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.
【저자키워드】 COVID-19, BNT162b2, adverse events, mRNA-1273., Herpes virus, Herpes zoster rash, 【초록키워드】 SARS-CoV-2, coronavirus, vaccination, Pneumonia, Infection, systematic review, database, mRNA vaccines, COVID-19 vaccination, female, Patient, death, age, latency, Rash, booster, SARS-CoV-2 vaccination, Evidence, Immunosuppressed, manifestation, Safe, herpes zoster, acute respiratory syndrome, Adverse, significant difference, subject, second dose, first dose, inclusion criteria, article, episode, Varicella zoster virus, Zoster, articles, event, Occurrence, occurred, reported, clinically, conducted, accounted, median, indicate, subjects, were recorded, Herpe, IQR, ophthalmicus, patients with COVID-19, 【제목키워드】 coronavirus, vaccination, virus, acute respiratory syndrome, New,