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Peer-reviewedCC BY 4.0Npj Women's Health

Menstrual cycle phase and its association with COVID-19 vaccine outcomes among period tracking app users

  • Poppy Alexandra Cooper1
  • Emily R. Boniface2
  • Blair G. Darney2
  • Alison Edelman2
  • Rebecca Sear3
  • Amanda A. Shea4
  • Sarah Walters1
  • Kirsten Weber4
  • Virginia J. Vitzthum4,5,6
  • Alexandra Alvergne7
7 affiliations
  1. 1LSHTM (London School of Hygiene & Tropical Medicine), London, UK
  2. 2OHSU (Oregon Health & Science University), Portland, OR USA
  3. 3Brunel University, London, UK
  4. 4Clue (BioWink GmbH), Berlin, Germany
  5. 5Centre for Menstrual Cycle and Ovulation Research (CeMCOR), Department of Medicine, University of British Columbia, Vancouver, BC Canada
  6. 6Indiana University, Bloomington, IN USA
  7. 7ISEM (Institute of Evolutionary Science of Montpelier), University of Montpellier, CNRS, IRD, Montpelier, France
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Abstract

Despite known hormonal influences on immune function, the impact of menstrual cycle phase on vaccine outcomes remains unexplored. Using prospectively tracked cycle data from the Clue period tracking-app, matched with an in-app survey of 1474 women, we compared self-reported COVID-19 vaccine outcomes between follicular-phase (estrogen-dominant) and luteal-phase (progesterone-dominant) vaccinated women. Side effect presence, severity and number were analysed using binary, ordinal, and negative binomial regression respectively, and post-vaccination time to infection (67–372 days) via Wilcoxon rank-sum test. Follicular-phase vaccination was associated with 35% higher odds of any self-reported side effects (OR: 1.35, 98.3% CI: 1.01–1.79) compared to luteal-phase vaccination. Median time to infection was 35 days longer following follicular-phase vaccination (200 [140–237] vs 165 [107–210] days, p = 0.05), though infection numbers were limited. These findings suggest menstrual cycle phase warrants consideration in sex-based immunity research and may inform future research on vaccination and personalised health strategies.

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Cite

BibTeXRIS
BibTeX
@article{cooper2026menstrual,
  title = {{Menstrual cycle phase and its association with COVID-19 vaccine outcomes among period tracking app users}},
  author = {Poppy Alexandra Cooper and Emily R. Boniface and Blair G. Darney and Alison Edelman and Rebecca Sear and Amanda A. Shea and Sarah Walters and Kirsten Weber and Virginia J. Vitzthum and Alexandra Alvergne},
  journal = {Npj Women's Health},
  year = {2026},
  month = jun,
  doi = {10.1038/s44294-026-00150-x},
  url = {https://doi.org/10.1038/s44294-026-00150-x},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Menstrual cycle phase and its association with COVID-19 vaccine outcomes among period tracking app users
AU  - Poppy Alexandra Cooper
AU  - Emily R. Boniface
AU  - Blair G. Darney
AU  - Alison Edelman
AU  - Rebecca Sear
AU  - Amanda A. Shea
AU  - Sarah Walters
AU  - Kirsten Weber
AU  - Virginia J. Vitzthum
AU  - Alexandra Alvergne
PY  - 2026
DA  - 2026/06/06
JO  - Npj Women's Health
DO  - 10.1038/s44294-026-00150-x
UR  - https://doi.org/10.1038/s44294-026-00150-x
AB  - Despite known hormonal influences on immune function, the impact of menstrual cycle phase on vaccine outcomes remains unexplored. Using prospectively tracked cycle data from the Clue period tracking-app, matched with an in-app survey of 1474 women, we compared self-reported COVID-19 vaccine outcomes between follicular-phase (estrogen-dominant) and luteal-phase (progesterone-dominant) vaccinated women. Side effect presence, severity and number were analysed using binary, ordinal, and negative binomial regression respectively, and post-vaccination time to infection (67–372 days) via Wilcoxon rank-sum test. Follicular-phase vaccination was associated with 35% higher odds of any self-reported side effects (OR: 1.35, 98.3% CI: 1.01–1.79) compared to luteal-phase vaccination. Median time to infection was 35 days longer following follicular-phase vaccination (200 [140–237] vs 165 [107–210] days, p = 0.05), though infection numbers were limited. These findings suggest menstrual cycle phase warrants consideration in sex-based immunity research and may inform future research on vaccination and personalised health strategies.
SN  - 2948-1716
ER  -