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Autoimmune adverse event following COVID-19 vaccination in Seoul, South Korea

Published: March 21, 2024

The emergence of coronavirus 2019 (COVID-19) resulted in a global challenge, overwhelming healthcare systems worldwide. With the rapid development of COVID-19 vaccines, vaccination has significantly reduced mortality and severity rates; however, adverse effects of COVID-19 vaccination have increasingly been reported. The current evidence suggests that both COVID-19 infection, and vaccination, can impact the immune system, ranging from inflammatory system to cytokine storms, and in some cases leading to the development of autoimmune diseases. However, reports of autoimmune adverse events (AEs) following COVID-19 vaccination have been limited to case reports and small case series, with a lack of large population-based cohort studies to investigate autoimmune AEs.

Published in The Journal of Allergy and Clinical Immunology (JACI), Dr. Chun and colleagues performed a population-based cohort study to investigate the autoimmune AEs after COVID-19 vaccination in Seoul, South Korea. Using the National Health Insurance Service database, a total of 4,203,887 participants, representing 50% of the population residing in Seoul, were included and divided into two groups based on COVID-19 vaccination to investigate autoimmune AEs including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Hashimoto’s thyroiditis (HT), Sjogren disease (SD), inflammatory bowel disease (IBD), vitiligo, Graves’ disease, ankylosing spondylitis (AS), primary biliary cholangitis (PBC), and autoimmune hepatitis (AIH).

The incidence of vitiligo has been observed to be significantly higher in the vaccination group compared to the no-vaccination group. Vitiligo (HR [95% CI] = 2.714 [1.777-4.146]) was an increased risk among autoimmune AEs. Furthermore, the risk of vitiligo was highest for heterologous vaccination, which is the administration of a vaccine platform different from the vaccine used to complete the primary vaccination (HR [95% CI] = 3.890 [2.303-6.573]).  Further work is needed, however, to define the mechanism involved.

Thus, vitiligo as an autoimmune AE was substantially higher in the COVID-19 vaccinated group compared to the controls, and vitiligo should be considered one of the significant AEs post-COVID-19 vaccination.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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