Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review

George Kroumpouzos, Maria Eleni Paroikaki, Sara Yumeen, Shashank Bhargava, Eleftherios Mylonakis

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines world-wide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca– Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination.

Original languageEnglish (US)
Article number624
Issue number3
StatePublished - Mar 2022


  • COVID-19 vaccine
  • Chilblains
  • Delayed hypersensitivity reaction
  • Herpes zoster
  • MRNA vaccine
  • Morbilliform
  • Rash
  • Skin reaction
  • Urticaria

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Virology


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