The lifesaving COVID-19 vaccine, as with all medications and vaccinations, is associated with adverse reactions, some vaccine-related and some not, some serious but mostly not. Yet those adverse reactions still stoke fear in unvaccinated and partially vaccinated persons and also pose challenges to the medical community. Aside from the expected flu-like symptoms reflective of the immune response itself, many common side effects are dermatologic.
The Most Common Reported Skin Reaction
According to an international dermatology registry, it was "erythema, swelling, tenderness, pain, induration, and pruritus within 7 days after injection."[1] Reactions tended to be more common in younger, mostly female patients. Similar reactions occurred in a small minority of persons in a delayed fashion, 8 days or more later. These were typically mild, large, local swelling of brief duration. Biopsies of these lesions in mRNA-vaccinated patients were consistent with a T-cell–mediated hypersensitivity reaction. Treatment was often deemed unnecessary, but some patients were treated with antihistamines and topical or oral corticosteroids.
Chronic Urticaria and Atopic Dermatitis
An abstract[2] presented at the 2022 American Academy of Allergy, Asthma, and Immunology annual meeting presented a small case series of both chronic urticaria (CU) and atopic dermatitisreactions to first and second doses of COVID mRNA vaccines.
