# Broad-Spectrum Adverse Events of Special Interests Based on Immune Response Following COVID-19 Vaccination: A Large-Scale Population-Based Cohort Study

## TL;DR

This study found that COVID-19 vaccination is linked to higher rates of various non-life-threatening adverse events, such as alopecia and gynecological issues, in a large population in South Korea.

## Contribution

The study introduces a large-scale analysis of non-severe adverse events following COVID-19 vaccination, focusing on immune-related issues often overlooked in prior research.

## Key findings

- Vaccinated individuals had significantly higher cumulative incidence rates of most immune-related adverse events compared to non-vaccinated individuals.
- Alopecia showed the highest risk increase following vaccination with a hazard ratio of 2.40.
- Heterologous vaccination was associated with increased risk for most adverse events.

## Abstract

Background/Objectives: Current studies on adverse events related to the COVID-19 vaccine have predominantly focused on severe, life-threatening side effects. However, numerous less severe but common adverse events (AEs) remain underreported and insufficiently investigated despite their potential impact. Methods: This population-based cohort study investigated the cumulative incidence rate (cIR) and risk of the broad-spectrum AEs of special interests (AESIs) based on immune response, including gynecological, dermatological, ophthalmological, otologic, and dental problems, following COVID-19 vaccination. Results: Among 4,203,887 individuals in Seoul, South Korea, the final analysis included 1,458,557 vaccinated subjects and 289,579 non-vaccinated subjects after the exclusion of underlying diseases. The cIR of AESIs for three months was significantly higher in vaccinated subjects than in non-vaccinated subjects, except for endometriosis. The vaccination significantly increased the risks of all the AESIs except for visual impairment. The risk of alopecia showed the highest HRs (HR [95% CI] = 2.40 [1.90–3.03]) among the AESIs following COVID-19 vaccination. Among the vaccinated subjects, heterologous vaccination was associated with the increased risk of most of the AESIs. Conclusions: Our findings suggest that clinicians should closely recognize and follow up on various COVID-19 vaccine-related AEs due to their unknown impact, even if they may not be serious at present.