‘COVID arm’ – histological features of a delayed‐type hypersensitivity reaction to Moderna mRNA‐1273 SARS‐CoV2 vaccine

Kempf, Werner; Kettelhack, Natascha; Kind, F; Courvoisier, S; Galambos, John T.; Pfaltz, K

doi:10.1111/jdv.17506

Cited by 19 publications

(34 citation statements)

References 10 publications

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“…1,2 Neutrophils are associated with ENL, as the lesional skin showed an intense perivascular neutrophilic infiltrate throughout the dermis and on stimulation with lipopolysaccharide(LPS) of Mycobacterium leprae, neutrophils in ENL patients release TNF-alpha and IL-8. 3 This supports the role of neutrophils as effector cells actively producing pro-inflammatory cytokines and not only as migratory cells following chemo-attractants.…”

supporting

confidence: 59%

“…Therefore, it is proposed that change in neutrophil counts in peripheral blood and tissues may be closely associated with pathological injury in Covid-19 patients. 2,4 Hence, we put forward above-mentioned hypothesis of Trigger of Type 2 reaction following Covid-19 vaccination based on the neutrophilic mechanism of immunological response in body. However, this hypothesis is only a possibility and needs to be established in future.…”

mentioning

confidence: 99%

“…'COVID arm'). 3 Less common reactions included a dyshidrotic eczema flare, pernio/ chilblains lesions and psoriasiform dermatitis (Figure 1).…”

mentioning

confidence: 99%

“…

Dear Editor,The clinical trials for the Moderna and Pfizer COVID-19 vaccines reported local injection site cutaneous reactions 1,2 ; however, varied cutaneous reactions have been noted including delayed large local cutaneous reaction called 'COVID arm' and rashes characterized by their dermatologic morphological equivalents including urticarial, morbilliform, pernio/chilblains-like and pityriasis rosea-like reactions. [3][4][5]

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confidence: 99%

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Cutaneous reactions due to Pfizer's BNT162b2 mRNA and Moderna's mRNA‐1273 vaccines

Oulee

Salem

Yahia

et al. 2022

Acad Dermatol Venereol

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confidence: 59%

mentioning

confidence: 99%

“…'COVID arm'). 3 Less common reactions included a dyshidrotic eczema flare, pernio/ chilblains lesions and psoriasiform dermatitis (Figure 1).…”

mentioning

confidence: 99%

“…

…”

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confidence: 99%

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Cutaneous reactions due to Pfizer's BNT162b2 mRNA and Moderna's mRNA‐1273 vaccines

Oulee

Salem

Yahia

et al. 2022

Acad Dermatol Venereol

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“…2e). 10 For all the patients, the lesions decreased in size, number or disappeared completely during the 2 weeks after the first consultation.…”

Section: Clinical and Histological Aspectsmentioning

confidence: 89%

Clinicopathological features of cutaneous reactions after mRNA‐based COVID‐19 vaccines

Tihy

Menzinger

André

et al. 2021

Acad Dermatol Venereol

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Background Cutaneous reactions, mostly on injection site after mRNA‐based COVID‐19 vaccines, have been reported but not with detailed histopathological characterization. Objectives Characterization and classification of these reactions in a clinical and pathological point of view. Methods Monocentric case series of 11 patients with cutaneous manifestations, clinically and histologically characterized after COVID‐19 vaccination. Results From January to June 2021, we recorded 11 cutaneous reactions to mRNA COVID‐19 vaccines from BNT162b2 (n = 8) and mRNA‐1273 (n = 3). Generalized reactions showing erythematous rash or purpura were the most common clinical presentation, and drug‐reaction‐like pattern was the most common histological finding. Conclusions A proper clinicopathological classification will be helpful in the early diagnosis and management of the cutaneous reactions to mRNA COVID‐19 vaccines.

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Assessment of Delayed Large Local Reactions After the First Dose of the SARS-CoV-2 mRNA-1273 Vaccine in Japan

et al. 2022

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IMPORTANCE A delayed large local reaction (DLLR) is a delayed-onset adverse skin reaction that may occur after injection of the mRNA-1273 vaccine against SARS-CoV-2.OBJECTIVE To examine the associations between sex and age and susceptibility of DLLRs after mRNA-1273 vaccination. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cross-sectional study was conducted at the Self-Defense Forces large-scale vaccination center in Tokyo, Japan, from May 24 to November 30, 2021. Participants were recipients of the second dose of the mRNA-1273 vaccine who had received the first dose 4 to 6 weeks earlier. Five experienced dermatologists interviewed participants to assess whether they had experienced symptoms of DLLR after administration of the first dose of the vaccine.EXPOSURE Receipt of the first dose of the mRNA-1273 vaccine.MAIN OUTCOMES AND MEASURES The primary outcome was the incidence rate of DLLR stratified by sex and age group. Odds ratios (ORs) were calculated to evaluate the differences between groups. Outcomes were tested for significance using the Pearson χ 2 test with 95% CIs. RESULTSOf 5893 participants in the study, 3318 (56.3%) were male (median age, 55 years [IQR,) and 2575 (43.7%) were female (median age, 50 years [IQR, 34-67 years]). A total of 747 participants (12.7%) experienced DLLR symptoms after the first dose of the mRNA-1273 vaccine. Symptoms were mild and not considered as contraindications to the vaccine. The incidence rate was significantly higher among females (22.4% [577 participants]; OR, 5.30; 95% CI, 4.42-6.34) than among males (5.1% [170 participants]; reference). Moreover, the incidence rate was significantly higher among participants aged 30 to 39 years (14.3% [129 participants]; OR, 1.68; 95% CI, 1.25-2.26), 40 to 49 years (15.8% [136 participants]; OR, 1.89; 95% CI, 1.41-2.53), 50 to 59 years (14.9% [104 participants]; OR, 1.76; 95% CI, 1.29-2.40), and 60 to 69 years (12.6% [182 participants]; OR, 1.45; 95% CI, 1.10-1.91) than among participants aged 18 to 29 years (9.0% [81 participants]; reference). CONCLUSIONS AND RELEVANCEIn this cross-sectional study, the first dose of the SARS-CoV-2 mRNA-1273 vaccine was associated with a higher incidence of DLLR among females and among individuals aged 30 to 69 years. The findings suggest that DLLR may be a type IV allergic skin reaction.

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‘COVID arm’ – histological features of a delayed‐type hypersensitivity reaction to Moderna mRNA‐1273 SARS‐CoV2 vaccine

Abstract: M et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases.

Cited by 19 publications

References 10 publications

Cutaneous reactions due to Pfizer's BNT162b2 mRNA and Moderna's mRNA‐1273 vaccines

Cutaneous reactions due to Pfizer's BNT162b2 mRNA and Moderna's mRNA‐1273 vaccines

Clinicopathological features of cutaneous reactions after mRNA‐based COVID‐19 vaccines

Assessment of Delayed Large Local Reactions After the First Dose of the SARS-CoV-2 mRNA-1273 Vaccine in Japan

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