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Side effects of COVID-19 vaccines

The Academy is tracking reports of dermatologic side effects related to COVID-19 vaccines and will update the information below if new ones are reported. The CDC is tracking reports of severe allergic reactions. If you see patients with reactions to a COVID-19 vaccine, please report them to the Dermatology COVID-19 Registry.

Each vaccine has different contents. Both vaccines the FDA has authorized for emergency use contain polyethylene glycol, an allergen seen with some regularity in dermatology.

Moderna: messenger ribonucleic acid (mRNA), lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose

Pfizer: messenger ribonucleic acid (mRNA), lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), 2 [(polyethylene glycol)-2000]-N,N-ditetradecylacetamide, 1,2-Distearoyl-sn-glycero-3- phosphocholine, and cholesterol), potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and sucrose

Three cases of facial swelling reported in Moderna vaccine trial

Recently there have been some cases and case series of adverse dermatologic reactions to COVID-19 vaccines either on the injection site or post-vaccination. This includes small vessel vasculitis (1), cutaneous mucormycosis (2), erythematous annular eruptions (3), severe cutaneous reactions (4), herpes-zoster (5-6), and nonspecific inflammatory reactions (7). Further monitoring and data are needed to determine if these adverse events are directly related to COVID-19 vaccination.

The Academy is closely monitoring any reports of cutaneous side effects as the vaccine roll out gets underway and asks physicians to report cases of potential dermatologic side effects in the COVID-19 Dermatology Registry. A recent paper in the Journal of the American Academy of Dermatology discusses 414 vaccine reaction cases reported to the registry, indicating that while cutaneous reactions to the mRNA vaccines are possible, none resulted in serious adverse events.

  1. Berry CT, Eliliwi M, Gallagher S, et al. Cutaneous small-vessel vasculitis following single-dose Janssen Ad26.COV2.S vaccination. JAAD Case Reports 2021.

  2. Shah KM, West C, Simpson J, Rainwater YB. Cutaneous mucormycosis following COVID-19 Vaccination in a Bullous Pemphigoid Patient. JAAD Case Rep. 2021.

  3. Song EJ, Wong AJS. Widespread annular eruption after Ad26.COV2.S COVID-19 vaccine. JAAD Case Rep. 2021;13:30-32.

  4. Lospinoso K, Nichols CS, Malachowski SJ, Mochel MC, Nutan F. A case of severe cutaneous adverse reaction following administration of the Janssen Ad26.COV2.S COVID-19 vaccine. JAAD Case Rep. 2021;13:134-137.

  5. Rodriguez-Jimenez P, Chicharro P, Cabrera LM, et al. Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: Report of 5 cases. JAAD Case Rep. 2021;12:58-59.

  6. Lee C, Cotter D, Basa J, Greenberg HL. 20 Post-COVID-19 vaccine-related shingles cases seen at the Las Vegas Dermatology clinic and sent to us via social media. J Cosmet Dermatol. 2021;20(7):1960-1964.

  7. Tammaro A, Adebanjo GAR, Magri F, Parisella FR, Chello C, De Marco G. Local skin reaction to the AZD1222 vaccine in a patient who survived COVID-19. J Cosmet Dermatol. 2021;20(7):1965-1966.

Updated 7/30/2021

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