What to Know About Drinking Alcohol After Getting Your Vaccine

Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID, is alcohol intolerance after covid characterized by persistent symptoms after acute SARS-CoV-2 infection that can vary from patient to patient. Alcohol reactions and sensitivity are not well characterized in the literature as it relates to post-viral illness. While there have been some anecdotal reports of new alcohol sensitivity in PASC patients in the media, there is a paucity of published data in the medical literature about this topic. During their medical consultation, the patients self-reported new changes in their symptoms or behaviors following the use of alcohol. A new onset of alcohol sensitivities should be assessed along with other post-COVID-19 symptoms and may provide novel avenues to explore the pathobiology of illness and potential interventions. The patient used to consume several drinks per week and drink socially, but reported that she had not consumed alcohol for the last seven months due to decreased tolerance.

New Alcohol Sensitivity in Patients With Post-acute Sequelae of SARS-CoV-2 (PASC): A Case Series

The patient reported a mild to moderate acute COVID infection that was managed outpatient with supportive care. Prior to his initial COVID infection, the patient reported consuming alcohol twice a month with no issue or reactions. The patient experienced chronic, daily headaches characterized by a squeezing sensation at the top and back of the head, typically worst at night. Developed in China, the inactivated whole-virus vaccine Sinopharm (Beijing, China) BBIBP-CorV, containing an aluminum hydroxide adjuvant, has been approved by the WHO for emergency use, and it has been distributed in more than 40 countries 70.

Common symptoms of alcohol intolerance include skin flushing, nasal congestion, and headaches. The only way to treat alcohol intolerance is to avoid alcohol or, at the very least, limit alcohol consumption. Very rarely, a person may have a “true” alcohol allergy, meaning they are allergic to the ethanol in alcohol.

“Spike Effect” of COVID-19 Vaccines and Alcohol

• However, in our K18-hACE2 transgenic mice model, only subunit 1 of the SARS-CoV-2 S protein, instilled intratracheally, provoked acute lung injury and cytokine storm in lungs, unlike the whole S protein.
• While moderate drinking is generally considered acceptable, it is essential to prioritize hydration and self-care after vaccination.
• Long COVID refers to persistent symptoms that occur more than three weeks after the initial COVID-19 infection.
• For example, the agency recommends avoiding OTC pain meds, like ibuprofen and Tylenol, in anticipation of vaccine side effects prior to the shot, but says it’s fine to take them within reason after you receive your dose.
• Alcohol sensitivity has been observed in a patient with PASC in a case report 20 but has not been widely studied.

In experimental models, acute alcohol intoxication has been demonstrated to impair the mucociliary defense of airways against invading pathogens 29. The Pfizer and Moderna vaccines use messenger RNA (mRNA) technology to mount an immune response in the body. This tech doesn’t inject live or inactive virus into your body, but rather encodes a piece of genetic material from the novel coronavirus’ spike protein (the portion of the virus that latches onto human cells), according to the CDC. The mRNA then serves as a set of instructions for your cells, so they can also start developing proteins.

Alcohol intolerance vs. allergy

Your body goes on to eliminate the proteins and the mRNA, but the antibodies stick around (it’s unclear for how long, as research is ongoing). If you do get infected in the future, your body will then be better prepared to fight off COVID-19. There are lots of questions about what you should and shouldn’t do before and after getting vaccinated for COVID-19—and some of the Centers for Disease Control and Prevention’s (CDC) guidelines might be surprising. For example, the agency recommends avoiding OTC pain meds, like ibuprofen and Tylenol, in anticipation of vaccine side effects prior to the shot, but says it’s fine to take them within reason after you receive your dose. Many long COVID patients (along with ME/CFS patients) experience issues with their autonomic nervous system, which plays a critical role in how blood vessels constrict and dilate, but researchers don’t yet fully understand why. One theory suggests that the virus causing COVID-19 acts as a severe stressor, possibly affecting a part of the brain called the hypothalamic paraventricular nucleus (PVN).

A 2023 study found that individuals with CFS are more likely to experience alcohol intolerance. Vaccines based on inactivated pathogens have been used for over a hundred years as a protective agent against bacteria and viruses. Inactivated viral vaccines are first cultivated on a substrate (primary and continuous cell lines, tissues, fertilized eggs, and even whole organisms) to produce large amounts of antigens 66.

Alcohol consumption can lead to different types of adverse reactions, ranging from mild to severe, from simple flushing to potentially life-threatening anaphylaxis. Those affected may experience symptoms, including facial flushing, nausea, and low blood pressure, even at low levels of consumption. True alcohol allergy, a rare occurrence, is an immune response to alcohol compounds that leads to rashes, itchiness, swelling, severe stomach cramps, and potentially severe manifestations, such as anaphylaxis 3.

The aim of this review article is to determine the link between the immune response to COVID-19 vaccines and the modulation of the immune system by alcohol consumption. There are several ongoing clinical trials for other S-protein subunit recombinant COVID-19 vaccines based on the S1 subunit or RBD protein (Covax19, Nanocovax, SCTV01C, GBP510, etc.), showing good effectiveness and safety 61. However, in our K18-hACE2 transgenic mice model, only subunit 1 of the SARS-CoV-2 S protein, instilled intratracheally, provoked acute lung injury and cytokine storm in lungs, unlike the whole S protein. Lung tissue homogenates from mice on alcohol diet showed the overexpression of ACE2 21. The S1 subunit of the SARS-CoV-2 spike protein exerted hippocampal neuronal cell death in mice, affecting brain functions 65. More additional studies are needed to evaluate the safety of S-protein subunits on all organs and systems.

COVID-19 Vaccination and Alcohol Consumption: Justification of Risks

More investigation is needed to understand the differences in response depending on the type of alcoholic beverage consumed, such as beer, hard liquor, or wine 34. Although clinical trials for the Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines did not instruct participants to avoid alcohol, they also did not test the effects of alcohol consumption on vaccine response. As such, it is recommended to avoid binge drinking or heavy drinking before or after vaccination, as defined by the CDC’s guidelines. An alcohol allergy involves an immune system overreaction to alcohol, which can cause widespread and sometimes life threatening symptoms. Anyone who experiences severe allergy symptoms after consuming alcohol needs to seek emergency care. Several lines of evidence suggest that epithelial cells, macrophages, and dendritic cells, as the first lines of immune defense, are the most susceptible to high doses of alcohol.

“There is no evidence that alcohol reduces the formation of antibodies,” says Richard Watkins, M.D., an infectious disease physician and a professor of internal medicine at the Northeast Ohio Medical University. The CDC does offer some guidance for people who have been newly vaccinated, but it focuses more on the possible side effects, information about ingredients, and what we know about COVID-19 immunity—no mention of booze, though. Given how complex long COVID is, it’s unlikely that just one of these theories can fully explain what’s going on. It’s also possible the coronavirus may directly affect the enzymes responsible for processing alcohol, said Dr. Vikrant Rachakonda, a hepatologist, gastroenterologist, and professor of medicine at UC Davis Health.

Is alcohol allergy treatable?

• Therefore, drinking alcohol may worsen these side effects, and it can be challenging to differentiate between vaccine side effects and hangover symptoms.
• Additionally, heavy drinking can cause side effects similar to those experienced after receiving the vaccine, such as headaches, fatigue, and body aches.
• Alcohol can suppress the immune system, making your body more vulnerable to infections and slowing down recovery from physical trauma and infections.
• Although inconvenient, not being able to drink alcohol isn’t the most earth-shattering of symptoms compared with more serious effects.

Long COVID, also known as post-COVID conditions, occurs when health problems last for weeks, months or even years after a coronavirus infection. It was recognized by the American With Disabilities Act in 2021 and roughly 30% of adults may experience at least one COVID symptom that lasts three months or more, according to research. While research on post-COVID alcohol intolerance is still limited, anecdotal evidence suggests that it’s a symptom experienced by many people following the virus. Some evidence suggests that post-COVID-19 fatigue syndrome may share characteristics with ME/CFS, a condition where approximately 4 out of 5 people exhibit alcohol intolerance.

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It depends not only on the sex and constitution of the person but also on the content of metabolizing enzymes in the liver 25. The liver, an important component of the innate immune system, when damaged due to chronic alcohol abuse, results in the decreased production of antibacterial proteins, thereby increasing the susceptibility to bacterial or viral infection. Patients with alcohol disorders also have an increased susceptibility to respiratory pathogens and an increased risk of acute respiratory distress syndrome (ARDS) 26.

Her tolerance has decreased to the point where one beer would result in a severe “hangover,” along with exacerbation of PASC symptoms for three days thereafter. OI is a condition characterized by an individual’s inability to tolerate an upright posture because of an abnormal response of the body’s autonomic nervous system to gravitational changes, resulting in inadequate blood flow to the heart and brain. This condition is notably common in patients with ME/CFS and is becoming increasingly recognized in patients with long COVID or PASC 13-15. Our understanding of why individuals develop OI after viral illnesses is incomplete, but it is plausible that this could be a key mechanism by which alcohol consumption aggravates symptoms in those recovering from viral infections. Alcohol dilates blood vessels, potentially worsening the drop in blood pressure seen in those with OI.

New-onset alcohol reactions and sensitivity can occur after COVID-19 infection in patients with PASC. Clinicians assessing PASC patients should inquire about alcohol consumption and tolerance in their social history, as this information can provide insights into potential triggers for worsening symptoms and help guide lifestyle management strategies. Furthermore, investigating the underlying biological mechanisms responsible for new-onset alcohol reactions and sensitivity may provide valuable insights into the underlying pathophysiology of post-viral conditions, such as PASC and ME/CFS.