Correlation between the immune response to COVID-19 vaccines and the constitutions of traditional Chinese medicine

Traditional Chinese Medicine (TCM) classifies individuals into constitution types that may influence physiological responses. SARS-CoV-2 vaccines induce spike-specific antibodies and activate B and T cells, including memory subsets. This study investigates whether TCM constitution types are associated with immune responses and adverse events following COVID-19 vaccination. From March 2021 to December 2023, 78 adults received two doses of the COVID-19 vaccine, including AstraZeneca, Moderna, MVC-COV1901, and Pfizer-BioNTech. PBMCs were collected before and after vaccination. Immune parameters-cytokines, antibody titers, dendritic cells (DCs), T cells, B cells, and memory T cell subsets-were measured. TCM constitution scores were determined using the Constitution in Chinese Medicine Questionnaire (CCMQ) before vaccination. Adverse reactions were recorded through structured surveys, and correlations between constitution scores and adverse events were analyzed using the Pearson correlation. Pre-vaccination TNF-α was negatively correlated with the gentleness constitution and positively with the qi-deficiency. DCs increased post-vaccination in individuals with qi-deficiency, phlegm-dampness, qi-depression, yin-deficiency, dampness-heat, and special diathesis constitutions. T cell proportions increased in yin-deficiency, dampness-heat, and special diathesis groups. Dampness-heat scores were negatively correlated with central memory T cell (Tcm) induction. No significant correlations were found between constitution types and antibody levels or neutralization. Adverse reactions were more frequent in individuals with phlegm-dampness, qi-depression, and blood-stasis constitutions, and less frequent in those with a gentleness constitution. TCM constitutions correlate with cellular immune responses and adverse reaction profiles, but not antibody production, after COVID-19 vaccination. This supports integrating TCM constitution frameworks into personalized vaccine prediction.