Study design and setting
We conducted a retrospective cohort study of individuals referred to our
fast-track suspected H&N cancer clinics. Our hospital is a leading NHS
trust providing tertiary H&N cancer services, with a dedicated regional
MDT. The study period covered 12 weeks between 16 December 2020 to 12
March 2021. Data was collected from the fast-track clinic referral forms
and the electronic records.
Study population
All patients referred to our fast-track H&N cancer clinics during the
study period were initially screened for their COVID-19 vaccination
status, and the reason for referral. All patients with cervical CVAL
(cCVAL) were included. We defined cCVAL as any unilateral and lower
cervical lymphadenopathy (level IV or V), first noticed within two weeks
of COVID-19 vaccine injection in the ipsilateral deltoid muscle. All
patients with bilateral, upper cervical, or known previous history of
cervical lymphadenopathy were excluded. We also excluded patients if
they received any other injection in the ipsilateral deltoid muscle
within four weeks before the onset of lymphadenopathy.