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Original article Risk of lymphadenopathy from SARS-CoV-2 vaccination: a self-controlled case series analysis
Mi-Sook Kim1orcid , Bongyoung Kim2orcid , Jeong Pil Choi3orcid , Nam-Kyong Choi4orcid , Jung Yeon Heo5orcid , Jun Yong Choi6orcid , Joongyub Lee3orcid , Sang Il Kim7orcid
Epidemiol Health 2023;e2023090
DOI: https://doi.org/10.4178/epih.e2023090 [Accepted]
Published online: October 13, 2023
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1Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea
2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
3Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
4Department of Health Convergence, Ewha Womans University, Seoul, Korea
5Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea
6Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea
7Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding author:  Joongyub Lee,
Email: c5cktail@snu.ac.kr
Sang Il Kim,
Email: c5cktail@snu.ac.kr
Received: 14 July 2023   • Revised: 11 September 2023   • Accepted: 22 September 2023
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Abstract

OBJECTIVES
To assess the risk of lymphadenopathy following SARS-CoV-2 vaccination.
METHODS
A self-controlled case series design was used to determine whether the risk of lymphadenopathy was higher in the 1- to 42-day risk interval after 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.
RESULTS
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% CI, 1.17-1.18) when the first, second, and third doses were combined. The RI was greater on the day of vaccination (1.47; 95% CI, 1.44-1.50). 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- to 42-day post-dose risk period, the relative risk was highest during the 1- to 7-day post-dose period (1.59; 95% CI, 1.57-1.60) 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.
CONCLUSIONS
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.

Epidemiol Health : Epidemiology and Health
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