Risk of lymphadenopathy from SARS-CoV-2 vaccination in Korea: a self-controlled case series analysis

TL;DR

This study finds that SARS-CoV-2 vaccination in Korea increases the risk of lymphadenopathy, especially with mRNA vaccines and within the first week after vaccination.

Contribution

The study uses a self-controlled case series design to show a significant association between SARS-CoV-2 vaccination and lymphadenopathy risk.

Findings

The risk of lymphadenopathy was significantly increased 1-42 days after vaccination with a relative incidence of 1.17.

The highest risk occurred within 1-7 days post-vaccination (relative incidence of 1.59).

mRNA vaccines showed a higher risk compared to other types, with mRNA-1273 having a greater risk than BNT162b2.

Abstract

To assess the risk of lymphadenopathy following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.

A self-controlled case series design was used to determine whether the risk of lymphadenopathy was higher in the 1-day to 42-day risk interval after coronavirus disease 2019 (COVID-19) vaccination compared to the control period. In addition, subgroup analyses were conducted according to baseline characteristics, time since vaccination, and sensitivity analyses adjusted for the length of the risk interval.

The risk of developing lymphadenopathy in the risk interval (1-42 days) after COVID-19 vaccination compared to the control period was significantly increased, with a relative incidence (RI) of 1.17 (95% confidence interval [CI], 1.17 to 1.18) when the first, second, and third doses were combined. The RI was greater on the day of vaccination (1.47; 95% CI, 1.44 to 1.50). In subgroup analyses by baseline characteristics, a significantly increased risk or trend toward increased risk was observed in most subgroups except for those aged 70 years and older, with a significant increase in risk in younger individuals, those with a Charlson’s comorbidity index <5, and those who received mRNA vaccines (mRNA-1273>BNT162b2). Within the 1-day to 42-day post-dose risk period, the relative risk was highest during the 1-day to 7-day post-dose period (1.59; 95% CI, 1.57 to 1.60) compared to the control period, and then the risk declined. In the sensitivity analysis, we found that the longer the risk window, the smaller the RI.

SARS-CoV-2 vaccination is associated with a statistically significant increase in the risk of lymphadenopathy, and this risk was observed only with mRNA vaccines.

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