Association between vaccination and immunobullous disorders: a brief, updated systematic review with focus on COVID‐19

Association between COVID‐19 vaccination and autoimmune bullous diseases: a random coincidence or rare event

“… 1 The results of our recent systematic review on the association between COVID‐19 vaccination and AIBDs support this finding to some extent, showing that the hypothesized relationship is, if at all, at least a rather rare event. 2 Out of 932 published post‐SARS‐CoV‐2‐vaccinal cases (mostly mRNA vaccines), only about 6% presented clinically with de novo AIBDs and 10% had a flare or worsening of pre‐existing AIBDs being usually well controlled with standard immunosuppressive treatment, whereas vaccination did not negatively influence the clinical course in all remaining patients. 2 Likewise, the validity of supposed induction or triggering of AIBDs by COVID‐19 vaccines is limited, taking into account that the summarized data are generally based on single case reports with a low level of evidence and a cross‐sectional study biased by subjective patient self‐reports.…”

“… 2 Out of 932 published post‐SARS‐CoV‐2‐vaccinal cases (mostly mRNA vaccines), only about 6% presented clinically with de novo AIBDs and 10% had a flare or worsening of pre‐existing AIBDs being usually well controlled with standard immunosuppressive treatment, whereas vaccination did not negatively influence the clinical course in all remaining patients. 2 Likewise, the validity of supposed induction or triggering of AIBDs by COVID‐19 vaccines is limited, taking into account that the summarized data are generally based on single case reports with a low level of evidence and a cross‐sectional study biased by subjective patient self‐reports. 2 , 3 In addition, our previous investigation with healthy individuals who received the mRNA COVID‐19 vaccine revealed that circulating anti‐SARS‐CoV‐2 antibodies do not cross‐react with pemphigus or pemphigoid autoantigens including desmoglein 1, desmoglein 3, envoplakin, BP180, BP230 and type VII collagen.…”

“…An association between COVID‐19 vaccination and autoimmune bullous diseases (AIBDs) has been suspected, but evidence‐based data from larger cohorts of patients required for improved decision‐making were lacking until recently. 1 , 2 Birabaharan et al . 1 determined the risk of bullous pemphigoid, the most frequent AIBD, in a large federated health research network involving over 1.5 million people with mRNA COVID‐19 vaccination.…”

“… 2 Likewise, the validity of supposed induction or triggering of AIBDs by COVID‐19 vaccines is limited, taking into account that the summarized data are generally based on single case reports with a low level of evidence and a cross‐sectional study biased by subjective patient self‐reports. 2 , 3 In addition, our previous investigation with healthy individuals who received the mRNA COVID‐19 vaccine revealed that circulating anti‐SARS‐CoV‐2 antibodies do not cross‐react with pemphigus or pemphigoid autoantigens including desmoglein 1, desmoglein 3, envoplakin, BP180, BP230 and type VII collagen. 4 This argues against a link between SARS‐CoV‐2 vaccines and AIBDs with respect to disease‐triggering antibody cross‐reactivity.…”

New onset of pemphigus foliaceus following BBIBP COVID ‐19 vaccine

“… 2 Recently, several reports of pemphigus vulgaris and bullous pemphigoid after COVID‐19 vaccination have been published. 3 In this study, we emphasized the incidence of pemphigus foliaceous after vaccination while other remarkable investigations described cases of de novo bullous pemphigoid and pemphigus vulgaris or flare‐up of these diseases. 4 , 5 In the review of the literature, we have found three other new cases of pemphigus foliaceous after the administration of COVID‐19 vaccines (Table 1 ).…”