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Monitoring adverse reactions following immunisation is essential, particularly for new vaccines such as those against COVID-19. We describe 20 cases of acute onset of a single supraclavicular lymphadenopathy manifesting between 24 h and 9 days after ipsilateral intramuscular administration of an mRNA-based COVID-19 vaccine, referred to our WHO Collaborating Centre for Vaccine Safety. Our results indicate that the swelling of supraclavicular lymph nodes following immunisation may constitute a benign and self-limited condition, related to a higher than recommended injection site.


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  1. World Health Organization Regional Office for Europe (WHO /Europe). Vaccine safety and false contraindications to vaccination. Copenhagen: WHO/Europe; 2017. Available from: https://www.euro.who.int/__data/assets/pdf_file/0009/351927/WHO-Vaccine-Manual.pdf
  2. Riva G, Sensini M, Peradotto F, Scolfaro C, Di Rosa G, Tavormina P. Pediatric neck masses: how clinical and radiological features can drive diagnosis. Eur J Pediatr. 2019;178(4):463-71.  https://doi.org/10.1007/s00431-018-3305-9  PMID: 30643937 
  3. Al-Hammadi S, Alkuwaiti NS, Ghatasheh GA, Al Dhanhani H, Shendi HM, Elomami AS, et al. Adverse events of the BCG (Bacillus Calmette-Guérin) and rotavirus vaccines in a young infant with inborn error of immunity. Case Reports Immunol. 2020;2020:8857152.  https://doi.org/10.1155/2020/8857152  PMID: 33354374 
  4. Marin M, Fiebelkorn AP, Bi D, Coleman LA, Routh J, Curns AT, et al. Adverse events among young adults following a third dose of measles-mumps-rubella vaccine. Clin Infect Dis. 2020:ciaa1090.  https://doi.org/10.1093/cid/ciaa1090  PMID: 32766827 
  5. Diaz-Mitoma F, Halperin SA, Scheifele D. Reactogenicity to a live attenuated varicella vaccine in Canadian children. Can J Infect Dis. 2000;11(2):97-101.  https://doi.org/10.1155/2000/647245  PMID: 18159273 
  6. European Agency for the Evaluation of Medicinal Products (EMEA). Summary of product characteristics - Comirnaty. Amsterdam: EMEA. [Accessed: 15 Feb 2021]. Available from: https://www.ema.europa.eu/en/documents/product-information/comirnaty-epar-product-information_en.pdf
  7. European Agency for the Evaluation of Medicinal Products (EMEA). Summary of product characteristics – COVID 19 vaccine Moderna. Amsterdam: EMEA. [Accessed: 15 Feb 2021]. Available from: https://www.ema.europa.eu/en/documents/product-information/covid-19-vaccine-moderna-epar-product-information_en.pdf
  8. Banjar FK, Wilson AM. Anatomy, head and neck, supraclavicular lymph node. [Updated 2020 Jul 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544300/
  9. Cybulska P, Hayes SA, Spirtos A, Rafizadeh MJ, Filippova OT, Leitao M, et al. Prognostic significance of supraclavicular lymphadenopathy in patients with high-grade serous ovarian cancer. Int J Gynecol Cancer. 2019;29(9):1377-80.  https://doi.org/10.1136/ijgc-2019-000829  PMID: 31575614 
  10. Toy H, Karasoy D, Keser M. Lymphadenitis caused by H1N1 vaccination: case report. Vaccine. 2010;28(10):2158-60.  https://doi.org/10.1016/j.vaccine.2009.12.043  PMID: 20060084 
  11. Pereira MP, Flores P, Neto AS. Neck and supraclavicular lymphadenopathy secondary to 9-valent human papillomavirus vaccination. BMJ Case Rep. 2019;12(11):e231582.  https://doi.org/10.1136/bcr-2019-231582  PMID: 31694828 
  12. Behrens RH, Patel V. Avoiding shoulder injury from intramuscular vaccines. Lancet. 2021;397(10273):471.  https://doi.org/10.1016/S0140-6736(21)00192-6  PMID: 33549186 

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