A Systematic Review on Mucocutaneous Presentations After COVID-19 Vaccination and Expert Recommendations About Vaccination of Important Immune-mediated Dermatologic Disorders

Overview

Journal Dermatol Ther

Specialty Dermatology

Date 2022 Mar 22

PMID 35316551

Authors

Farnoosh Seirafianpour

Homa Pourriyahi

Milad Gholizadeh Mesgarha

Arash Pour Mohammad

Zoha Shaka

Azadeh Goodarzi

Affiliations

Soon will be listed here.

Abstract

With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.

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References

Waldman R, Creed M, Sharp K, Adalsteinsson J, Imitola J, Durso T . Toward a COVID-19 vaccine strategy for patients with pemphigus on rituximab. J Am Acad Dermatol. 2020; 84(4):e197-e198. PMC: 7598732. DOI: 10.1016/j.jaad.2020.10.075. View

Baden L, El Sahly H, Essink B, Kotloff K, Frey S, Novak R . Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. N Engl J Med. 2020; 384(5):403-416. PMC: 7787219. DOI: 10.1056/NEJMoa2035389. View

Zhang J, Hu Z, He J, Liao Y, Li Y, Pei R . Safety and immunogenicity of a recombinant interferon-armed RBD dimer vaccine (V-01) for COVID-19 in healthy adults: a randomized, double-blind, placebo-controlled, Phase I trial. Emerg Microbes Infect. 2021; 10(1):1589-1597. PMC: 8366678. DOI: 10.1080/22221751.2021.1951126. View

Pan H, Liu J, Huang B, Li G, Chang X, Liu Y . Immunogenicity and safety of a severe acute respiratory syndrome coronavirus 2 inactivated vaccine in healthy adults: randomized, double-blind, and placebo-controlled phase 1 and phase 2 clinical trials. Chin Med J (Engl). 2021; 134(11):1289-1298. PMC: 8183795. DOI: 10.1097/CM9.0000000000001573. View

Moutsopoulos H . A recommended paradigm for vaccination of rheumatic disease patients with the SARS-CoV-2 vaccine. J Autoimmun. 2021; 121:102649. PMC: 8088234. DOI: 10.1016/j.jaut.2021.102649. View

Kooranifar S, Sadeghipour A, Riahi T, Goodarzi A, Tabrizi S, Davoody N . Histopathologic survey on lung necropsy specimens of 15 patients who died from COVID-19: A large study from Iran with a high rate of anthracosis. Med J Islam Repub Iran. 2021; 35:63. PMC: 8278026. DOI: 10.47176/mjiri.35.63. View

Rice S, Ferree S, Kourosh A . COVID-19 Vaccine Reactions in Dermatology: "Filling" in the Gaps. Cutis. 2021; 107(6):288-290. DOI: 10.12788/cutis.0268. View

Gotkin R, Gout U, Sattler S, Piansay-Soriano M, Wanitphakdeedecha R, Ghannam S . Global Recommendations on COVID-19 Vaccines and Soft Tissue Filler Reactions: A Survey-Based Investigation in Cooperation With the International Society for Dermatologic and Aesthetic Surgery (ISDS). J Drugs Dermatol. 2021; 20(4):374-378. DOI: 10.36849/JDD.2021.6041. View

Frenck Jr R, Klein N, Kitchin N, Gurtman A, Absalon J, Lockhart S . Safety, Immunogenicity, and Efficacy of the BNT162b2 Covid-19 Vaccine in Adolescents. N Engl J Med. 2021; 385(3):239-250. PMC: 8174030. DOI: 10.1056/NEJMoa2107456. View

10.

Menni C, Klaser K, May A, Polidori L, Capdevila J, Louca P . Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: a prospective observational study. Lancet Infect Dis. 2021; 21(7):939-949. PMC: 8078878. DOI: 10.1016/S1473-3099(21)00224-3. View

11.

Xia S, Duan K, Zhang Y, Zhao D, Zhang H, Xie Z . Effect of an Inactivated Vaccine Against SARS-CoV-2 on Safety and Immunogenicity Outcomes: Interim Analysis of 2 Randomized Clinical Trials. JAMA. 2020; 324(10):951-960. PMC: 7426884. DOI: 10.1001/jama.2020.15543. View

12.

Klimek L, Novak N, Hamelmann E, Werfel T, Wagenmann M, Taube C . Severe allergic reactions after COVID-19 vaccination with the Pfizer/BioNTech vaccine in Great Britain and USA: Position statement of the German Allergy Societies: Medical Association of German Allergologists (AeDA), German Society for Allergology.... Allergo J Int. 2021; 30(2):51-55. PMC: 7903024. DOI: 10.1007/s40629-020-00160-4. View

13.

Yang S, Li Y, Dai L, Wang J, He P, Li C . Safety and immunogenicity of a recombinant tandem-repeat dimeric RBD-based protein subunit vaccine (ZF2001) against COVID-19 in adults: two randomised, double-blind, placebo-controlled, phase 1 and 2 trials. Lancet Infect Dis. 2021; 21(8):1107-1119. PMC: 7990482. DOI: 10.1016/S1473-3099(21)00127-4. View

14.

Peter J . COVID-19 vaccination: Recommendations for management of patients with allergy or immune-based diseases. S Afr Med J. 2021; 111(4):291-294. DOI: 10.7196/SAMJ.2021.v111i4.15576. View

15.

Voysey M, Clemens S, Madhi S, Weckx L, Folegatti P, Aley P . Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2020; 397(10269):99-111. PMC: 7723445. DOI: 10.1016/S0140-6736(20)32661-1. View

16.

Elalamy I, Gerotziafas G, Alamowitch S, Laroche J, Van Dreden P, Ageno W . SARS-CoV-2 Vaccine and Thrombosis: An Expert Consensus on Vaccine-Induced Immune Thrombotic Thrombocytopenia. Thromb Haemost. 2021; 121(8):982-991. PMC: 8322589. DOI: 10.1055/a-1499-0119. View

17.

McMahon D, Amerson E, Rosenbach M, Lipoff J, Moustafa D, Tyagi A . Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: A registry-based study of 414 cases. J Am Acad Dermatol. 2021; 85(1):46-55. PMC: 8024548. DOI: 10.1016/j.jaad.2021.03.092. View

18.

Tanno L, Berard F, Beaudoin E, Didier A, Demoly P . SARS-CoV-2 Vaccination and Anaphylaxis: Recommendations of the French Allergy Community and the Montpellier World Health Organization Collaborating Center. Vaccines (Basel). 2021; 9(6). PMC: 8228790. DOI: 10.3390/vaccines9060560. View

19.

Sadoff J, Gray G, Vandebosch A, Cardenas V, Shukarev G, Grinsztejn B . Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19. N Engl J Med. 2021; 384(23):2187-2201. PMC: 8220996. DOI: 10.1056/NEJMoa2101544. View

20.

Rice S, Ferree S, Atanaskova Mesinkovska N, Kourosh A . The art of prevention: COVID-19 vaccine preparedness for the dermatologist. Int J Womens Dermatol. 2021; 7(2):209-212. PMC: 7802521. DOI: 10.1016/j.ijwd.2021.01.007. View