key: cord-0957547-2jw3oque
authors: Rerknimitr, P.; Puaratanaarunkon, T.; Wongtada, C.; Wittayabusarakam, N.; Krithin, S.; Paitoonpong, L.; Kumtornrut, C.; Kerr, S.J.; Asawanonda, P.; Jantarabenjakul, W.; Klaewsongkram, J.
title: Cutaneous adverse reactions from 35,229 doses of Sinovac and AstraZeneca COVID‐19 vaccination: a prospective cohort study in healthcare workers
date: 2021-10-29
journal: J Eur Acad Dermatol Venereol
DOI: 10.1111/jdv.17761
sha: 8ea4508c5d57dbc2b7c9e664b23784a5d376b356
doc_id: 957547
cord_uid: 2jw3oque

Cutaneous adverse reaction (CARs) from mRNA-based COVID-19 vaccines have been reported in the literature.[1, 2] On the contrary, information regarding Sinovac (CoronaVac), (SV) inactivated virus and adenoviral vector AstraZeneca (ChAdOx1 nCoV-19), (AZ) vaccines remains scarce. We have conducted this prospective cohort study to address this issue.

. When the first and second doses were analysed, 155 and 33 participants who developed CARs cases from the first doses of SV and AZ, respectively, went on to receive a second dose of the same vaccine. Skin reactions were found in 50 (32.26%) and 3 (9.09%) cases in these cases after the second dose of SV or AZ. Table 2 provides information on the recurrence. Compared to those who experienced urticaria >30 minutes after the first vaccination, those who experienced a first reaction within 30 min after the first vaccination had an increased risk of urticaria after the second vaccination (OR 2.9 (95%CI 0.44-19.3); P = 0.27).

Although not statistically significant, the 95%CI was consistent with an increased risk of second reaction in this group with an early first reaction. For those with no skin reactions from the first injection, the incidence of CARs occurring only after the second dose was 0.39% (49/12,484) for SV and 0.15% (3/1935) for AZ.

There were no cases of vaccine-induced immune thrombotic thrombocytopenia (VITT) in our cohort; however, a case with multiple ecchymosis as a sign of secondary immune thrombocytopenic purpura (ITP) was observed post-AZ. This is in keeping with the reports in the literature of ITP post-COVID-19 vaccination. 4 Dermatologists should be aware of the importance of these skin findings. Interestingly, types of CARs associated with SV and AZ are similar to those reported from mRNA vaccines including vasculitis, herpes reactivation and pityriasis rosea. 1, 2 However, no delayed inflammatory reactions to filler was detected in our cohort. Form this study, we found that most CARs from SV and AZ were non-serious, and the incidence was ≤ 1%. Such skin reactions should not deter individuals from receiving vaccinations as soon as is practical when they are available. Negative ----

Cutaneous reactions reported after Moderna and Pfizer COVID-19 vaccination: a registry-based study of 414 cases

Incidence of cutaneous reactions after messenger RNA COVID-19 vaccines

The health of the healthcare workers

Thrombocytopenia including immune thrombocytopenia after receipt of mRNA COVID-19 vaccines reported to the Vaccine Adverse Event Reporting System (VAERS)

The authors graciously thank the Skin and Allergy Research Unit for their support. The patients in this manuscript have given written informed consent to publication of their case details.