{
  "slug": "pacvs",
  "id": "pacvs-biomarkers",
  "condition": {
    "name": "Post-Acute COVID-19 Vaccination Syndrome",
    "shortName": "PACVS",
    "alternateNames": [
      "PACVS",
      "PCVS"
    ]
  },
  "page": {
    "title": "PACVS Biomarker Atlas | Post-Vaccination Syndrome Blood Tests & Spike Markers",
    "breadcrumbName": "PACVS Biomarkers",
    "description": "Searchable atlas of PACVS biomarkers from peer-reviewed post-vaccination syndrome literature — spike persistence, serologic discrimination, GPCR autoantibodies, and cohort laboratory findings in PACVS/PCVS patients.",
    "keywords": [
      "PACVS biomarkers",
      "post-vaccination syndrome blood tests",
      "spike protein persistence",
      "GPCR autoantibodies",
      "post COVID vaccine syndrome",
      "post COVID vaccine syndrome markers",
      "spike protein in blood after vaccine",
      "anti-spike antibodies PACVS",
      "vaccine injury biomarkers",
      "post vaccination fatigue blood tests",
      "POTS post vaccination biomarkers",
      "biomarker atlas",
      "biomarker database",
      "peer-reviewed biomarkers",
      "mitochondrial dysfunction PACVS",
      "amyloid fibrin microclots",
      "chronic illness biomarkers"
    ],
    "canonical": "https://research.opensourcemed.info/pacvs-biomarkers.html",
    "hero": "Molecular, serologic, immunologic, and functional alterations reported in Post-Acute COVID-19 Vaccination Syndrome (PACVS) — persistent symptoms following SARS-CoV-2 vaccination — from PACVS/PCVS primary studies and post-vaccination adverse-event literature.",
    "dateModified": "2026-06-30"
  },
  "categories": {
    "spike": "Spike Antigen",
    "serologic": "Serologic",
    "autoimmune": "Autoimmune",
    "metabolic": "Metabolic",
    "molecular": "Molecular",
    "proteomic": "Proteomic",
    "inflammatory": "Inflammatory",
    "functional": "Functional"
  },
  "filters": [
    "spike",
    "serologic",
    "autoimmune",
    "metabolic",
    "molecular",
    "proteomic",
    "inflammatory",
    "functional"
  ],
  "markers": [
    {
      "name": "S1 in CD16+ monocytes",
      "alternateName": "Intracellular spike persistence",
      "direction": "up",
      "category": "spike",
      "comparison": "SARS-CoV-2-negative PCVS",
      "symptoms": "Persistent antigenemia up to 245 days",
      "reference": {
        "citation": "Patterson et al. 2025",
        "doi": "10.1080/21645515.2025.2494934"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Circulating spike (post-mRNA myocarditis)",
      "alternateName": "Full-length spike",
      "direction": "up",
      "category": "spike",
      "comparison": "Healthy adolescents",
      "symptoms": "Cardiac inflammation post-vaccination",
      "reference": {
        "citation": "Yonker et al. 2023",
        "doi": "10.1161/CIRCULATIONAHA.122.061725"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Spike in cutaneous lesions",
      "alternateName": "Tissue spike expression",
      "direction": "up",
      "category": "spike",
      "comparison": "Normal skin",
      "symptoms": "Dermatological vaccine reactions",
      "reference": {
        "citation": "Sano et al. 2025",
        "doi": "10.1016/j.jdermsci.2025.09.007"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Spike in neurological tissue",
      "alternateName": "Post-vaccine neurological AE",
      "direction": "up",
      "category": "spike",
      "comparison": "HC",
      "symptoms": "Neurological complications",
      "reference": {
        "citation": "Ota et al. 2025",
        "doi": "10.1016/j.jocn.2025.111223"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Anti-Spike (Anti-S) antibodies",
      "alternateName": "Vaccination exposure marker",
      "direction": "up",
      "category": "serologic",
      "comparison": "Pre-vaccination baseline",
      "symptoms": "Confirms vaccine exposure",
      "reference": {
        "citation": "Federico 2024",
        "doi": "10.3390/vaccines12111281"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-Nucleocapsid (Anti-N) antibodies",
      "alternateName": "Infection-specific marker",
      "direction": "down",
      "category": "serologic",
      "comparison": "Expected absent in vaccinated-only",
      "symptoms": "Rules out prior SARS-CoV-2 infection",
      "reference": {
        "citation": "Federico 2024",
        "doi": "10.3390/vaccines12111281"
      },
      "testType": "BloodTest"
    },
    {
      "name": "2P proteotypic peptides (K986P/V987P)",
      "alternateName": "Vaccine-encoded spike signature",
      "direction": "up",
      "category": "molecular",
      "comparison": "Wild-type viral spike",
      "symptoms": "Confirms vaccine-derived spike origin",
      "reference": {
        "citation": "Sutton et al. 2023",
        "doi": "10.1016/j.vaccine.2023.04.044"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Wild-type viral spike peptides",
      "alternateName": "Infection-derived spike",
      "direction": "down",
      "category": "molecular",
      "comparison": "Vaccine-only individuals",
      "symptoms": "Indicates prior infection, not pure PACVS",
      "reference": {
        "citation": "Sutton et al. 2023",
        "doi": "10.1016/j.vaccine.2023.04.044"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "BNT162b2 vaccine mRNA (qPCR)",
      "alternateName": "Modified 3'UTR / 2P spike region",
      "direction": "mixed",
      "category": "molecular",
      "comparison": "HC",
      "symptoms": "Persistent vaccine mRNA detection",
      "reference": {
        "citation": "Camperi et al. 2025",
        "doi": "10.3390/molecules30071629"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Vaccine mRNA (hybrid 3'UTR motifs)",
      "alternateName": "mtRNR1 / AES sequences",
      "direction": "mixed",
      "category": "molecular",
      "comparison": "Viral RNA",
      "symptoms": "Distinguishes vaccine from viral RNA",
      "reference": {
        "citation": "Camperi et al. 2025",
        "doi": "10.3390/molecules30071629"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Anti-ACE2 autoantibodies",
      "alternateName": "Angiotensin-converting enzyme 2",
      "direction": "up",
      "category": "autoimmune",
      "comparison": "HC",
      "symptoms": "Ecchymosis, skin edema, rash",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-AT1R (angiotensin II type 1 receptor)",
      "alternateName": "ATR1 autoantibody",
      "direction": "up",
      "category": "autoimmune",
      "comparison": "HC",
      "symptoms": "Lymphadenopathy, tonsillitis",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-MAS1 receptor autoantibodies",
      "alternateName": "RAS-related GPCR",
      "direction": "up",
      "category": "autoimmune",
      "comparison": "HC",
      "symptoms": "Widespread burning sensation",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-STAB1 autoantibodies",
      "alternateName": "Stabilin-1",
      "direction": "up",
      "category": "autoimmune",
      "comparison": "HC",
      "symptoms": "Skin edema, rash",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-ADRA2A (α2B adrenergic receptor)",
      "alternateName": "GPCR autoantibody",
      "direction": "down",
      "category": "autoimmune",
      "comparison": "HC (inverse with symptoms)",
      "symptoms": "Negatively associated with brain fog",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-CHRM3 (muscarinic M3)",
      "alternateName": "GPCR autoantibody",
      "direction": "mixed",
      "category": "autoimmune",
      "comparison": "HC",
      "symptoms": "Autonomic, GI symptoms",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-idiotype antibodies (ACE2 ↔ Anti-S)",
      "alternateName": "Immunopathogenic mechanism",
      "direction": "mixed",
      "category": "autoimmune",
      "comparison": "Internal correlation",
      "symptoms": "ACE2 levels correlate with anti-S titers",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Anti-GPCR autoantibodies (panel)",
      "alternateName": "16 autoantibodies tested",
      "direction": "up",
      "category": "autoimmune",
      "comparison": "HC",
      "symptoms": "Dysautonomia, vascular instability",
      "reference": {
        "citation": "Mantovani et al. 2024",
        "doi": "10.3390/biomedicines12122852"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Ferritin index",
      "alternateName": "Iron metabolism marker",
      "direction": "down",
      "category": "metabolic",
      "comparison": "HC",
      "symptoms": "Impaired iron storage in >50% of PACVS subjects",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "BloodTest",
      "loinc": "2276-4"
    },
    {
      "name": "Transferrin saturation",
      "alternateName": "Iron transport",
      "direction": "down",
      "category": "metabolic",
      "comparison": "HC",
      "symptoms": "Subnormal in affected patients",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Blood lactate (exercise)",
      "alternateName": "Anaerobic threshold marker",
      "direction": "up",
      "category": "metabolic",
      "comparison": "HC",
      "symptoms": "Earlier lactate threshold, PEM",
      "reference": {
        "citation": "Halma & Varon 2025",
        "doi": "10.1016/j.biopha.2025.118864"
      },
      "testType": "BloodTest"
    },
    {
      "name": "IL-6",
      "alternateName": "Pro-inflammatory cytokine",
      "direction": "up",
      "category": "inflammatory",
      "comparison": "HC",
      "symptoms": "Elevated in >80% of PACVS registry cohort",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "BloodTest",
      "loinc": "26881-5"
    },
    {
      "name": "IL-8",
      "alternateName": "Pro-inflammatory cytokine",
      "direction": "up",
      "category": "inflammatory",
      "comparison": "HC",
      "symptoms": "Elevated in >80% of PACVS registry cohort",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Spike (LC-MS/MS quantification)",
      "alternateName": "Immunocapture + mass spectrometry",
      "direction": "mixed",
      "category": "proteomic",
      "comparison": "HC",
      "symptoms": "Quantitative vaccine-encoded spike detection",
      "reference": {
        "citation": "Sutton et al. 2023",
        "doi": "10.1016/j.vaccine.2023.04.044"
      },
      "testType": "BloodTest"
    },
    {
      "name": "Heart rate variability (HRV)",
      "alternateName": "Autonomic function",
      "direction": "down",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Dysautonomia, POTS",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Salivary nitric oxide",
      "alternateName": "Enterosalivary NO pathway",
      "direction": "down",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Reduced NO bioavailability",
      "reference": {
        "citation": "Halma 2024",
        "doi": "10.2196/preprints.70342"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Orthostatic heart rate increment",
      "alternateName": "Tilt/stand test",
      "direction": "up",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "POTS, orthostatic intolerance",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "6-minute walk distance",
      "alternateName": "Exercise capacity",
      "direction": "down",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Reduced functional capacity",
      "reference": {
        "citation": "Halma 2024",
        "doi": "10.2196/preprints.70342"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Exertional SpO₂ nadir",
      "alternateName": "Pulse oximetry",
      "direction": "down",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Exercise-induced hypoxemia",
      "reference": {
        "citation": "Halma 2024",
        "doi": "10.2196/preprints.70342"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Chester Step Test (VO₂ proxy)",
      "alternateName": "Submaximal fitness test",
      "direction": "down",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Reduced aerobic capacity",
      "reference": {
        "citation": "Halma 2024",
        "doi": "10.2196/preprints.70342"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "PAC-19QoL score",
      "alternateName": "Post-acute COVID quality of life",
      "direction": "down",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Reduced quality of life",
      "reference": {
        "citation": "Halma 2024",
        "doi": "10.2196/preprints.70342"
      },
      "testType": "MedicalTest"
    },
    {
      "name": "Neurofilament light chain (NfL)",
      "alternateName": "Axonal damage",
      "direction": "up",
      "category": "functional",
      "comparison": "HC",
      "symptoms": "Elevated sNfL in >30% of PACVS registry cohort",
      "reference": {
        "citation": "Mundorf et al. 2024",
        "doi": "10.3390/vaccines12070790"
      },
      "testType": "MedicalTest",
      "loinc": "94635-5"
    }
  ]
}