key: cord-0897312-bsovdk43
authors: Davido, Benjamin; Mascitti, Helene; Fortier-Beaulieu, Marc; Jaffal, Karim; de Truchis, Pierre
title: ‘Blue toes’ following vaccination with the BNT162b2 mRNA COVID-19 vaccine
date: 2021-02-23
journal: J Travel Med
DOI: 10.1093/jtm/taab024
sha: 6e6a57da79fbc09dd32cfe130da262f4e01078d3
doc_id: 897312
cord_uid: bsovdk43

Highlights: COVID toes can be encountered in young individuals during acute COVID-19 infection while it results from the direct action of Spike protein on vessels. We report the case of COVID toes during the French campaign of vaccination that occurred 4 days after the vaccination with the Pfizer-BioNTech mRNA vaccine against COVID-19.

A young Caucasian female aged of 41 years-old, non-smoker, with a medical history of bipolar disorder under valproate for more than 10 years, consulted for the evaluation of

chilblain-like skin changes on her toes. She reported no previous signs compatible with Raynaud's syndrome. She presented a sudden toe pain with walking impairment and itching at night, that appeared 4 days after the first injection with the Pfizer-BioNTech-162b2 vaccine against COVID-19. She was otherwise asymptomatic, especially with no ear-nose-throat symptoms or fever and nasopharyngeal SARS-CoV-2 PCR was tested twice negative. Four-weeks after vaccination, she remained totally asymptomatic and afebrile, except for one remaining chilblain-like lesion deemed to last a long time (until 150 days). 3 Balancing the possible link between vaccination and the observed chilblain-like toes, we decided to contraindicate the second dose of vaccine considering she was at risk of relapsing with further vascular symptoms.

Transparency declarations: None to declare.

BD, PDT and HM conceptualized and designed the manuscript, coordinated and supervised data collection, drafted the initial manuscript, and reviewed the manuscript. BD was in charge of the Figure. MFB and KJ reviewed and revised the manuscript.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. 

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COVID toes"): Histologic, immunofluorescence, and immunohistochemical study of 17 cases

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Authors would like to thank all their colleagues at Raymond-Poincare Teaching Hospital, especially Azzam Saleh-Mghir for his unfailing support.