PACVS Biomarker Atlas
Molecular, serologic, immunologic, and functional alterations reported in Post-Acute COVID-19 Vaccination Syndrome (PACVS) — from PACVS/PCVS primary studies and post-vaccination adverse-event literature only.
Literature Overview
PACVS research is emerging. This atlas includes only markers from post-vaccination syndrome primary studies — spike persistence after vaccination, GPCR autoantibodies, registry cohort laboratory findings, and PACVS trial protocols.
Searchable Alterations Database
Filter by category. HC = healthy controls. All entries cite PACVS/PCVS or post-vaccination adverse-event primary literature only.
Long COVID markers excluded
This atlas deliberately excludes infection-associated (Long COVID/PASC) biomarker literature. Shared-pathway markers documented only in post-infection cohorts — coagulation, complement, mitochondrial metabolites, and similar — are listed in the Long COVID Biomarker Atlas instead.
Related atlases: All Atlases · Long COVID · ME/CFS
Proposed diagnostic framework (Halma & Varon, 2025)
No single biomarker defines PACVS. Post-vaccination studies propose combining: (1) serology confirming vaccination exposure without prior infection (Anti-S+, Anti-N−); (2) spike antigenemia detection in vaccine adverse-event cohorts; (3) GPCR/RAS autoantibodies; (4) LC-MS/MS peptide profiling to distinguish vaccine-encoded spike (K986P/V987P "2P" mutations) from wild-type viral spike; and (5) optional qPCR for persistent vaccine mRNA sequences. Definitive diagnostic criteria remain under development.
| Marker / Metabolite | Direction | Category | vs. Comparison | Associated Symptoms | Key Reference |
|---|
Category Deep Dives
PACVS-specific findings from post-vaccination primary studies and PACVS cohort registries.
💉 Spike Protein & Antigen Persistence
- S1 in CD16+ monocytes ↑ up to 245d
- Spike in post-mRNA myocarditis ↑ adolescents
- Spike in cutaneous vaccine lesions ↑ tissue
- Spike in neurological tissue ↑ post-vaccine AE
- Vaccine mRNA (BNT162b2-specific) Detected in subset
🔬 Serologic Discrimination Panel
- Anti-Spike (Anti-S) antibodies ↑ Expected+
- Anti-Nucleocapsid (Anti-N) ↓ Expected−
- 2P proteotypic peptides (LC-MS/MS) Vaccine-specific
- Wild-type viral spike peptides Absent if no infection
🛡️ GPCR & RAS Autoantibodies (PACVS-specific)
- Anti-ACE2 ↑ skin symptoms
- Anti-AT1R (angiotensin II type 1 receptor) ↑ lymphadenopathy
- Anti-MAS1 receptor ↑ burning sensation
- Anti-STAB1 ↑ skin edema/rash
- Anti-ADRA2A (α2B adrenergic) ↓ with brain fog
- Anti-CHRM3 (muscarinic) Symptom-associated
- Anti-idiotype mechanism (ACE2 ↔ Anti-S) Correlated
⚡ Metabolic & Inflammatory Alterations
- Ferritin index ↓ >50% of subjects
- Transferrin saturation ↓ subnormal
- Blood lactate (exercise) ↑ earlier threshold
- IL-6 / IL-8 ↑ >80% of cohort
- Neurofilament light chain (NfL) ↑ >30% of cohort
📊 Functional & Clinical Markers
- Heart rate variability (HRV) ↓ dysautonomia
- Salivary nitric oxide ↓ NO pathway
- Orthostatic HR increment ↑ POTS
- 6-minute walk distance ↓ exercise capacity
- Exertional SpO₂ nadir ↓ hypoxemia
- Chester Step Test (VO₂ proxy) ↓ fitness
- PAC-19QoL scores ↓ quality of life
Key References
Primary PACVS and post-vaccination adverse-event literature underpinning this atlas.