“COVID Arm”: Very delayed large injection site reactions to mRNA COVID-19 vaccines

Ramos, Courtney L.; Kelso, John M.

doi:10.1016/j.jaip.2021.03.055

Cited by 30 publications

(28 citation statements)

References 2 publications

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“… 3 Subsequent studies report a median onset of 7 days following initial dose. 4 , 5 , 6 These findings suggest that the late appearance of skin lesions may actually be characteristic in this clinical context.…”

Section: Figurementioning

confidence: 68%

“…There are multiple reports of local immunologic reactions to the Moderna and Pfizer‐BioNTech COVID‐19 vaccines. 1 , 2 , 3 , 4 , 5 , 6 These delayed injection‐site reactions, nicknamed “COVID‐arm,” are thought to represent a dermal hypersensitivity response. In a retrospective study of 4775 Pfizer‐BioNTech COVID‐19 vaccine recipients, delayed injection‐site reactions were observed in 103 subjects (2.1%).…”

Section: Figurementioning

confidence: 99%

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Generalized dermal hypersensitivity reaction following Moderna COVID‐19 vaccination

Myrdal

Culpepper

S³

2021

Dermatologic Therapy

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Section: Figurementioning

confidence: 68%

Section: Figurementioning

confidence: 99%

Generalized dermal hypersensitivity reaction following Moderna COVID‐19 vaccination

Myrdal

Culpepper

S³

2021

Dermatologic Therapy

View full text Add to dashboard Cite

show abstract

“…In the study by Català et al, the ‘COVID arm’ was much more common in females (95.4%) and is more likely to be associated with systemic symptoms (64.6%) than other post-vaccination eruptions [ 2 ]. It can manifest as a solitary pink patch or plaque associated with erythema, induration, pruritus, and/or tenderness ( Figure 1 ) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Severe reactions with lesion sizes of >10 cm have been reported [ 9 ].…”

Section: Resultsmentioning

confidence: 99%

Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review

et al. 2022

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Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca–Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination.

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“…Some authors argue that delayed injection-site reactions (DIRs) and distant reactions involving cosmetic dermal fillers (e.g., hyaluronic acid) might be another manifestation of delayed hypersensitivity [65]. The phenomenon that has been dubbed "COVID-arm" has been linked initially to mRNA vaccines, especially mRNA-1273 [25,66,67]. On the other hand, more recent reports demonstrated comparable findings with viral vector vaccines as well [68].…”

Section: Injection Site Reactions and Allergic Contact Dermatitismentioning

confidence: 99%

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

et al. 2021

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(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.

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“COVID Arm”: Very delayed large injection site reactions to mRNA COVID-19 vaccines

Cited by 30 publications

References 2 publications

Generalized dermal hypersensitivity reaction following Moderna COVID‐19 vaccination

Generalized dermal hypersensitivity reaction following Moderna COVID‐19 vaccination

Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

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