Delayed Skin Reactions to COVID-19 mRNA-1273 Vaccine: Case Report and Literature Review
Abstract
:1. Introduction
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Khan, T.; Jamal, S.M. SARS-CoV-2 nomenclature: Viruses, variants and vaccines need a standardized naming system. Future Virol. 2021, 16, 777–779. [Google Scholar] [CrossRef] [PubMed]
- CDC COVID-19 Response Team; Food and Drug Administration. Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Moderna COVID-19 Vaccine—United States, December 21, 2020-January 10, 2021. MMWR Morb. Mortal. Wkly. Rep. 2021, 70, 125–129. [Google Scholar] [CrossRef] [PubMed]
- Blumenthal, K.G.; Freeman, E.E.; Saff, R.R.; Robinson, L.B.; Wolfson, A.R.; Foreman, R.K.; Hashimoto, D.; Banerji, A.; Li, L.; Anvari, S.; et al. Delayed Large Local Reactions to mRNA-1273 Vaccine against SARS-CoV-2. N. Engl. J. Med. 2021, 384, 1273–1277. [Google Scholar] [CrossRef] [PubMed]
- Jacobson, M.A.; Zakaria, A.; Maung, Z.; Hart, C.; McCalmont, T.H.; Fassett, M.; Amerson, E. Incidence and Characteristics of Delayed Injection Site Reaction to the mRNA-1273 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccine (Moderna) in a Cohort of Hospital Employees. Clin. Infect. Dis. 2021, 74, 591–596. [Google Scholar] [CrossRef] [PubMed]
- Wei, N.; Fishman, M.; Wattenberg, D.; Gordon, M.; Lebwohl, M. “COVID arm”: A reaction to the Moderna vaccine. JAAD Case Rep. 2021, 10, 92–95. [Google Scholar] [CrossRef] [PubMed]
- Baden, L.R.; El Sahly, H.M.; Essink, B.; Kotloff, K.; Frey, S.; Novak, R.; Diemert, D.; Spector, S.A.; Rouphael, N.; Creech, C.B.; et al. Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N. Engl. J. Med. 2021, 384, 403–416. [Google Scholar] [CrossRef] [PubMed]
- Ramos, C.L.; Kelso, J.M. “COVID Arm”: Very delayed large injection site reactions to mRNA COVID-19 vaccines. J. Allergy Clin. Immunol. Pract. 2021, 9, 2480–2481. [Google Scholar] [CrossRef] [PubMed]
- Blumenthal, K.G.; Saff, R.R.; Freeman, E. Delayed Large Local Reactions to mRNA Vaccines. N. Engl. J. Med. 2021, 384, e98. [Google Scholar] [CrossRef] [PubMed]
- Kaiser Family Foundation. KFF COVID-19 vaccine monitor: December 2020. Available online: https://www.kff.org/coronavirus-covid-19/dashboard/kff-covid-19-vaccinemonitor-dashboard/ (accessed on 4 March 2021).
- McNeil, M.M.; DeStefano, F. Vaccine-associated hypersensitivity. J. Allergy Clin. Immunol. 2018, 141, 463–472. [Google Scholar] [CrossRef] [PubMed]
- Stone, C.A., Jr.; Rukasin, C.R.F.; Beachkofsky, T.M.; Phillips, E.J. Immune-mediated adverse reactions to vaccines. Br. J. Clin. Pharmacol. 2019, 85, 2694–2706. [Google Scholar] [CrossRef] [PubMed]
- Banerji, A.; Wickner, P.G.; Saff, R.; Stone, C.A., Jr.; Robinson, L.B.; Long, A.A.; Wolfson, A.R.; Williams, P.; Khan, D.A.; Phillips, E.; et al. mRNA Vaccines to Prevent COVID-19 Disease and Reported Allergic Reactions: Current Evidence and Suggested Approach. J. Allergy Clin. Immunol. Pract. 2021, 9, 1423–1437. [Google Scholar] [CrossRef] [PubMed]
- McMahon, D.E.; Amerson, E.; Rosenbach, M.; Lipoff, J.B.; Moustafa, D.; Tyagi, A.; Desai, S.R.; French, L.E.; Lim, H.W.; Thiers, B.H.; et al. Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. J. Am. Acad. Dermatol. 2021, 85, 46–55. [Google Scholar] [CrossRef] [PubMed]
- Rademaker, M. Do Women Have More Adverse Drug Reactions? Am. J. Clin. Dermatol. 2001, 2, 349–351. [Google Scholar] [CrossRef] [PubMed]
- De Vries, S.T.; Denig, P.; Ekhart, C.; Burgers, J.S.; Kleefstra, N.; Mol, P.G.; Van Puijenbroek, E.P. Sex differences in adverse drug reactions reported to the National Pharmacovigilance Centre in the Netherlands: An explorative observational study. Br. J. Clin. Pharmacol. 2019, 85, 1507–1515. [Google Scholar] [CrossRef] [Green Version]
Parameter | Result | Unit | Normal Range |
---|---|---|---|
BUN | 18.2 | mg/dL | 7–25 |
Creatinine | 0.60 | mg/dL | F: 0.44–1.03; M: 0.64–1.27 |
eGFR | 82.5 | ml/min/1.732 m2 | |
Sodium | 138.2 | mmol/L | 136–146 |
Potassium | 4.3 | mmol/L | 3.5–5.1 |
Calcium | 8.8 | mg/dL | 8.6–10.3 |
Chloride | 106.8 | mmol/L | 101–109 |
GOT | 25 | mmol/L | Adult: ≤34 |
GPT | 30 | mmol/L | Adult: ≤36 |
Total bilirubin | 0.92 | mmol/L | 0.3–1.2 (5 days–60 y) |
Glucose | 88.7 | mg/dL | AC: 74–100 (≥18 y) PC: <140 (≥18 y) |
White blood cell count | 9.05 | /µl | M: 3.9–10.6; F: 3.5–11 |
Red blood cell count | 4.0 | /µl | M: 4.5–5.9; F: 4.0–5.2 |
Hemoglobin | 13.1 | g/dL | M: 13.5–17.5; F: 12–16 |
Hematocrit | 40.2 | % | M: 41–53; F36–46 |
MCV | 96.8 | fl | 80–100 |
MCH | 31.7 | pg | 26–34 |
MCHC | 32.5 | g/dL | 31–37 |
Platelet count | 203 | /mm | 150–400 |
Ref. | Clinical Feature | Case Number/ Duration after Vaccination | Relevant Data or Examination | Treatment | Resolving Date after Onset |
---|---|---|---|---|---|
[3] | Plaques, fatigue, headache. | 12. 4–11 days (median on day 8). | Skin biopsy showed superficial perivascular and perifollicular lymphocytic infiltrates. | Steroids, antibiotic treatment. | 2–11 days (median on day 6). |
[4] | Erythema, pruritus, tenderness. | 13. 3–9 days. | Skin biopsy demonstrated a largely perivascular lymphocytic infiltrate with little epidermal change. | Steroids, antihistamine. | Within a week. |
[5] | Pruritic erythematous rash, maculopapular eruption. | 4. 7–10 days. | Not mentioned. | Steroids, antihistamine. | Not mentioned. |
[6] | Erythema, induration, and tenderness. | 244. 8 days or more. | Not mentioned. | Not mentioned. | 4–5 days. |
[7] | Pain, with or without associated redness and swelling. | 12. One week. | Not mentioned. | Steroids, antihistamine, ice. | 3–8 days. |
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Wang, R.-L.; Chiang, W.-F.; Chiu, C.-C.; Wu, K.-A.; Lin, C.-Y.; Kao, Y.-H.; Chuu, C.-P.; Chan, J.-S.; Hsiao, P.-J. Delayed Skin Reactions to COVID-19 mRNA-1273 Vaccine: Case Report and Literature Review. Vaccines 2022, 10, 1412. https://doi.org/10.3390/vaccines10091412
Wang R-L, Chiang W-F, Chiu C-C, Wu K-A, Lin C-Y, Kao Y-H, Chuu C-P, Chan J-S, Hsiao P-J. Delayed Skin Reactions to COVID-19 mRNA-1273 Vaccine: Case Report and Literature Review. Vaccines. 2022; 10(9):1412. https://doi.org/10.3390/vaccines10091412
Chicago/Turabian StyleWang, Ruei-Lin, Wen-Fang Chiang, Chih-Chiun Chiu, Kuo-An Wu, Chia-Yi Lin, Yung-Hsi Kao, Chih-Pin Chuu, Jenq-Shyong Chan, and Po-Jen Hsiao. 2022. "Delayed Skin Reactions to COVID-19 mRNA-1273 Vaccine: Case Report and Literature Review" Vaccines 10, no. 9: 1412. https://doi.org/10.3390/vaccines10091412