Epidemiology and Health

Original article

Risk of lymphadenopathy from SARS-CoV-2 vaccination: a self-controlled case series analysis: Mi-Sook Kim, Bongyoung Kim, Jeong Pil Choi, Nam-Kyong Choi, Jung Yeon Heo, Jun Yong Choi, Joongyub Lee, Sang Il Kim; Epidemiol Health. 2023;e2023090. Published online October 13, 2023; DOI: https://doi.org/10.4178/epih.e2023090 [Accepted]

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Abstract PDF: 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.; Summary

COVID-19: Brief Communication

Self-reported adverse events after 2 doses of COVID-19 vaccine in Korea: Yunhyung Kwon, Insob Hwang, Mijeong Ko, Hyungjun Kim, Seontae Kim, Soon-Young Seo, Enhi Cho, Yeon-Kyeng Lee; Epidemiol Health. 2023;45:e2023006. Published online December 26, 2022; DOI: https://doi.org/10.4178/epih.e2023006

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Abstract Summary PDF

Abstract

OBJECTIVES
In Korea, a national coronavirus disease 2019 (COVID-19) vaccination program was implemented, including 4 vaccines against COVID-19. A text messaging-based survey, in addition to a passive adverse event reporting system, was launched to quickly report unusual symptoms post-vaccination. This study compared the frequency of adverse events after COVID-19 vaccination based on the vaccine type and the type of 2-dose regimen (homologous or heterologous).

METHODS

Self-reported adverse events were collected through a text-message survey for 7 days after each vaccination. This study included 50,950 vaccine recipients who responded to the survey at least once. Informed consent to receive surveys via text was obtained from the vaccine recipients on the date of first vaccination.

RESULTS

The recipients of mRNA vaccines reported local and systemic reactions 1.6 times to 2.8 times more frequently after dose 2 than after dose 1 (p<0.001), whereas ChAdOx1-S recipients reported significantly fewer local and systemic reactions after dose 2 than after dose 1 (p<0.001). Local and systemic reactions were approximately 2 times and 4 times more frequent for heterologous vaccination than for BNT162b2/BNT162b2 and ChAdOx1-S/ChAdOx1-S regimens, respectively. Young individuals, female, and those receiving heterologous vaccine regimens including ChAdOx1-S/BNT162b2 vaccines reported more adverse events than older participants, male, and those with homologous vaccine regimens.

CONCLUSIONS

Although a heterologous regimen, youth, and female sex were associated with a higher risk of adverse reactions after COVID-19 vaccination, no critical issues were noted. Active consideration of heterologous schedules based on the evidence of efficacy and safety appears desirable.

Summary

Korean summary
본 연구는 코로나19 백신 접종 후 7일 동안 문자 설문조사를 통해 50,950명이 자가 보고한 이상반응자료를 분석하였다. mRNA 백신 접종자는1회 접종 후보다 2회 접종 후 국소 이상반응 및 전신이상반응을 1.6~2.8배 더 자주 보고한 반면, ChAdOx1-S 백신 접종자는1회 접종 후 보다 2회 접종 후 이상반응을 더 적게 보고하였다. 동종 백신접종 보다 교차 접종의 경우 2-4배 더 많은 이상반응을 보고 하였다. COVID-19 백신 접종 후 교차접종, 젊은 연령, 여성의 경우 좀 더 많은 이상반응을 보고하였지만,중대한 문제는 보고되지 않았다.

Key Message
Self-reported adverse events were collected through a text-message survey from 50,950 recipients for 7 days after COVID-19 vaccination. The mRNA vaccine recipients reported local and systemic reactions 1.6 to 2.8 times more frequently after dose 2 than after dose 1, whereas ChAdOx1-S recipients reported significantly fewer local and systemic reactions after dose 2 than after dose 1. Local and systemic reactions were approximately 2 to 4 times more frequent for heterologous vaccination than for homologous regimens. Although a heterologous regimen, youth, and female were associated with a higher risk of adverse reac¬tions after COVID-19 vaccination, no critical issues were noted.

Citations

Citations to this article as recorded by

A Nationwide Survey of mRNA COVID-19 Vaccinee’s Experiences on Adverse Events and Its Associated Factors
Dongwon Yoon, Ha-Lim Jeon, Yunha Noh, Young June Choe, Seung-Ah Choe, Jaehun Jung, Ju-Young Shin
Journal of Korean Medical Science.2023;[Epub] CrossRef

COVID-19: Original Article

Parental concerns about COVID-19 vaccine safety and hesitancy in Korea: implications for vaccine communication: Hye-Kyung Cho, Hyunju Lee, Young June Choe, Shinkyeong Kim, Sujin Seo, Jiwon Moon, Eun Hwa Choi, Geun-Yong Kwon, Jee Yeon Shin, Sang-Yoon Choi, Mi Jin Jeong, Myoungsoon You; Epidemiol Health. 2023;45:e2023004. Published online December 13, 2022; DOI: https://doi.org/10.4178/epih.e2023004

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Abstract Summary PDF

Abstract

OBJECTIVES
Vaccination is one of the most important strategies to contain the spread of coronavirus disease 2019 (COVID-19). Vaccination in children is dependent on their parents, making it important to understand parents’ awareness and attitudes toward vaccines in order to devise strategies to raise vaccination rates in children.

METHODS

A web-based nationwide survey was conducted among Korean parents of 7-year-old to 18-year-old children in August 2021 to estimate parents’ intention to vaccinate their children against COVID-19 and identify key factors affecting parental acceptance and hesitancy through regression analysis.

RESULTS

Approximately 56.4% (575/1,019) were willing to vaccinate their children against COVID-19. Contributing factors to COVID-19 vaccine hesitancy were being a mother (adjusted odds ratio [aOR], 0.36; 95% confidence interval [CI], 0.25 to 0.52), a lower education level (aOR, 0.83; 95% CI, 0.70 to 0.97), hesitancy to other childhood vaccines (aOR, 0.78; 95% CI, 0.64 to 0.96), and refusal to vaccinate themselves (aOR, 0.08; 95% CI, 0.02 to 0.20). Having older children (aOR, 1.20; 95% CI, 1.13 to 1.28), trusting the child’s doctor (aOR, 1.19; 95% CI, 1.07 to 1.32), positive perceptions of the COVID-19 vaccine’s effectiveness (aOR, 2.60; 95% CI, 1.90 to 3.57) and perceiving the COVID-19 vaccine as low-risk (aOR, 1.68; 95% CI, 1.27 to 2.24) were associated with COVID-19 vaccine acceptance. Concerns about adverse reactions were the most common cause of hesitancy.

CONCLUSIONS

Providing parents with accurate and reliable information on vaccine effectiveness and safety is important to increase COVID-19 vaccine uptake in children. Differential or targeted approaches to parents according to gender, age, and their children’s age are necessary for effective communication about vaccination in children.

Summary

Korean summary
부모에게 백신 효과와 안전성에 대한 정확하고 믿을만한 정보를 제공하는 것이 소아 코로나19 백신 접종률을 높이는데 중요하다. 자녀의 백신 접종에 대한 의사소통을 효율적으로 하기 위해서는 부모의 성별과 연령, 자녀의 연령을 고려한 차별적인 접근 방법이 필요하다.

Key Message
To improve COVID-19 vaccine uptake in children, it's crucial to provide parents with reliable and precise information about vaccine safety and effectiveness. Targeted communication strategies that consider factors such as the age of the parents and their children, as well as gender, may be necessary to effectively convey this information.

Citations

Citations to this article as recorded by

Willingness and hesitancy of parents to vaccinate against COVID-19 their children ages 6 months to 4 years with frail conditions in Italy
Grazia Miraglia del Giudice, Giorgia Della Polla, Mario Postiglione, Italo Francesco Angelillo
Frontiers in Public Health.2023;[Epub] CrossRef
Safety of BNT162b2 mRNA COVID-19 vaccine in children with chronic kidney disease: a national population study from South Korea
Young June Choe, Yo-Han Ahn, Eunsun Gwak, Eunseo Jo, Jinseob Kim, Seung-Ah Choe
Pediatric Nephrology.2023;[Epub] CrossRef

COVID-19: Brief Communication

Dynamics of hospitalizations and in-hospital deaths from COVID-19 in northeast Brazil: a retrospective analysis based on the circulation of SARS-CoV-2 variants and vaccination coverage: Paulo Ricardo Martins-Filho, Adriano Antunes de Souza Araújo, Lucindo José Quintans-Júnior, Bárbara dos Santos Soares, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Victor Santana Santos; Epidemiol Health. 2022;44:e2022036. Published online April 5, 2022; DOI: https://doi.org/10.4178/epih.e2022036

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8 Citations

Abstract Summary PDF

Abstract

This study investigated the dynamics of hospitalizations and in-hospital deaths from coronavirus disease 2019 (COVID-19) throughout the pandemic in northeast Brazil, the Brazilian region with the worst socioeconomic indicators. In total, 141,445 cases, 8,213 hospital admissions, and 1,644 in-hospital deaths from COVID-19 were registered from March 14, 2020 to February 5, 2022. The overall rates of hospitalization and in-hospital deaths were 5.8% and 20.0%, respectively. The hospitalization and death rates significantly decreased over time, which may have been related to progress in vaccination. During the spread of the Gamma variant (January to June 2021), most hospitalized individuals were young adults, and approximately 40% of deaths occurred in this age group. During the predominance of Delta (July to December 2021), over 75% of deaths occurred among the elderly and unvaccinated or partially vaccinated individuals. This rate decreased to 42.3% during the transmission of the Omicron variant (January to February 2022), during which 34.6% of deaths were recorded among fully vaccinated individuals (2 doses) and 23.1% among those who received full vaccination and a booster. The Omicron-driven third wave was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose.

Summary

Key Message
The Omicron-driven third wave in Brazil was associated with a rise in the proportion of deaths among vaccinated individuals, especially among those who had not received a booster dose

Citations

Citations to this article as recorded by

Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
Enfermedades Infecciosas y Microbiología Clínica.2023; 41(3): 199. CrossRef
SARS-CoV-2 infection and mortality in pediatric patients with hematological malignancies and solid tumors
João Eduardo Andrade Tavares de Aguiar, Marcos Antônio Lima Carvalho, Simone Santana Viana, Paulo Ricardo Martins-Filho, Rosana Cipolotti
Pediatric Hematology and Oncology.2023; 40(4): 429. CrossRef
Comparison of Epidemiologic and Clinical COVID-19 Profiles in Children in Argentina, During Circulation of Original and Variant (Alpha, Gamma and Lambda) Strains
Angela Gentile, María Del Valle Juárez, Lucia Romero Bollon, Valeria Aprea, Erika Matteucci, Andrea Falaschi, Martin Brizuela, Cristina Euliarte, Gabriela Gregorio, Maria Paula Della Latta, Carlota Russ, Gabriela Nidia Ensinck, Liliana Saraceni, Miriam Br
Pediatric Infectious Disease Journal.2023; 42(2): 136. CrossRef
Case-fatality rates and risk of death from COVID-19 and influenza A/H3N2 in Brazil: A nationwide ecological study
Paulo Ricardo Martins-Filho, Jerocílio Maciel de Oliveira Júnior, Cliomar Alves dos Santos
Enfermedades infecciosas y microbiologia clinica (English ed.).2023; 41(3): 199. CrossRef
Impact of inactivated vaccines on decrease of viral RNA levels in individuals with the SARS-CoV-2 Omicron (BA.2) variant: A retrospective cohort study in Shanghai, China
Peng Yang, Bianli Dang, Wen Kang, Xiaofeng Li, Tianping Wang, Ruijuan Li, Meijuan Peng, Yushen Liu, Linxu Wang, Yan Cheng, Suhuai Yu, Min Wei, Han Gao, Wenzhen Kang, Lei Shang
Frontiers in Public Health.2023;[Epub] CrossRef
Comparison of the disease severity with infection of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta and Omicron variants: A meta‐analysis
Ying Qiu, Zhenghao Li, Fan Lin, Yilin Yang, Lanxuan Yang, Ting Li
MedComm – Future Medicine.2023;[Epub] CrossRef
Clinical Characteristics and Risk Factors for Mortality in Critical COVID-19 Patients Aged 50 Years or Younger During Omicron Wave in Korea: Comparison With Patients Older Than 50 Years of Age
Hye Jin Shi, Jinyoung Yang, Joong Sik Eom, Jae-Hoon Ko, Kyong Ran Peck, Uh Jin Kim, Sook In Jung, Seulki Kim, Hyeri Seok, Miri Hyun, Hyun Ah Kim, Bomi Kim, Eun-Jeong Joo, Hae Suk Cheong, Cheon Hoo Jun, Yu Mi Wi, Jungok Kim, Sungmin Kym, Seungjin Lim, Yoon
Journal of Korean Medical Science.2023;[Epub] CrossRef
Prevalence of SARS-CoV-2 infection among urban cleaning and solid waste management workers during transmission of the Omicron variant in Brazil
Paulo Ricardo Martins-Filho, Joyce Thayane da Conceição dos Santos, Márcia Santos Rezende, Fernanda Oliveira de Carvalho, Érica Santos dos Reis, Waneska de Souza Barboza, Taise Ferreira Cavalcante, Cliomar Alves dos Santos, Lucindo José Quintans-Júnior,
Epidemiology and Health.2023;[Epub] CrossRef

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