J Korean Med Sci.  2021 Mar;36(9):e67. 10.3346/jkms.2021.36.e67.

Estimating Baseline Incidence of Conditions Potentially Associated with Vaccine Adverse Events: a Call for Surveillance System Using the Korean National Health Insurance Claims Data

• Huh K
• Kim YE
• Radnaabaatar M
• Lee DH
• Kim DW
• Shin SA
• Jung J

• KMID: 2513587
• DOI: http://doi.org/10.3346/jkms.2021.36.e67

Abstract

Background
Vaccines against coronavirus disease 2019 (COVID-19) are raising concerns about vaccine safety, particularly in the context of large-scale immunization. To address public concerns, we measured the baseline incidence rates of major conditions potentially related to vaccine-related adverse events (VAEs). We aimed to provide a basis for evaluating VAEs and verifying causality.
Methods
Conditions of interest were selected from the US Vaccine Adverse Event Reporting System Table of Reportable Events and a recent report from a European consortium on vaccine surveillance. We used the National Health Insurance Service database in Korea to identify the monthly numbers of cases with these conditions. Data from January 2006 to June 2020 were included. Prediction models were constructed from the observed incidences using an autoregressive integrated moving average. We predicted the incidences of the conditions and their respective 95% confidence intervals (CIs) for January through December 2021. In addition, subgroup analysis for the expected vaccination population was conducted.
Results
Mean values (95% CIs) of the predicted monthly incidence of vasovagal syncope, anaphylaxis, brachial neuritis, acute disseminated encephalomyelitis, Bell's palsy, Guillain-Barré syndrome, encephalopathy, optic neuritis, transverse myelitis, immune thrombocytopenic purpura, and systemic lupus erythematosus in 2021 were 23.89 (19.81– 27.98), 4.72 (3.83–5.61), 57.62 (51.37–63.88), 0.03 (0.01–0.04), 8.58 (7.90–9.26), 0.26 (0.18– 0.34), 2.13 (1.42–2.83), 1.65 (1.17–2.13), 0.19 (0.14–0.25), 0.75 (0.61–0.90), and 3.40 (2.79– 4.01) cases per 100,000 respectively. The majority of the conditions showed an increasing trend with seasonal variations in their incidences.
Conclusion
We measured the incidence of a total of 11 conditions that could potentially be associated with VAEs to predict the monthly incidence in 2021. In Korea, conditions that could potentially be related to VAEs occur on a regular basis, and an increasing trend is observed with seasonality.

Keyword

COVID-19; Vaccination; Vaccine Adverse Events; Vaccine Hesitancy

Figure

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  Fig. 1 Observed and predicted incidences of the study conditions. Green line denotes observed incidence from January 2006 through June 2020. Red line, fitted value; thick red line, predicted incidence from June 2020 through December 2021. Dark and light blue shade, 80% and 95% confidence intervals of prediction. Grey shade, the year 2021.

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