"Abstract
We present the case of a 24-year-old Caucasian man, who developed a scaly erythematous skin rash after the second dose of coronavirus disease 2019 (COVID-19) vaccination with Comirnaty (BNT162b2, BioNTech/Pfizer; Pfizer, New York, NY, USA) and proved positive for Epstein-Barr virus (EBV) reactivation...
Introduction
In response to the recent coronavirus disease 2019 (COVID-19) pandemics, newly developed gene-therapy-based vaccines are being routinely administered worldwide, and accompanying adverse effects, including viral reactivations, are being increasingly reported.
Interestingly, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines have been associated with an up-regulated T helper type 1 (Th1)-cell response, which probably increments inflammatory cytokines involved in a systemic inflammatory syndrome favoring an immune system imbalance.
Viral reactivations, especially of herpesviruses comprising human herpesvirus (HHV)6, HHV7, and virus zoster varicella (VZV), have been described after COVID-19 vaccination, possibly inducing clinical manifestations as pityriasis rosea (PR) and PR-like eruptions and herpes zoster. Also, Epstein-Barr virus (EBV) reactivation has been postulated after COVID-19 vaccination, but only in the immunosuppressed, where viral reactivation has been linked to monomorphic posttransplant lymphoproliferative disorder.
Herein we report the first case of EBV reactivation associated with cutaneous manifestations in an immunocompetent patient after the COVID-19 vaccine...
Discussion
... The patient had been administered Oxford-AstraZeneca vaccination 1 week before detecting viral reactivation...
Though in the presented case, the link between COVID-19 vaccine administration and EBV reactivation with clinically manifest exanthema, remains just a hypothesis, an alteration in the T cell balance after vaccination, favoring tissue EBV reactivation, cannot be excluded and needs to be addressed in further studies."
© Korean Vaccine Society.
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