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

Hong Jin Kim; Min-Ho Kim; Seong Jun Park; Myeong Geun Choi; Eun Mi Chun

doi:10.1016/j.jaci.2024.01.025

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

J Allergy Clin Immunol. 2024 Mar 18:S0091-6749(24)00129-5. doi: 10.1016/j.jaci.2024.01.025. Online ahead of print.

Authors

Hong Jin Kim¹, Min-Ho Kim², Seong Jun Park³, Myeong Geun Choi³, Eun Mi Chun⁴

Affiliations

¹ Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea.
² Informatization Department, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, Korea.
³ Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
⁴ Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. Electronic address: cem@ewha.ac.kr.

PMID: 38520423
DOI: 10.1016/j.jaci.2024.01.025

Abstract

Background: There is growing evidence that the coronavirus disease 2019 (COVID-19) vaccination can affect the regulation of the immune system, leading to the development of autoimmune diseases. However, the autoimmune adverse events (AEs) after COVID-19 vaccination remain largely unclear.

Objective: We sought to investigate the autoimmune AEs after COVID-19 vaccination from a population-based cohort in South Korea.

Methods: A total of 4,203,887 participants, representing 50% of the population residing in Seoul, were recruited from the National Health Insurance Service database and then divided into 2 groups on the basis of COVID-19 vaccination. The cumulative incidence, hazard ratios (HRs), and 95% CIs of autoimmune AEs were assessed following COVID-19 vaccination.

Results: The incidence of vitiligo has been observed to be significantly higher in the vaccination group compared with the no vaccination group. The cumulative incidence of vitiligo began to show a significant difference starting 2 weeks after vaccination, and it reached 2.2% in the vaccination group and 0.6% in the no vaccination group by 3 months after COVID-19 vaccination. Vitiligo (HR, 2.714; 95% CI, 1.777-4.146) was an increased risk among autoimmune AEs. Furthermore, the risk of vitiligo was the highest for heterologous vaccination (HR, 3.890; 95% CI, 2.303-6.573) compared with using cDNA vaccine (HR, 2.861; 95% CI, 1.838-4.453) or mRNA vaccine (HR, 2.475; 95% CI, 1.607-3.813).

Conclusions: Vitiligo as an autoimmune AE was noted to be substantially higher in the COVID-19-vaccinated group compared with the controls. Therefore, the occurrence of vitiligo could be considered as one of the significant AEs post-COVID-19 vaccination.

Keywords: COVID-19; autoimmune adverse events; complications; vaccination; vitiligo.