Getting COVID-19 can cause all kinds of weird skin reactions. New study reveals that some of them, including COVID toes, measles-like rash and shingles can also be rare and, thankfully, brief side effects related to getting Pfizer-BioNTech vaccines or Moderna.
Minor reactions, although sometimes irritating and annoying were observed in a database of 414 cases of delayed skin problems vaccine-related and reported to healthcare professionals. The cases were collected between December and February before the Johnson & Johnson vaccine was cleared, so it was not included.
None elicited a life-threatening reaction, a finding that the study’s lead author, Dr. Esther Freeman, found reassuring.
“People can get rashes all over their body, and it can be surprising and a little scary, but these patients did extremely well, recovered and were able to come back and get their second dose,” Freeman said, director of global health dermatology at Massachusetts General Hospital.
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“For people whose rashes started four hours or more after receiving the vaccine, 0% of them got anaphylaxis or some other serious reaction,” she said. “Zero is a nice number.”
The delayed skin responses described in the study often begin about a day after vaccination, but can appear up to seven to eight days later. They are different from severe and immediate allergic reactions, which occur within the first four hours after vaccination.
The results were published Wednesday in the Journal of the American Academy of Dermatology. Becausecases include only those reported to a dermatological registry, it is impossible to say how common they are in everyone receiving the vaccines. In general, researchers believe they are rare given the low number of patients observed.
Although skin reactions to vaccines can occur, as long as they start more than four hours after vaccination, they are usually not life threatening.
“People can feel reassured that they are receiving the second dose of their vaccine,” said Freeman, who is the lead investigator of the International COVID-19 Dermatology Registry. “Even if you have a fairly impressive rash after the vaccine, until it does not start within four hours of the vaccine, you should be comfortable getting the second dose.”
The researchers point out that most people who get vaccinated do so without developing any reactions. The Moderna and Pfizer-BioNTech clinical trials reported rare skin reactions and a recent study of nearly 65,000 people found anaphylaxis after vaccination to be an extremely unusual event.
Anyone with severe symptoms should see a healthcare professional, Freeman said.
Having a skin response to the first dose of a vaccine does not mean that you will have one in the second dose. Less than half – 43% – of patients who had a rash in response to their first dose of the vaccine had a rash after the second.
The most common reaction reported was an increased red rash, sometimes itchy, often at the injection site, which can occur up to about a week after being vaccinated. It has been referred to as the COVID arm or Moderna arm because about 95% of reactions occur with the Moderna vaccine.
For the Moderna arm, most people did not have a recurrence when they received their second stroke. Of those who did, it was generally less pronounced and faded on average in three to four days.
Another rare, annoying but not fatal reaction was COVID toes. Also called pernio or frostbite, sores or skin lumps occur on the patient’s toes and in about 10% of cases on the fingers. They can cause red or purple swelling of the fingers and are probably related to inflammation of the walls of the blood vessels.
“Having your toes turn purple is uncomfortable, but that’s no reason not to get the second dose,” Freeman said.
A rash all over the body reported by some patients, called a disease rash, is often referred to as “measles” although it is not measles.
There have been a few reports of people who had chickenpox as a child having had an outbreak of shingles in response to the vaccine.
Another reaction has been swelling of the skin in people who have had dermatological fillers as a cosmetic treatment, although this is very rare.
“If you’ve had a facial filler, that doesn’t mean you shouldn’t get the vaccine,” Freeman said.
Among those who had an immediate allergic reaction to Pfizer-BioNTech or Moderna vaccines, it was extremely rare and no deaths were reported.
A study of 65,000 Massachusetts General Hospital employees who were vaccinated with the Pfizer or Moderna vaccine found that the rate of potentially fatal anaphylaxis was 0.025%.
“It’s a fortieth of 1%. That’s a really good low number, ”Freeman said.
Contact Elizabeth Weise at firstname.lastname@example.org