have some transient side effects, in order to protect ourselves against a virus that really could put any of us into the intensive care unit within 48 hours."

Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.