"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...
Discussion
... The autoimmune disease such as vitiligo originated from trained immunity, which was significantly related to the mechanism of vaccine action. Thus, the vaccination program is sufficiently expected on the onset of vitiligo as new-onset COVID-19 vaccine–related vitiligo. Indeed, Jacobs et al showed that DC vaccinations triggered immunotherapy-associated vitiligo in patients with melanoma. A dominant hypothesis for this phenomenon is that the SARS-CoV-2 spike protein is involved in inflammatory and immune response, which is believed to trigger various AEs including myocarditis. On the basis of this hypothesis, vitiligo as autoimmune AEs following COVID-19 vaccination may be associated with SARS-CoV-2 spike protein but it needs to be demonstrated by future experimental studies."
"Vitiligo is a condition resulting in patches of depigmented skin. Vitiligo can be widespread or affect only a small area of the body. While the primary symptom of vitiligo is skin discoloration, people with vitiligo can also experience hearing loss, eye inflammation, and other autoimmune conditions." (source)
© 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.
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