Axillary adenopathy is a potential side effect following COVID-19 vaccination. We report four cases of axillary adenopathy in the setting of recent COVID-19 vaccination (Moderna and Pfizer-BioNTech) at our institution. Our cases show unilateral axillary adenopathy, as well as adenopathy persisting for two to three weeks following vaccination. The Society of Breast Imaging (SBI) and Harvard University have each released guidelines for management of axillary adenopathy following COVID-19 vaccination. While SBI recommends short term imaging 4–12 weeks following the second dose, a group of physicians from Harvard suggest clinical follow-up with sonographic imaging if clinical concern persists beyond six weeks. As a larger percentage of the general population becomes vaccinated, it is important for radiologists to be aware of potential vaccine-induced ipsilateral axillary adenopathy on screening and diagnostic breast imaging to reduce the number of unnecessary biopsies performed in this patient population.
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