Herpes zoster emergence following mRNA COVID‐19 vaccine

Eid, Edward; Abdullah, Lina; Kurban, Mazen; Abbas, Ossama

doi:10.1002/jmv.27036

Cited by 94 publications

(94 citation statements)

References 6 publications

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“…15 As the occurrence of HZ was not specifically captured in the mRNA vaccine clinical trials, no data are available on the postvaccination HZ prevalence in the general population. Case reports on HZ following the BNT162b2 mRNA vaccination in subjects without immunosuppressive treatment 45 46 and in one patient with AAV in remission 47 were recently published. Further epidemiological studies and surveillance programmes are needed to investigate the prevalence of HZ in vaccinated subjects.…”

Section: Epidemiologymentioning

confidence: 99%

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study

et al. 2021

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IntroductionVaccination represents a cornerstone in mastering the COVID-19 pandemic. Data on immunogenicity and safety of messenger RNA (mRNA) vaccines in patients with autoimmune inflammatory rheumatic diseases (AIIRD) are limited.MethodsA multicentre observational study evaluated the immunogenicity and safety of the two-dose regimen BNT162b2 mRNA vaccine in adult patients with AIIRD (n=686) compared with the general population (n=121). Serum IgG antibody levels against SARS-CoV-2 spike S1/S2 proteins were measured 2–6 weeks after the second vaccine dose. Seropositivity was defined as IgG ≥15 binding antibody units (BAU)/mL. Vaccination efficacy, safety, and disease activity were assessed within 6 weeks after the second vaccine dose.ResultsFollowing vaccination, the seropositivity rate and S1/S2 IgG levels were significantly lower among patients with AIIRD versus controls (86% (n=590) vs 100%, p<0.0001 and 132.9±91.7 vs 218.6±82.06 BAU/mL, p<0.0001, respectively). Risk factors for reduced immunogenicity included older age and treatment with glucocorticoids, rituximab, mycophenolate mofetil (MMF), and abatacept. Rituximab was the main cause of a seronegative response (39% seropositivity). There were no postvaccination symptomatic cases of COVID-19 among patients with AIIRD and one mild case in the control group. Major adverse events in patients with AIIRD included death (n=2) several weeks after the second vaccine dose, non-disseminated herpes zoster (n=6), uveitis (n=2), and pericarditis (n=1). Postvaccination disease activity remained stable in the majority of patients.ConclusionmRNA BNTb262 vaccine was immunogenic in the majority of patients with AIIRD, with an acceptable safety profile. Treatment with glucocorticoids, rituximab, MMF, and abatacept was associated with a significantly reduced BNT162b2-induced immunogenicity.

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Section: Epidemiologymentioning

confidence: 99%

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study

et al. 2021

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“…Activation of herpes zoster is not uncommon among elderly patients during any vaccination [ 37 ]. In a case series from Spain, however, all patients with herpes zoster after first or second vaccination with BTN162b2 were young and healthy [ 38 ].…”

Section: Reactivation Of Skin Disordersmentioning

confidence: 99%

Cutaneous and hypersensitivity reactions associated with COVID-19 vaccination—a narrative review

Wollina

Chiriac

Kocic

et al. 2021

Wien Med Wochenschr

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Vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV‑2) has become a major tool in the battle against the coronavirus disease 2019 (COVID-19) pandemic. Numerous products have been developed and more are to come. Vaccination success varies greatly between different countries. There are a number of different vaccine types, such as mRNA, DNA vaccines, adenovirus vector vaccines, and full-length spike protein nanoparticles with a special matrix. The different types may also cause a different spectrum of adverse events. With mass vaccination, post-marketing surveillance for product safety becomes increasingly important. In this review, we discuss possible hypersensitivity and cutaneous adverse events related to SARS-CoV‑2 vaccination—from local reactions like COVID arm to systemic and severe reactions like anaphylaxis. Vaccination may also induce or exacerbate preexisting disorders such as herpes zoster infection. This review should provide information to tailor, whenever possible, vaccination to patients’ needs. It is a contribution to patient safety as well. There is general consensus that the benefits of SARS-CoV‑2 vaccination currently outweigh the risks of possible adverse events.

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“…It is interesting to note that cases of varicella–zoster virus reactivation have already been described following vaccinations against Hepatitis A, influenza virus, rabies and Japanese encephalitis [ 3 ]. Recently, two cases of Herpes Zoster reactivation have been associated with COVID-19 vaccination; the first, a 78-year-old man with a history of hypertension, cerebrovascular accident and bladder cancer, after the inoculation of an inactivated COVID-19 vaccine [ 4 ]; the second, a 79-year-old man with a history of hypertension and anti-neutrophilic cytoplasmic antibody-related glomerulonephritis, after mRNA COVID-19 vaccination [ 5 ]. Moreover, Furer and colleagues recently described an interesting case series of varicella–zoster virus reactivation in 6 patients affected by autoimmune inflammatory rheumatic disease after Pfizer-BioNTech inoculation [ 6 ].…”

Section: Varicella–zoster Virus Reactivation After Bnt162b2 Vaccine Second Dosementioning

confidence: 99%

A case of reactivation of varicella–zoster virus after BNT162b2 vaccine second dose?

Santovito

Pinna

2021

Inflamm. Res.

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We report a case of itchy papulovesicular rash consistent with varicella–zoster virus reactivation after Pfizer-BioNTech vaccine second dose administration. While there have been cases of varicella–zoster virus reactivation due to COVID-19 or COVID-19 vaccine inoculation in older individuals with pre-existing conditions, this case report describes the first case of varicella–zoster virus reactivation on a healthy, young male in the absence of pre-existing conditions. The mechanisms underlying varicella-zoster virus reactivation in patients with COVID-19 are unknown and should be further characterized.

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Herpes zoster emergence following mRNA COVID‐19 vaccine

Cited by 94 publications

References 6 publications

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study

Immunogenicity and safety of the BNT162b2 mRNA COVID-19 vaccine in adult patients with autoimmune inflammatory rheumatic diseases and in the general population: a multicentre study

Cutaneous and hypersensitivity reactions associated with COVID-19 vaccination—a narrative review

A case of reactivation of varicella–zoster virus after BNT162b2 vaccine second dose?

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