tetano
Editor, Senior Moderator
Eur J Intern Med
. 2022 Aug 1;S0953-6205(22)00270-9.
doi: 10.1016/j.ejim.2022.07.022. Online ahead of print.
Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights
Raquel Martinez-Reviejo[SUP] 1 [/SUP], Sofia Tejada[SUP] 1 [/SUP], Ganiyat A R Adebanjo[SUP] 2 [/SUP], Camilla Chello[SUP] 2 [/SUP], Miriam C Machado[SUP] 3 [/SUP], Francesca R Parisella[SUP] 4 [/SUP], Magda Campins[SUP] 5 [/SUP], Antonella Tammaro[SUP] 2 [/SUP], Jordi Rello[SUP] 6 [/SUP]
Affiliations
Abstract
Introduction: Varicella zoster virus (VZV) reactivation has been reported following vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the real extent remains unknown.
Methods: We conducted a systematic review to summarize evidence of VZV reactivation or infection following SARS-CoV-2 vaccination. Episodes after coronavirus disease-2019 (COVID-19) were also identified. Related articles were identified in PubMed and EMBASE databases till December 31, 2021 using the terms "varicella zoster" and "COVID-19″. PROSPERO Register Number: CRD42021289399.
Results: The search revealed 314 articles, of which 55 met the inclusion criteria. VZV manifestations were documented in 179 (82.1%) subjects following SARS-CoV-2 vaccination and in 39 (17.9%) patients with COVID-19. Among the vaccinated, median (IQR) age was 56.5 (42-70) years, and 56.8% were female. Twenty-one (16.8%) were immunosuppressed. The median (IQR) latency time after vaccination was 6 (3-10) days, and 84.4% received mRNA vaccines. VZV reactivation occurred following a first dose (68.2%), a second dose (12.8%) or a booster (0.6%). The most important VZV manifestation was dermatome herpes zoster rash, which accounted for 86.4% of events in vaccinated subjects. Twenty patients (11.3%) presented serious VZV events after vaccination, with Herpes Zoster ophthalmicus (5.6%) and post-herpetic neuralgia (3.4%) predominating. No VZV pneumonia or deaths were recorded. Antiviral prescriptions were made in 96.2% of vaccinated subjects. No significant differences between vaccinated and infected subjects were found.
Conclusion: This study indicates that the occurrence of VZV reactivation is clinically relevant. However, our findings suggest that COVID-19 vaccination is safe, and remains strongly recommended.
Keywords: Adverse events; Bnt162b2; Covid-19; Herpes virus; Herpes zoster rash; Mrna-1273.
. 2022 Aug 1;S0953-6205(22)00270-9.
doi: 10.1016/j.ejim.2022.07.022. Online ahead of print.
Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights
Raquel Martinez-Reviejo[SUP] 1 [/SUP], Sofia Tejada[SUP] 1 [/SUP], Ganiyat A R Adebanjo[SUP] 2 [/SUP], Camilla Chello[SUP] 2 [/SUP], Miriam C Machado[SUP] 3 [/SUP], Francesca R Parisella[SUP] 4 [/SUP], Magda Campins[SUP] 5 [/SUP], Antonella Tammaro[SUP] 2 [/SUP], Jordi Rello[SUP] 6 [/SUP]
Affiliations
- PMID: 35931613
- PMCID: PMC9340059
- DOI: 10.1016/j.ejim.2022.07.022
Abstract
Introduction: Varicella zoster virus (VZV) reactivation has been reported following vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the real extent remains unknown.
Methods: We conducted a systematic review to summarize evidence of VZV reactivation or infection following SARS-CoV-2 vaccination. Episodes after coronavirus disease-2019 (COVID-19) were also identified. Related articles were identified in PubMed and EMBASE databases till December 31, 2021 using the terms "varicella zoster" and "COVID-19″. PROSPERO Register Number: CRD42021289399.
Results: The search revealed 314 articles, of which 55 met the inclusion criteria. VZV manifestations were documented in 179 (82.1%) subjects following SARS-CoV-2 vaccination and in 39 (17.9%) patients with COVID-19. Among the vaccinated, median (IQR) age was 56.5 (42-70) years, and 56.8% were female. Twenty-one (16.8%) were immunosuppressed. The median (IQR) latency time after vaccination was 6 (3-10) days, and 84.4% received mRNA vaccines. VZV reactivation occurred following a first dose (68.2%), a second dose (12.8%) or a booster (0.6%). The most important VZV manifestation was dermatome herpes zoster rash, which accounted for 86.4% of events in vaccinated subjects. Twenty patients (11.3%) presented serious VZV events after vaccination, with Herpes Zoster ophthalmicus (5.6%) and post-herpetic neuralgia (3.4%) predominating. No VZV pneumonia or deaths were recorded. Antiviral prescriptions were made in 96.2% of vaccinated subjects. No significant differences between vaccinated and infected subjects were found.
Conclusion: This study indicates that the occurrence of VZV reactivation is clinically relevant. However, our findings suggest that COVID-19 vaccination is safe, and remains strongly recommended.
Keywords: Adverse events; Bnt162b2; Covid-19; Herpes virus; Herpes zoster rash; Mrna-1273.