Bacillus Calmette-Guerin scar reactivation in multisystem inflammatory syndrome in children

Zaki, Syed Ahmed; Hazeem, Anas Abu; Rashid, Asrar

doi:10.1177/00494755211051194

Cited by 1 publication

(2 citation statements)

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“…It may occur as an (early) symptom of Kawasaki's disease (KD) 7,8 . BCG scar reactivation has also been described after infection with measles and human herpesvirus 6, and recently after multisystem inflammatory syndrome‐children (MIS‐C) 9–12 . In addition, some cases of BCG scar reactivation occurred after vaccination with influenza vaccine, 13 and one case has been described following adalimumab 14 .…”

Section: Introductionmentioning

confidence: 99%

“…7,8 BCG scar reactivation has also been described after infection with measles and human herpesvirus 6, and recently after multisystem inflammatory syndrome-children (MIS-C). [9][10][11][12] In addition, some cases of BCG scar reactivation occurred after vaccination with influenza vaccine, 13 and one case has been described following adalimumab. 14 Since the start of the COVID-19 vaccination campaigns worldwide, a few cases of BCG scar reactivation have been described as adverse events following immunization (AEFI) of an mRNA COVID-19 vaccine.…”

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confidence: 99%

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A case series of bacillus Calmette‐Guérin scar reactivation after administration of both mRNA and viral vector COVID‐19 vaccines

Balveren

Puijenbroek

Davidson

et al. 2023

Brit J Clinical Pharma

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Aim Reactivation of the scar resulting from intradermal injection of bacillus Calmette‐Guérin (BCG) is a common specific reaction in Kawasaki's disease. It has also sporadically been associated with viral infections, multisystem inflammatory syndrome in children, influenza vaccination and mRNA COVID‐19 vaccination. In this case series, characteristics of BCG scar reactivation after different COVID‐19 vaccinations are presented and possible mechanisms are discussed. Methods Data were collected from the spontaneous reporting system of the Netherlands Pharmacovigilance Centre Lareb. Descriptives were made for the case reports in which a BCG scar reactivation was detected. Results Since the start of the COVID‐19 vaccination campaign in January 2021, the Netherlands Pharmacovigilance Centre Lareb has received 22 case reports of BCG reactivation after vaccination with a COVID‐19 vaccine. In 20 case reports, it concerned mRNA COVID‐19 vaccines Moderna (14) and Pfizer (6). In two case reports, the viral vector COVID‐19 vaccine AstraZeneca was administered. Erythema and pain were the most frequently reported symptoms and the size of the inflammation was between 1.5 and 5 cm. BCG scar reactivation occurred with a median time to onset of 2 days after the second or booster COVID‐19 vaccination, whereas the median time to onset was 7 days after the first COVID‐19 vaccination. None of the BCG scar reactivations were treated. Conclusions The exact mechanism of the occurrence of BCG scar reactivation remains unknown, but involvement of heat shock protein 65 is suggested. BCG scar reactivation is a nonserious, self‐limiting reaction that can occur after vaccination with both mRNA and viral vector COVID‐19 vaccines.

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