Detection of S1 spike protein in CD16+ monocytes up to 245 days in SARS-CoV-2-negative post-COVID-19 vaccine syndrome (PCVS) individuals

Hum Vaccin Immunother. 2025 Dec;21(1):2494934. doi: 10.1080/21645515.2025.2494934. Epub 2025 May 13.

Abstract

Despite over 13 billion SARS-CoV-2 vaccine doses administered globally, persistent post-vaccination symptoms, termed post-COVID-19 vaccine syndrome (PCVS), resemble post-acute sequelae of COVID-19 (PASC). Symptoms like cardiac, vascular, and neurological issues often emerge shortly after vaccination and persist for months to years, mirroring PASC. We previously showed the S1 subunit of the SARS-CoV-2 spike protein persists in CD16+ monocytes after infection, potentially driving PASC. Approved vaccines (Pfizer, Moderna, Janssen, AstraZeneca) deliver synthetic S1 to elicit immunity, suggesting a shared mechanism. We hypothesized that vaccine-derived S1 persistence in CD16+ monocytes sustains inflammation akin to PASC, contributing to PCVS. We studied 50 individuals with PCVS symptoms lasting over 30 days post-vaccination and 26 asymptomatic controls, using (1) machine learning-based immune profiling to compare cytokine signatures with PASC, (2) flow cytometry to detect S1 in CD16+ monocytes, and (3) LC-MS to confirm S1 across vaccine types. We correlated S1 persistence with symptom duration and inflammation. Prior infection was excluded via clinical history, anti-nucleocapsid antibody tests, and T-detect assays, though definitive tests are lacking. Preliminary findings suggest S1 persistence in CD16+ monocytes and an associated inflammatory profile may contribute to PCVS. Further studies are needed to confirm causality and prevalence.

Keywords: CCR5; COVID-19; PASC; SARS CoV-2 S1 protein; fractalkine; non-classical monocytes.

Plain language summary

SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-COVID-19 Vaccine Syndrome (PCVS).

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines* / administration & dosage
  • COVID-19 Vaccines* / adverse effects
  • COVID-19 Vaccines* / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Cytokines
  • Female
  • GPI-Linked Proteins
  • Humans
  • Male
  • Middle Aged
  • Monocytes* / immunology
  • Monocytes* / metabolism
  • Receptors, IgG* / immunology
  • Receptors, IgG* / metabolism
  • SARS-CoV-2* / immunology
  • Spike Glycoprotein, Coronavirus* / analysis
  • Spike Glycoprotein, Coronavirus* / immunology

Substances

  • Spike Glycoprotein, Coronavirus
  • spike protein, SARS-CoV-2
  • Receptors, IgG
  • COVID-19 Vaccines
  • FCGR3B protein, human
  • Cytokines
  • GPI-Linked Proteins