Since these factors are related to muscle mass, the relationship between healthy lifestyle habits and the successful acquisition of immunogenicity needs be studied in a large-scale cohort. Acknowledgments We thank staff of the chemistry and immunology unit in the department of laboratory medicine for cooperation in making the equipment available. questionnaires. Information on health status and lifestyle were collected from the most recent health checkup data. Generally, females experience more reactogenicity in both intensity and duration. The rash of the first shot and chills of the second shot were associated with humoral immunity. However, comprehensive adverse effects had no correlation with humoral and cellular immunity. The T-spot-positive SLC4A1 group had a higher creatinine level, which reflects muscle mass, than the T-spot-negative group. Males presented a higher level of Tonapofylline T-spot assays. Body mass index and age were negatively correlated with the T-spot assay and anti-S1 antibody, respectively. Immune acquisition after the second AZD1222 shot was not associated with reactogenicity. However, individuals sex, age, and BMI were found to be associated with immunogenicity after vaccination. = the intensity of AEs, = the duration (days) of AEs, = the dose of the vaccine (= 1 or 2 2), and = AEs (four local and eight systemic AEs). 2.3. Measurements of Individual Health Status The most recent health checkup data collected within one year were used to determine individual health status. The health checkup data included anthropometric profiles; body mass index (BMI) and waist circumference (WC), existence of comorbidity, smoking status, alcohol consumption, physical activity, muscle exercise, blood pressure (BP), and laboratory studies; hemoglobin (Hb), fasting blood glucose (FBG), serum creatinine (Cr), estimated glomerular filtration rate (eGFR), alanine transaminase (AST), aspartate transaminase (ALT), gamma-glutamyl transferase (GGT), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels) and total cholesterol (TC). Smoking status was classified according to the national health interview survey of the United States . Nonsmokers and former smokers were designated to the No smoking category and current smokers were designated to the Yes category. Level of alcohol consumption was calculated following the Korean alcohol guidelines . In terms of physical activity and muscle exercise, the global physical activity questionnaire was used . The judgment criteria were in accordance with the guidelines of the Ministry of Health and Welfare of Korea . Adequate physical activity was defined as more than 150 min per week of moderate activity (activity causing a slight shortness of breath or increase in heart rate), while adequate muscle exercise was defined as carrying out exercises such as push-ups, sit-ups, dumbbells presses, etc., more than twice per week . 2.4. Measurement of Cellular and Humoral Immune Responses 2.4.1. Humoral Immunity The Euroimmun ELISA (Euroimmun, Lbeck, Germany) was used to semi-quantitatively detect IgG antibodies against the viral S1 protein. The Euroimmun Anti-SARS-CoV-2 NCP ELISA (IgG) test was used to exclude participants who had experienced an actual infection, because AZD1222 does not include NCP as a viral antigen. Both tests were performed using thawed aliquots, and for the signal to cut-off (S/Co) value, dividing the optical density (OD) of the sample by the OD of the calibrator, 1.1 was determined to be positive. The plaque reduction neutralization test (PRNT), a conventional virus neutralization test (cVNT), is considered the gold standard to detect neutralizing antibodies. However, because the method requires a biosafety level (BSL)-3 facility, it is not easily accessible in general laboratory conditions, and has low test efficiency. Therefore, we utilized the cPASS SARS-CoV-2 neutralizing antibody detection kit, surrogate VNT, sVNT (Genscript Biotech Corporation, Piscataway, NJ, USA), which is known to have a high correlation Tonapofylline with the PRNT [22,23]. 2.4.2. Cellular Immunity The T-spot Discovery SARS-CoV-2 kit (Oxford Immunotec Ltd., Abingdon, Oxfordshire, UK) was used to confirm cellular immunity. This method is a simplified variant of the ELISpot assay technique. Peripheral blood mononuclear cells (PMBCs) are isolated from a whole blood sample. Subsequently, in response to SARS-CoV-2 antigens, interferon-gamma (IFN-gamma) is secreted from the PMBCs and forms spots which are measured. Two experts in laboratory medicine read the report and averaged the results, with the difference in the number of spots read between the two readers not exceeding three. The T-spot Discovery SARS-CoV-2 kit is composed of four panels: panel 1, panel 3, panel 4, and panel 13, consisting of the SARS-CoV-2 S antigen, nucleocapsid protein, membrane protein, and the high-homology regions of the coronaviruses, respectively. For the quantitative dedication of the T-spot, the value acquired by subtracting the number of nil control places from the number of panel 1 (S antigen) places was regarded as the index. Even though T-spot Finding SARS-CoV-2 kit did not provide a cut-off Tonapofylline point, we regarded as 10 places/250,000 PBMCs or more to be positive, as suggested inside a previous study.