Wednesday, 22 March 2023 11:48

Oral and General Side Effects of Pfizer COVID-19 Vaccine in Health Care Workers

1Saja Qasim Abbas, B.D.S., 2Taghreed Fadhil Zaidan, PhD
1Department of Oral Diagnosis, College of Dentistry, University of Baghdad, Baghdad, Iraq, 2Department of Dentistry, Al-Turath University College, Baghdad, Iraq.

Corresponding author: Saja Qasim Abbas
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Received 12 September 2022.
Accepted for publication on December 12, 2022.
Published March 23, 2023.


The first hit of the COVID-19 pandemic was reported in December 2019, in Wuhan, Hubei province, China and seafood wholesale markets were reported to be the source of infection. The development of effective and safe vaccines against SARS-CoV-2 has been extremely fast. The development of the COVID-19 mRNA vaccine started in early January; 2020, after the release of the SARS-CoV-2 genetic sequence by the Chinese Center for Disease Control and Prevention, and its global dissemination by the Global Initiative on Sharing All Influenza Data (GISAID). Initial safety and efficacy for COVID-19 mRNA (Pfizer) have been demonstrated in a study on a total of 43,584 participants randomized to vaccine and placebo. Objectives To determine the prevalence of oral and general side effects of Pfizer COVID-19 vaccination after two doses and booster vaccine in an Iraq cohort. Assessment of oral findings and salivary flow rate in response to Pfizer COVID-19 vaccine. Materials and Methods A randomly selected 85 Iraqi healthcare workers (HCW) from Baghdad Medical City and Al-Yarmouk Teaching Hospital participated in this study. The first study group were thirty HCW who received the COVID-19 vaccination from Pfizer in two doses, the subjects were recruited in this group 2 weeks – 3 months after they were vaccinated and had no prior history of COVID-19 symptoms. The second group comprised thirty HCW who had received the COVID-19 vaccination from Pfizer in two doses; were recruited 3 – 6 months after they were vaccinated and had no prior history of the virus› symptoms. The third group were twenty-five (HCW) who received a third booster dose of COVID-19 vaccination from Pfizer two weeks previously. The medical history (smoking, allergy, medication and previous COVID-19 infection) and general side effects of the vaccine (Injection site pain, Injection site swelling, Fever, Injection site redness, Tiredness, Headache, Nausea, Muscle pain, Alteration in smell, Swollen lymph node, Facial paralysis, Allergic reaction and Palpitation) and oral side effects (Ulcer, Mouth odour, Bleeding gum and Taste alteration) were recorded. An oral examination was performed to detect any oral lesions. Saliva samples were collected from each participant for salivary flow rate calculation. Results The results showed that the differences between the three groups’ side effects are not significant, but clinically 79 out of 85 expressed pain at the injection site, 62 subjects expressed fever and 62 expressed tiredness. The taste detection threshold for (sweets) showed a significant difference between the first and second groups and between the second and third groups. Similarly, the taste detection threshold for (salt) was found to be significantly different between the first and second groups. The taste detection threshold of sweets and salt was significantly higher in the second group, which means the taste is affected negatively by the vaccine. Conclusion The observed side effects following the Pfizer COVID-19 vaccine second dose were similar to those observed following the booster dose. The side effects of the Pfizer vaccine were on the whole moderate and tolerable and are in line with those mentioned in the FDA Fact Sheet and by the manufacturing firm. The COVID-19 vaccination was revealed to be linked to uncommon oral adverse effects.


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