Cutaneous adverse reactions of COVID-19 vaccines: a systematic review

Background: Numerous vaccines are implementation for the prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19).Objective: This systematic review aims to summarize and integrated the findings of studies regarding cutaneous side effects of COVID-19 vaccines. Methods: This systematic review conducted by searching the scientific databases of PubMed, Scopus, Science direct, and Web of knowledge from the beginning of the COVID-19 to10/5/2021. Articles were reviewed and analyzed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.Results: Seventeen studies were included after the screening of search results based on to the eligibility criteria. The results showed that injection site reactions and delayed large local reactions were the most common side effects arising from all vaccine types. Most cutaneous reactions occurred in middle-aged women, after the first dose of vaccine, and 1-21 days after vaccination. Most cutaneous reactions were self-limiting, need little or no therapeutic intervention, and were not regarded as a barrier to injecting a second dose.Limitations:Conclusion: In certain groups such as patients with allergies and a history of local injection reactions, pre-vaccination counseling and the use of appropriate medications may be helpful. However, more studies are needed to investigate the side effect profile of all COVID-19 vaccines.

Higher venom-specific IgE levels differentiate children with previous local large reactions from children with previous systemic reactions of different severity

Introduction: Risk factors for systemic reactions (SRs) from hymenoptera venom (HV) allergy are well known in the adult population but they have been little studied in the pediatric one. Method: The aim of our study was to identify risk factors for SRs in a population of children allergic to HV, comparing a series of clinical (age, gender, atopy, asthma) and laboratory (total IgE, tryptase, venom-specific IgE levels) variables between patients with at least two large local reactions (LLRs) and patients with SRs of different severity for the identified insect. We selected a population of HV allergic children aged <15 years with LLRs or SRs stratified according to Mueller grades after stinging. Results: The population included 80 children, 35 with at least 2 LLRs and 45 with SRs. The level of specific IgE for vespid (Polistes dominula, Vespula species) venoms was significantly higher (p = 0.0321) in children with SRs (Mueller grade II+III+IV) than in those with LLRs and the same significance was also found for specific IgE for Apis mellifera, considering SRs group (Mueller grade I+II+III+IV) in respect with LLRs group (p = 0.0001). Conclusion: The main difference in our pediatric population was the highest level of specific IgE in children with a history of SRs compared to those with a history of LLRs for both vespids and honey bees. These results, once confirmed on a larger population, could suggest the opportunity to follow the behavior of venom specific IgE in children with LLRs to reveal a risk to develop future more serious reactions.