Cutaneous reactions after SARS-CoV-2 vaccination: a cross-sectional Spanish nationwide study of 405 cases.
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Català A, Muñoz-Santos C, Galván-Casas C, Roncero Riesco M, Revilla Nebreda D, Solá-Truyols A, Giavedoni P, Llamas-Velasco M, González-Cruz C, Cubiró X, Ruíz-Villaverde R, Gómez-Armayones S, Gil Mateo M P, Pesqué D, Marcantonio O, Fernández-Nieto D, Romaní J, Iglesias Pena N, Carnero Gonzalez L, Tercedor-Sanchez J, Carretero G, Masat-Ticó T, Rodríguez-Jiménez P, Gimenez-Arnau A M, Utrera-Busquets M, Vargas Laguna E, Angulo Menéndez A G, San Juan Lasser E, Iglesias-Sancho M, Alonso Naranjo L, Hiltun I, Cutillas Marco E, Polimon Olabarrieta I, Marinero Escobedo S, García-Navarro X, Calderón Gutiérrez M J, Baeza-Hernández G, Bou Camps L, Toledo-Pastrana T, Guilabert A
Аннотация
OBJECTIVE: To describe and classify cutaneous reactions after SARS-CoV-2 vaccination.
METHODS: A nationwide Spanish cross-sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face-to-face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification.
RESULTS: From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer-BioNTech; 40·2%), mRNA-1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site ('COVID arm', 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea-like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA-1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer-BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA-1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment.
CONCLUSIONS: Cutaneous reactions after SARS-CoV-2 vaccination are heterogeneous. Most are mild-to-moderate and self-limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients.