Following COVID-19 vaccination, several occurrences of face swelling in people with a history of dermatological treatments have been observed. Although uncommon, these occurrences should be noted in light of the widespread availability of vaccines, according to a study.

The study's authors analyzed literature published as of May 2021 describing cutaneous adverse effects from currently approved m-RNA vaccinations and complemented their research using data from the CDC's Vaccine Adverse Event Reporting System (CDC-VAERS).

"Usually, the cutaneous reactions described are not a cause for concern, existing reports should reassure patients of the overall compelling safety profiles and benignity of skin reactions following mRNA COVID-19 vaccination," says co-author Christian Gronbeck.

Local injection site responses, which might include swelling, redness/erythema, and/or discomfort, can occur quickly after vaccine administration. According to published reports, these reactions are mild, transitory, and generally resolve within two to five days.

These events must be distinguished from immediate allergic-type hypersensitivity reactions, such as angioedema, respiratory distress, or anaphylaxis, which occur within four hours following vaccination. Existing studies, on the other hand, reassure patients and clinicians because dermatological symptoms are temporary and rarely related to anaphylaxis.

covid-19 vaccination

Adverse reactions no cause for panic

Delayed local reactions, often with slight stiffening of the tissue at the injection site, occur days rather than hours after Moderna vaccine injection. They are only transient and may become less common after the second dose. They are most likely T-cell-mediated hypersensitivity, and the authors concur that they do not compromise vaccine safety, said the study.

Seldom documented and more rare cutaneous responses to the mRNA COVID-19 vaccinations have occurred, while data are scarce and determining overall incidence rates is difficult. Crusted, vesicular, and painful skin lesions, consistent with herpes zoster reactivation, have been recorded in the aftermath of both the Pfizer and Moderna vaccines.

It has been proposed that the immunomodulatory effects of the COVID-19 vaccines may have aided zoster reactivation, but more research is needed. In the interim, the authors recommend that patients with risk factors be closely monitored.

Currently, the CDC-VAERS database has 260 cases of immune thrombocytopenia (ITP), a condition characterized by severe bruising and bleeding caused by low platelet counts. Case reports indicate that it may manifest differently and in diverse patient populations.

Graphic created by M.E. Newman, Johns Hopkins Medicine, with public domain images and background artist rendition of SARS-CoV-2 courtesy of the U.S. Centers for Disease Control and Prevention

"We propose several reassuring clinical considerations for those who are hesitant to be vaccinated. First, the reported reactions are largely self-limited, and the most frequent reactions were also found in the clinical trials of the drugs, which have been authorized for use in the general population. Allergic-type symptoms are transient and rarely associated with anaphylaxis. The development of uncommon reactions such as herpes zoster, dermal filler reactions, and ITP were seldom serious in nature but justify clinical monitoring," says Dr. Grant-Kels.

While more research is required to analyze the reaction mechanisms and management options for skin vaccination reactions, the authors stated that the evidence released to now should provide reassurance to all about the safety of these vaccines.