Cutaneous adverse effects of the available COVID-19 vaccines
TL;DR: In this article, a plethora of cutaneous adverse events have been reported, most of them mild or moderate injection-site reactions, posing questions on their pathophysiology and clinical importance.
About: This article is published in Clinics in Dermatology.The article was published on 2021-04-27 and is currently open access. It has received 60 citations till now. The article focuses on the topics: Vaccination.
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TL;DR: There is growing evidence that not only the novel coronavirus disease (COVID-19) but also the COVID19 vaccines can cause a variety of skin reactions as mentioned in this paper, including delayed large local skin lesions, inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars.
Abstract: There is growing evidence that not only the novel coronavirus disease (COVID-19) but also the COVID-19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID-19 vaccination campaigns all over the world. Unspecific injection site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g., urticaria, angioedema, anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions ("COVID arm"), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly moribilliform and erythema multiforme-like rashes. Autoimmune-mediated skin findings after COVID-19 vaccination include leukocytoclastic vasculitis, lupus erythematosus, and immune thrombocytopenia. Functional angiopathies (chilblain-like lesions, erythromelalgia) may also be observed. Pityriasis rosea-like rashes and reactivation of herpes zoster have also been reported after COVID-19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID-19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS-CoV-2 (e.g., the spike-protein sequences used to design the vaccines) and human components and may thus explain some COVID-19 pathologies as well adverse skin reactions to COVID-19 vaccinations.
114 citations
TL;DR: In this paper, the authors performed a literature research concerning cutaneous adverse drug reactions (ADRs) to different COVID-19 vaccines, and incorporated their own experiences, finding that injection site reactions are the most frequent side effects arising from all vaccine types.
55 citations
TL;DR: In this article, the authors assessed the immediate symptoms associated with taking the Oxford-AstraZeneca COVID-19 vaccine and found that most side effects peaked within the first 24 hours following vaccination and usually lasted 1-3 days.
Abstract: Purpose: The Oxford-AstraZeneca is one of COVID-19 vaccine which is expected to be mass-produced and plays a critical role in controlling the pandemic that the globe faced. Ethiopia launched the AstraZeneca vaccination and planned to vaccinate 20% of the population by the end of 2021. Health care professionals are one of the eligible groups of the community to receive the vaccine with priority. Although individuals are advised to take the vaccine to protect themselves and the people around them from COVID-19 infection, many are doubtful about the consequences of the vaccine. So, this study assessed the immediate symptoms associated with taking the Oxford-AstraZeneca COVID-19 vaccine. Methods: This online study was conducted from April 15 to 30, 2021 at a national level across health care providers who took their first dose of Oxford-AstraZeneca vaccine in Ethiopia. Results: There were 672 study participants engaged in this study and around 75.8% of health care providers who took the vaccine had injection site symptoms like pain (65.48%) and tenderness (57.89%). Most of them (60%) developed their injection site symptom within 12 hours after vaccination and the symptoms lasted for about 24-72 hours on most (63.53%) of the participants. Mild symptoms were identified among 70.98% of the study participants; tiredness and headache were the most reported symptoms with 52.08% and 50.15%, respectively. Only 6.1% of participants reported severe symptoms. Conclusion: As like that of other vaccines, the Oxford-AstraZeneca COVID-19 vaccine has some adverse effects and most side effects peaked within the first 24 hours following vaccination and usually lasted 1-3 days. Severe symptoms were uncommon, but they were found to be a major reason why vaccine recipients did not recommend it to others and did not plan to take their second dose. After receiving the COVID-19 vaccination, recipients should be advised about potential vaccine symptoms, how to handle them, and when and where to seek additional guidance if necessary.
40 citations
30 citations
TL;DR: Patients with skin manifestation within 30 days or less following COVID‐19 vaccination were enrolled in the case‐series and Physicians should be aware of the possible side effects especially cutaneous manifestations associated with CO VID‐19 vaccines.
Abstract: Various adverse effects particularly cutaneous manifestations associated with different COVID‐19 vaccines have been observed in practice. The aim of our study was to evaluate all patients who presented to our tertiary center with skin manifestations following COVID‐19 vaccines injection from September to December 2021. All patients with skin manifestation within 30 days or less following COVID‐19 vaccination were enrolled in our case‐series. All cases included in our study were diagnosed based on clinical and/or histopathological evaluation and all other possible differential diagnoses were ruled out. Twenty‐five individuals including 16 (64%) males and 9 (36%) females with the mean age of 47 ± 17.62 years (range 18–91) were enrolled in our study. Twenty‐two (88%) patients developed lesions after Sinopharm vaccine injection and 3 (12%) cases manifested lesions after the AstraZeneca vaccine. Six (24%) patients developed new‐onset lichen planus (LP) and 1 (4%) patient manifested LP flare‐up. Two (8%) individuals developed psoriasis and 1 (4%) case showed psoriasis exacerbation. One (4%) patient developed new‐onset pemphigus vulgaris (PV) and 1 (4%) case experienced a flare of PV lesions. One (4%) patient manifested pityriasis lichenoides et varioliformis acuta (PLEVA) flare‐up. Other new‐onset cases were as follows: toxic epidermal necrolysis (TEN) (n = 1, 4%), bullous pemphigoid (BP) (n = 2, 8%), alopecia areata (AA) (n = 2, 8%), pytriasis rosea (n = 1, 4%), herpes zoster (n = 1, 4%), cutaneous small vessel vasculitis (n = 1, 4%), erythema multiform (EM) and urticaria (n = 3, 12%), and morphea (n = 1, 4%). Physicians should be aware of the possible side effects especially cutaneous manifestations associated with COVID‐19 vaccines.
23 citations
References
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University of Oxford1, Federal University of São Paulo2, University of the Witwatersrand3, Stellenbosch University4, Liverpool School of Tropical Medicine5, University of Sheffield6, University of London7, Newcastle upon Tyne Hospitals NHS Foundation Trust8, University Hospital Southampton NHS Foundation Trust9, University Hospitals Bristol NHS Foundation Trust10, Guy's and St Thomas' NHS Foundation Trust11, University Hospitals Birmingham NHS Foundation Trust12, St George's, University of London13, AstraZeneca14, North Bristol NHS Trust15, University College Hospital16, University of Hull17, Escola Bahiana de Medicina e Saúde Pública18, Federal University of Rio Grande do Norte19, Northwest University (China)20, Universidade Federal de Santa Maria21, Glasgow Dental Hospital and School22, Boston Children's Hospital23, Universidade Federal do Rio Grande do Sul24, Western General Hospital25, University of Glasgow26, Cambridge University Hospitals NHS Foundation Trust27, University of Cambridge28, Nottingham University Hospitals NHS Trust29, Aneurin Bevan University Health Board30
TL;DR: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials.
3,741 citations
Brigham and Women's Hospital1, Baylor College of Medicine2, Emory University3, University of Maryland, Baltimore4, Saint Louis University5, University of Illinois at Chicago6, George Washington University7, University of California, San Diego8, Vanderbilt University9, Fred Hutchinson Cancer Research Center10
TL;DR: The mRNA-1273 vaccine as discussed by the authors is a lipid nanoparticle-encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19.
Abstract: Background Vaccines are needed to prevent coronavirus disease 2019 (Covid-19) and to protect persons who are at high risk for complications. The mRNA-1273 vaccine is a lipid nanoparticle-encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19. Methods This phase 3 randomized, observer-blinded, placebo-controlled trial was conducted at 99 centers across the United States. Persons at high risk for SARS-CoV-2 infection or its complications were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo 28 days apart. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2. Results The trial enrolled 30,420 volunteers who were randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline. Symptomatic Covid-19 illness was confirmed in 185 participants in the placebo group (56.5 per 1000 person-years; 95% confidence interval [CI], 48.7 to 65.3) and in 11 participants in the mRNA-1273 group (3.3 per 1000 person-years; 95% CI, 1.7 to 6.0); vaccine efficacy was 94.1% (95% CI, 89.3 to 96.8%; P Conclusions The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427.).
2,721 citations
TL;DR: A phase 1/2, single-blind, randomized controlled trial in five trial sites in the UK of a chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19) expressing the SARS-CoV2 spike protein compared with a meningococcal conjugate vaccine (MenACWY) as control was conducted.
1,899 citations
TL;DR: Gam-COVID-Vac (Sputnik V) showed a good safety profile and induced strong humoral and cellular immune responses in participants in phase 1/2 clinical trials as discussed by the authors.
1,251 citations
TL;DR: A dose-escalation, single-centre, open-label, non-randomised, phase 1 trial of an Ad5 vectored COVID-19 vaccine expressing the spike glycoprotein of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain to assess the safety, tolerability, and immunogenicity.
1,081 citations