A vaccine side effect you haven't heard about: Weird food cravings

Immune activation is often linked to changes in appetite, which could explain why you're dreaming of pizza.Craig F. Walker

Nauseated, achy, and sweating in bed from my second Moderna shot, I was surprised to find myself craving pizza. How are you fantasizing about a slice right now? my inner dieter scolded.

What, exactly, was going on? Was the pizza a last grasp at a socially acceptable pandemic binge? Or was it something real? Maybe this is one of the odd vaccine side effects that have been surfacing.

I Googled “Fauci” and “pizza,” but found only a story about his takeout habits, and a Yelp review of Fauci Pizza in Lynn (motto: “Be Fussy, Go Fauci”). I checked my e-mail. No Grubhub offer for a post-vaccine discount, like you’d expect to see if jab-induced cravings had been recognized as a marketing opportunity. Even the conspiracy theorists were silent.

So I figured the pizza thing was just me. But I asked around anyway, and whoa! Corn on the cob, eggplant parmigiana, steak, ice cream . . . you name it and people with sore arms want it. Cravings are not uncommon, but the crazy part is that everyone, lying alone in their beds, thinks it’s just them.

Moderna, Pfizer, Johnson & Johnson, all three seemed to set off hankerings, and not everyone in my little survey even felt sick. Some people were just tired; others felt sick to their stomachs, hungry, and thirsty all at the same time.

“I was at home, sitting at my desk, not thinking about food at all, when all of a sudden it was like, ‘I must have fondue,’ ” said Roz Cummings, a writer from Watertown.

“I could have swum in a vat of pasta,” said Toni Lansbury, a freelance advertising copywriter from Brookline.

“I had a profound salt craving and ordered Thai food from bed,” said Shruthi Mahalingaiah.

She’s not only a mother of three who ordered spring rolls and tom yom soup for herself only, while her children did their schoolwork downstairs, she’s an assistant professor at the Harvard T.H. Chan School of Public Health.

Despite Mahalingaiah’s having experienced firsthand takeout Thai lust, cravings aren’t a clinical focus in her medical practice. “They don’t make the list of things we ask about around vaccine administration,” she said.

Mahalingaiah, like other doctors interviewed by the Globe, said that while no rigorous studies have been conducted — Slim Jims has not funded research — there are possible scientific explanations.

“I’ve heard about food cravings and the opposite — people who don’t eat anything,” said Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital

“I wish I could tell you exactly what is going on, but the reality is nobody knows,” he said.

But, Sax said, there are well-established connections between immune activation — which is what the vaccine does — and changes in appetite. This is likely caused by an increase in cytokines, chemicals in the blood released by the immune system as it fights off infections or responds to a vaccine.

He gave a non-vaccine example: When the immune system is activated during active infections, such as the flu or a gastrointestinal illness, appetite drops substantially. And then, quite quickly after recovery, people often report feeling ravenous.

Mahalingaiah, an expert in women’s health, likened post-vaccine cravings for salty foods — which help retain water — to premenstrual cravings.

In the vaccine situation, a person who was sweating with a fever is trying to replace lost fluids, salt, and other minerals, she said. In a woman about to get her period, the body wants to retain water to prepare for a possible pregnancy.

Respected medical opinions aside, after a lifetime spent counting calories, I still sort of wondered if there wasn’t at least some psychological component.

I called Joan Salge Blake, the well-known nutritionist and Boston University clinical professor. “This is not all in your head,” she began.

“If you have a craving and you want to eat something, eat it,” she almost yelled, sounding like a grandmother from the old country. “You’ve got other problems in your life.” (Not something I had brought up, and yet I can’t say she was wrong.)

But Brian Chow, an infectious disease physician at Tufts Medical Center, allowed a little more wiggle room for the “all in my head” theory.

“It would be interesting to see if people revert to [craving] their comfort foods,” he said. “They may have the same types of nutrients, but be culturally influenced.” One person craves Italian food, for example, another a Chinese dish, and a third an Indian meal, but in the end, what they really all want is salt.

Meanwhile, after recovering from my own cravings episode, in which I settled for sourdough with olive oil and salt, and never did get my wood-fired pizza, I called a friend who’d gotten her shot a couple of days ago.

“Did you have cravings?” I asked. “Not yet!” she said.

She sounded so hopeful I didn’t have the heart to tell her. The window on that particular excuse has closed.