{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:58:50Z","timestamp":1760057930122,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Current studies on adverse events related to the COVID-19 vaccine have predominantly focused on severe, life-threatening side effects. However, numerous less severe but common adverse events (AEs) remain underreported and insufficiently investigated despite their potential impact. Methods: This population-based cohort study investigated the cumulative incidence rate (cIR) and risk of the broad-spectrum AEs of special interests (AESIs) based on immune response, including gynecological, dermatological, ophthalmological, otologic, and dental problems, following COVID-19 vaccination. Results: Among 4,203,887 individuals in Seoul, South Korea, the final analysis included 1,458,557 vaccinated subjects and 289,579 non-vaccinated subjects after the exclusion of underlying diseases. The cIR of AESIs for three months was significantly higher in vaccinated subjects than in non-vaccinated subjects, except for endometriosis. The vaccination significantly increased the risks of all the AESIs except for visual impairment. The risk of alopecia showed the highest HRs (HR [95% CI] = 2.40 [1.90\u20133.03]) among the AESIs following COVID-19 vaccination. Among the vaccinated subjects, heterologous vaccination was associated with the increased risk of most of the AESIs. Conclusions: Our findings suggest that clinicians should closely recognize and follow up on various COVID-19 vaccine-related AEs due to their unknown impact, even if they may not be serious at present.<\/jats:p>","DOI":"10.3390\/jcm14051767","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T04:55:08Z","timestamp":1741236908000},"page":"1767","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Broad-Spectrum Adverse Events of Special Interests Based on Immune Response Following COVID-19 Vaccination: A Large-Scale Population-Based Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8162-9585","authenticated-orcid":false,"given":"Hong Jin","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Kyung-in Regional Military Manpower Administration, Suwon 16440, Republic of Korea"},{"name":"Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul 01757, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9789-0235","authenticated-orcid":false,"given":"Jee Hyun","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Informatization Department, Ewha Womans University Seoul Hospital, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myeong Geun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Mi","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1038\/s41591-020-0968-3","article-title":"Extrapulmonary manifestations of COVID-19","volume":"26","author":"Gupta","year":"2020","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/S0140-6736(22)00152-0","article-title":"Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: Results of a systematic review and meta-regression","volume":"399","author":"Feikin","year":"2022","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0140-6736(20)32661-1","article-title":"Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK","volume":"397","author":"Voysey","year":"2021","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1056\/NEJMoa2110345","article-title":"Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine through 6 Months","volume":"385","author":"Thomas","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1038\/s41591-021-01556-7","article-title":"Neurological complications after first dose of COVID-19 vaccines and SARS-CoV-2 infection","volume":"27","author":"Patone","year":"2021","journal-title":"Nat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101619","DOI":"10.1016\/j.eclinm.2022.101619","article-title":"Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks","volume":"53","author":"Wang","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1093\/eurheartj\/ehad339","article-title":"COVID-19 vaccination-related myocarditis: A Korean nationwide study","volume":"44","author":"Cho","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e59","DOI":"10.3346\/jkms.2021.36.e59","article-title":"Preparing for the Coronavirus Disease (COVID-19) Vaccination: Evidence, Plans, and Implications","volume":"36","author":"Jung","year":"2021","journal-title":"J. Korean Med. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ijid.2022.03.007","article-title":"Adverse events following COVID-19 vaccination in South Korea between February 28 and August 21, 2021: A nationwide observational study","volume":"118","author":"Lee","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"117607","DOI":"10.1016\/j.jns.2021.117607","article-title":"Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review","volume":"428","author":"Bahmanyar","year":"2021","journal-title":"J. Neurol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/s41591-020-01194-5","article-title":"T cell and antibody responses induced by a single dose of ChAdOx1 nCoV-19 (AZD1222) vaccine in a phase 1\/2 clinical trial","volume":"27","author":"Ewer","year":"2021","journal-title":"Nat. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1038\/s41590-022-01163-9","article-title":"Mechanisms of innate and adaptive immunity to the Pfizer-BioNTech BNT162b2 vaccine","volume":"23","author":"Li","year":"2022","journal-title":"Nat. Immunol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ophtha.2022.08.027","article-title":"Vaccine-Associated Uveitis after COVID-19 Vaccination: Vaccine Adverse Event Reporting System Database Analysis","volume":"130","author":"Singh","year":"2023","journal-title":"Ophthalmology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e1213","DOI":"10.1097\/MAO.0000000000003275","article-title":"Otologic Manifestations After COVID-19 Vaccination: The House Ear Clinic Experience","volume":"42","author":"Wichova","year":"2021","journal-title":"Otol. Neurotol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2318","DOI":"10.1002\/rmv.2318","article-title":"Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series","volume":"32","author":"Fazlollahi","year":"2022","journal-title":"Rev. Med. Virol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1159\/000528719","article-title":"Alopecia Areata after COVID-19 Vaccines","volume":"9","author":"Genco","year":"2023","journal-title":"Ski. Appendage Disord."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Cazzato, G., Romita, P., Foti, C., Lobreglio, D., Trilli, I., Colagrande, A., Ingravallo, G., and Resta, L. (2022). Development of Flat Warts on the Cheeks after BioNTech-Pfizer BNT162b2 Vaccine: Is There a Correlation?. Vaccines, 10.","DOI":"10.3390\/vaccines10040532"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"577785","DOI":"10.1016\/j.jneuroim.2021.577785","article-title":"New diagnosis of multiple sclerosis in the setting of mRNA COVID-19 vaccine exposure","volume":"362","author":"Toljan","year":"2022","journal-title":"J. Neuroimmunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.7774\/cevr.2022.11.1.129","article-title":"Alopecia areata after COVID-19 vaccination","volume":"11","author":"Gallo","year":"2022","journal-title":"Clin. Exp. Vaccine Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1016\/j.jclinepi.2004.03.012","article-title":"New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality","volume":"57","author":"Sundararajan","year":"2004","journal-title":"J. Clin. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.virol.2020.08.011","article-title":"The novel coronavirus Disease-2019 (COVID-19): Mechanism of action, detection and recent therapeutic strategies","volume":"551","author":"Nikzad","year":"2020","journal-title":"Virology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"104473","DOI":"10.1016\/j.isci.2022.104473","article-title":"Heterologous ChAdOx1-BNT162b2 vaccination in Korean cohort induces robust immune and antibody responses that includes Omicron","volume":"25","author":"Lee","year":"2022","journal-title":"iScience"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1161\/CIRCULATIONAHA.122.061025","article-title":"Circulating Spike Protein Detected in Post-COVID-19 mRNA Vaccine Myocarditis","volume":"147","author":"Yonker","year":"2023","journal-title":"Circulation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103479","DOI":"10.1016\/j.isci.2021.103479","article-title":"The mRNA-LNP platform\u2019s lipid nanoparticle component used in preclinical vaccine studies is highly inflammatory","volume":"24","author":"Ndeupen","year":"2021","journal-title":"iScience"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"eadg1391","DOI":"10.1126\/sciadv.adg1391","article-title":"Unexpected vaginal bleeding and COVID-19 vaccination in nonmenstruating women","volume":"9","author":"Blix","year":"2023","journal-title":"Sci. Adv."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"eabm7201","DOI":"10.1126\/sciadv.abm7201","article-title":"Investigating trends in those who experience menstrual bleeding changes after SARS-CoV-2 vaccination","volume":"8","author":"Lee","year":"2022","journal-title":"Sci. Adv."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2058738418808680","DOI":"10.1177\/2058738418808680","article-title":"Autoimmune inner ear disease (AIED): A diagnostic challenge","volume":"32","author":"Ciorba","year":"2018","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.fertnstert.2022.12.023","article-title":"COVID-19 vaccination and changes in the menstrual cycle among vaccinated persons","volume":"119","author":"Farland","year":"2023","journal-title":"Fertil. Steril."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"106","DOI":"10.5005\/jp-journals-10078-1408","article-title":"New-onset Glaucoma Following Moderna COVID-19 Vaccination","volume":"17","author":"Su","year":"2023","journal-title":"J. Curr. Glaucoma Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/s41586-023-06800-3","article-title":"N(1)-methylpseudouridylation of mRNA causes +1 ribosomal frameshifting","volume":"625","author":"Mulroney","year":"2024","journal-title":"Nature"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"103952","DOI":"10.1016\/j.jri.2023.103952","article-title":"Menstrual disturbances following COVID-19 vaccination: A probable puzzle about the role of endocrine and immune pathways","volume":"158","author":"Keyvanfar","year":"2023","journal-title":"J. Reprod. Immunol."},{"key":"ref_34","unstructured":"Mulroney, T.E., P\u00f6yry, T., Yam-Puc, J.C., Rust, M., Harvey, R.F., Kalmar, L., Horner, E., Booth, L., Ferreira, A.P., and Stoneley, M. (2021). The Looming Effects of Estrogen in Covid-19: A Rocky Rollout. Front. Nutr., 18."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1016\/j.jaci.2024.01.025","article-title":"Autoimmune adverse event following COVID-19 vaccination in Seoul, South Korea","volume":"156","author":"Kim","year":"2024","journal-title":"J. Allergy Clin. Immunol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1767\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:48:03Z","timestamp":1760028483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/5\/1767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,6]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14051767"],"URL":"https:\/\/doi.org\/10.3390\/jcm14051767","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,3,6]]}}}