{"doi":"10.1001/jamanetworkopen.2025.7871","title":"Menstrual Cycle Length Changes Following Vaccination Against Influenza Alone or With COVID-19","abstract":"Importance: Multiple studies have identified an association between COVID-19 vaccination and menstrual disturbances. Data on whether menstrual health is impacted by other vaccines are needed to counsel individuals about what to expect and to address vaccine hesitancy. Objective: To assess the association of changes in length of the menstrual cycle with influenza vaccination, with or without concurrent receipt of a COVID-19 vaccine. Design, Setting, and Participants: This global retrospective cohort study prospectively collected menstrual cycle data from April 25, 2023, to February 27, 2024 (4-5 cycles per individual), among international English-speaking users of a digital birth control application. Participants included individuals aged 18 to 45 years, not using hormonal contraception, and with average cycle lengths of 24 to 38 days in 3 consecutive cycles before receipt of vaccines. Exposure: Seasonal influenza vaccination with or without concurrent receipt of COVID-19 vaccine. Main Outcome and Measure: The primary outcome consisted of adjusted mean within-individual changes of menstrual cycle length assessed by vaccination group. Secondary analysis evaluated the phase of menstrual cycle at time of vaccination. Results: A total of 1501 individuals met the inclusion criteria, of whom 791 were vaccinated for influenza only and 710 were concurrently vaccinated for influenza and COVID-19. By race and ethnicity, 1 participant (0.1%) was American Indian or Alaska Native; 10 (0.7%), Asian; 3 (0.2%), Black; 15 (1.0%), Hispanic or Latina; 1 (0.1%), Middle Eastern or North African; 368 (24.5%), White; and 19 (1.3%), other; and 1084 (72.2%), missing. Most of the cohort was younger than 35 years (1230 [82.0%]), had at least a college degree (1122 [74.8%]), and was located in the US or Canada (938 [62.5%]). Individuals vaccinated for influenza alone experienced an adjusted mean increase of 0.40 (95% CI, 0.08-0.72) days, while those vaccinated concurrently for influenza and COVID-19 experienced a mean increase of 0.49 (95% CI, 0.16-0.83) days (P = .69 for difference between vaccine groups). A total of 37 individuals (4.7%) experienced a change in cycle length of at least 8 days with influenza vaccine only and 42 (5.9%) with concurrent receipt of both vaccines (P = .28). In the postvaccination cycle, both vaccination groups returned to their prevaccination cycle lengths. Menstrual cycle changes occurred with vaccination in the follicular phase but not the luteal phase. Conclusions and Relevance: In this cohort study of individuals with regular menstrual cycles, influenza vaccine given alone or in combination with a COVID-19 vaccine was associated with a small but temporary change in menstrual cycle length. These findings may help clinicians confirm the utility of vaccination for patients with concerns about menstrual adverse effects of vaccination.","journal":"JAMA Network Open","year":2025,"id":552560,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9658,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":308488,"name":"Blair G. Darney","orcid":"0000-0001-8120-028X","position":1,"is_corresponding":false},{"id":853799,"name":"Agathe van Lamsweerde","orcid":null,"position":2,"is_corresponding":false},{"id":852816,"name":"Eleonora Benhar","orcid":"0009-0000-6654-4906","position":3,"is_corresponding":false},{"id":897092,"name":"Alexandra Alvergne","orcid":"0000-0002-3151-9919","position":4,"is_corresponding":false},{"id":350956,"name":"Alison Edelman","orcid":"0000-0001-5040-7288","position":5,"is_corresponding":false},{"id":704509,"name":"Emily R. Boniface","orcid":"0000-0001-8012-1758","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T02:54:33.203144Z","pmid":"40299380","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}