“Objective: To describe the demographic, clinical, morphological characteristics, outcomes, and timing of development of herpes zoster to the various COVID-19 vaccines. And to identify on whether COVID-19 vaccine has temporal relationship between development of herpes zoster (HZ).
Methods: We have performed a systemic review of articles from PubMed and Embase...
Results: A total of 54 cases consisting of 27 male and 27 female patients have been reported. There were cases with known risk factors for herpes zoster, which included age more than 50 years (n = 36), immunological disorders (n = 10), chronic disease (n = 25), metabolic disorder (n = 13), malignancy (n = 4), and psychiatric disorder (n = 2). The mean (SD) period between development of herpes zoster and COVID-19 vaccination was 7.64 (6.92) days. Majority of the cases were from the high-income and/or middle-income countries. 86.27% of the cases of HZ were reported due to mRNA vaccine. Thirty-six patients 36/45 (80%) developed herpes zoster following the priming dose of COVID-19 vaccine among those who received mRNA vaccine...
4.1 Is there a medical or biological basis for an increased risk of COVID-19 vaccine-induced HZ?
Several theories can be postulated to explain the relationship between development of herpes zoster and COVID-19 vaccines. Age was found to be the major risk factor for the development of HZ partly due to age-related decline in cell-mediated immune responses to VZV, whereas disease-related immunocompromise is another risk factor including such as HIV infection, iatrogenic immunocompromission, physical trauma, or comorbid conditions such as malignancy or chronic kidney or liver disease. Studies have reported cross-reactivity between spike protein and self-antigen may lead to development of immune-mediated disorders in COVID-19 patients in the long run. The authors hypothesized that similar response can happen following COVID-19 vaccine. Toll-like receptors (TLR) stimulation of innate immunity might be the connection between COVID-19 vaccine and HZ development. The stimulation of these receptors has been related to the reactivation of VZV, allowing the latent virus to remain dormant in the afflicted people. The COVID-19 immunization may lead to the production of type I IFNs [interferons] and other inflammatory cytokines, activating T- and B-cell immunity and negatively affecting antigen expression, resulting in herpes zoster reactivation. The peak of antigen expression is determined by the administration method and vaccine composition, which is another approach to modulate the immune response.”
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.© 2021 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc/4.0/