Cutaneous Reactions Reported after Moderna and Pfizer COVID-19 Vaccination: A Registry-Based Study of 414 Cases

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Abstract

Background

Cutaneous reactions after mRNA-based COVID-19 vaccines have been reported but are not well characterized.

Objective

To evaluate morphology and timing of cutaneous reactions after mRNA COVID-19 vaccines.

Methods

A provider-facing registry-based study collected cases of cutaneous manifestations after COVID-19 vaccination.

Results

From December 2020-February 2021, we recorded 414 cutaneous reactions to mRNA COVID-19 vaccines from Moderna (83%) and Pfizer (17%). Delayed large local reactions were most common, followed by local injection site reactions, urticarial eruptions, and morbilliform eruptions. Forty-three percent of patients with first dose reactions experienced second dose recurrence.

Limitations

Registry analysis does not measure incidence. Morphologic misclassification is possible.

Conclusion

We report a spectrum of cutaneous reactions after COVID-19 mRNA vaccines. Most patients with first dose reactions did not develop a second dose reaction, and no patients in the registry developed serious adverse events after the first or second dose. These data provide reassurance to patients and providers.

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Author and article information

Journal

Journal ID (nlm-ta): J Am Acad Dermatol

Journal ID (iso-abbrev): J Am Acad Dermatol

Title: Journal of the American Academy of Dermatology

Publisher: by the American Academy of Dermatology, Inc.

ISSN (Print): 0190-9622

ISSN (Electronic): 1097-6787

Publication date PMC-release: 7 April 2021

Publication date (Electronic): 7 April 2021

Affiliations

[1 ]Massachusetts General Hospital, Harvard Medical School, Boston, MA

[2 ]Department of Dermatology, University of California San Francisco, San Francisco, CA

[3 ]Department of Dermatology, University of Pennsylvania, Philadelphia, PA

[4 ]The University of Texas Southwestern Medical Center, Dallas, Texas, Innovative Dermatology, Plano, Texas

[5 ]Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany

[6 ]Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL

[7 ]Department of Dermatology, Henry Ford Health System, Detroit, MI, USA

[8 ]Department of Dermatology and Dermatologic Surgery, Medical University of SC, Charleston, SC

[9 ]Department of Dermatology, St. Louis University, St. Louis, MO

[10 ]Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA

Author notes

[∗ ]Corresponding Author: Esther Freeman, MD, PhD, Massachusetts General Hospital 55 Fruit St, Boston, MA 02114

Article

Publisher Item ID: S0190-9622(21)00658-7

DOI: 10.1016/j.jaad.2021.03.092

PMC ID: 8024548

PubMed ID: 33838206

SO-VID: fe08b056-2427-4a97-83ca-0f4fa02d2c0a

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 23 February 2021

Date revision received : 16 March 2021

Date accepted : 26 March 2021

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