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Original article
Identifying adverse reactions following COVID-19 vaccination from data collected through active surveillance: a text mining approach
Hye Ah Lee, Bomi Park, Chung Ho Kim, Yeonjae Kim, Hyunjin Park, Seunghee Jun, Hyelim Lee, Seunghyun Lewis Kwon, Yesul Heo, Hyungmin Lee, Hyesook Park
Epidemiol Health. 2025;e2025034.   Published online June 30, 2025
DOI: https://doi.org/10.4178/epih.e2025034    [Accepted]
  • 276 View
  • 14 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
Unstructured text data collected through vaccine safety surveillance systems can identify previously unreported adverse reactions and provide critical information to enhance these systems. This study explored adverse reactions using text data collected through an active surveillance system following COVID-19 vaccination.
METHODS
We performed text mining on 2,608 and 2,054 records from 2 survey seasons (2023–2024 and 2024–2025), in which participants reported health conditions experienced within 7 days of vaccination using free-text responses. Frequency analysis was conducted to identify key terms, followed by subgroup analyses by sex, age, and concomitant influenza vaccination. In addition, semantic network analysis was used to examine terms reported together.
RESULTS
The analysis identified several common (≥1%) adverse events, such as respiratory symptoms, sleep disturbances, lumbago, and indigestion, which had not been frequently noted in prior literature. Moreover, less frequent (≥0.1% to <1%) adverse reactions affecting the eyes, ears, and oral cavity were also detected. These adverse reactions did not differ significantly in frequency based on the presence or absence of simultaneous influenza vaccination. Co-occurrence analysis and estimation of correlation coefficients further revealed associations between frequently co-reported symptoms.
CONCLUSIONS
This study utilized text mining to uncover previously unrecognized adverse reactions associated with COVID-19 vaccination, thereby broadening our understanding of the vaccine’s safety profile. The insights obtained may inform future investigations into vaccine-related adverse reactions and improve the processing of text data in surveillance systems.
Summary
Original Article
Prospective association between handgrip strength in childhood and the metabolic syndrome score and insulin resistance indices in adolescence: an analysis based on the Ewha Birth and Growth Study
Seunghee Jun, Hyunjin Park, Hyelim Lee, Hye Ah Lee, Young Sun Hong, Hyesook Park
Epidemiol Health. 2025;47:e2025001.   Published online January 2, 2025
DOI: https://doi.org/10.4178/epih.e2025001
  • 4,238 View
  • 149 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Low handgrip strength (HGS) in children and adolescents might be associated with the risk of metabolic syndrome (MetS) and insulin resistance. This study prospectively evaluated the association between HGS in childhood and MetS in adolescence.
METHODS
Based on data from the Ewha Birth and Growth Study, this study analyzed HGS at ages 7 to 9 and metabolic indices at ages 13 to 15. In total, 219 participants were analyzed. The risk of MetS was evaluated using the continuous metabolic syndrome score (cMetS), and insulin resistance was assessed using fasting blood insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Relative HGS in childhood was determined by dividing HGS by body weight and categorized as sex-specific quartiles.
RESULTS
This study found an inverse association between relative HGS levels in childhood and MetS and insulin resistance in adolescence. For each 1-group increase in relative HGS quartiles, cMetS (standarard [Std] β=-0.64, p<0.01), HOMA-IR (Std β=-0.21, p<0.01), and fasting blood insulin (Std β=-0.21, p<0.01) all decreased on average. These associations remained significant even after adjusting for confounding factors.
CONCLUSIONS
Our study showed a prospective association between HGS in childhood and the risk of MetS and insulin resistance in adolescence. It provides significant epidemiological evidence, emphasizing the importance of efforts to increase muscle strength from a young age to mitigate the risk of MetS and insulin resistance in adolescence.
Summary
Korean summary
본 연구는 소아기 악력 수준이 청소년기의 대사증후군 및 인슐린 저항성과 연관이 있음을 발견했음. 이러한 결과는 소아기 근력 향상이 향후 대사 위험을 완화하는데 중요함을 강조함.
Key Message
This study found that higher childhood relative handgrip strength was inversely associated with metabolic syndrome and insulin resistance in adolescence. The findings emphasize the importance of enhancing muscle strength early in life to mitigate metabolic risks.
Special Article
Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis
Seunghee Jun, Hyunjin Park, Ui-Jeong Kim, Eun Jeong Choi, Hye Ah Lee, Bomi Park, Soon Young Lee, Sun Ha Jee, Hyesook Park
Epidemiol Health. 2023;45:e2023092.   Published online October 16, 2023
DOI: https://doi.org/10.4178/epih.e2023092
  • 32,778 View
  • 788 Download
  • 23 Web of Science
  • 29 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis.
METHODS
Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis.
RESULTS
Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males.
CONCLUSIONS
Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.
Summary
Korean summary
본 연구는 코호트 연구를 기반으로 하여 음주의 수준에 따른 암 위험 연관성에 대해 체계적 문헌고찰(139편)과 메타분석(106편)을 수행하였다. 연구 결과, 음주와 암 위험 사이에 용량-반응 관계가 나타났으며, 소량의 음주는 암 유형에 따라 차이가 있었으나, 식도암, 대장암, 전립선암(남성), 유방암(여성)에서 암 위험과의 연관성이 있음을 발견했다. 따라서, 암 위험 측면에서 음주에 안전한 수준이 없음을 시사하며, 음주와 관련된 잠재적 피해를 완화하기 위해서는 음주 지침 강화와 같은 공중보건개입이 필요하다.
Key Message
The aim of this study was to assess the relationship between different levels of alcohol consumption and the risk of various cancer types through a systematic review and meta-analysis, providing insights into the ongoing debate about alcohol consumption and cancer causality. The findings support a dose-response relationship between alcohol consumption levels and cancer risk and the light alcohol consumption was associated with risks of esophageal, colorectal, prostate (male), and breast (female) cancer. These results emphasize the absence of a safe threshold for alcohol consumption in terms of cancer risk.

Citations

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COVID-19: Original Article
Changes in eating behaviors according to household income in adolescents during the COVID-19 pandemic: findings from the Korea National Health and Nutrition Examination Survey
Hye Ah Lee, Ho Jung Lee, Bomi Park, Yoonhee Shin, Hyunjin Park, Hyesook Park
Epidemiol Health. 2022;44:e2022102.   Published online November 9, 2022
DOI: https://doi.org/10.4178/epih.e2022102
  • 10,244 View
  • 157 Download
  • 2 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To assess social inequalities in changes in dietary behaviors among adolescents during the coronavirus disease 2019 (COVID-19) pandemic, we compared changes in dietary behavior indicators by household income.
METHODS
Using cross-sectional data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, the prevalence of dietary behaviors in adolescents (12-18 years old) was estimated and changes in dietary behaviors during the COVID-19 pandemic were evaluated. We assessed changes in dietary behaviors with a household income (as a measure of socioeconomic status, SES) disparity.
RESULTS
During the COVID-19 pandemic, the average consumption of vegetables decreased and food insecurity worsened. Adolescents were more likely to skip breakfast than before COVID-19 (33.1 and 37.4%). Soft drink consumption also increased in 2020 from 2019 (7.6 and 14.8%), especially among boys. Average sugar intake and sodium intake showed a tendency to decrease only in girls, but there was no significant difference according to SES level. Skipping breakfast was particularly evident in the low-SES group, and the difference according to household income level (high vs. low) was greater during COVID-19 than before. The prevalence of soft drink consumption increased significantly in the low-SES group, but the rate of increase did not differ by SES level.
CONCLUSIONS
We found that the social disparity in skipping breakfast was further aggravated during the COVID-19 pandemic. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.
Summary
Korean summary
국민건강영양조사 자료를 활용하여, COVID-19 팬데믹 전후 청소년의 식생활 변화 및 가구소득 수준에 따른 차이를 평가하였다. 대체로, 평균 채소 섭취량은 감소하고 탄산음료 소비는 증가한 것으로 나타났으며, 아침식사 결식율도 약간 증가한 것으로 나타났다. 게다가, 가구소득 수준에 따라 평가하였을 때, 아침식사 결식율 증가는 가구소득이 높은 군에 비해 가구소득 수준이 낮은 군에서 두드러진 것으로 나타났다. COVID-19 팬데믹이 장기화됨에 따라, 청소년의 식생활 변화에 대해서는 지속적인 모니터링이 필요하다.
Key Message
Using data from the 2019 and 2020 Korea National Health and Nutrition Examination Survey, changes in dietary behaviors of adolescents (12-18 years old) during the COVID-19 pandemic were evaluated. During the COVID-19 pandemic, average consumption of vegetables decreased and consumption of soft drinks increased in 2020 from 2019 (7.6% and 14.8%). In addition, the social disparity in skipping breakfast among adolescents was further aggravated. To reach a better understanding of the dietary behaviors of adolescents, continuous monitoring is necessary.

Citations

Citations to this article as recorded by  
  • Dietary Changes of Youth during the COVID-19 Pandemic: A Systematic Review
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