Delayed urticaria after the third dose of mRNA COVID19 vaccine: A case series

Spikevax booster and delayed urticaria: a Swiss signal with diagnostic uncertainties due to a high proportion of direct patient reports

“…Similarly to delayed urticaria developed following COVID-19 mRNA primary vaccinations [ 5 – 8 ], delayed urticaria after booster vaccination with Spikevax® from the literature [ 2 – 4 ] and the present series of spontaneous reports was not accompanied by specific patterns of organ toxicity. By contrast, the present study highlighted that delayed urticaria developing after booster vaccination with Spikevax® appeared in most cases not self-limiting and with a prolonged course, which might warrant a follow-up system to continue monitoring their outcome.…”

“…Up to February 8, 2022, 107 spontaneous reports of delayed urticaria following booster vaccination with Spikevax® have been recorded in the Swiss national pharmacovigilance database (out of 12,334 reports of suspected adverse reactions to COVID-19 vaccines by January 1, 2022, and 6,103,662 vaccinated people with at least one dose). To date, two case reports [ 2 , 3 ] and a series of 21 patients from three Italian university hospitals [ 4 ] describing the onset of delayed urticaria following booster vaccination with Spikevax® have been reported in the literature. The present case series from the Swiss national pharmacovigilance database is the first to recognize this issue through a spontaneous reporting system.…”

“…However, even if the uncertainties about clinical diagnosis, duration, and clinical course of delayed urticaria following booster vaccination with Spikevax® are taken into account, based on previous findings on successfully treated delayed urticaria with COVID-19 mRNA primary and booster vaccinations [ 4 – 8 ], it is presumable that these reactions do not change the positive benefit-risk ratio of subsequent COVID-19 mRNA vaccinations, although further investigation is required. Meanwhile, the Swiss product information of Spikevax® was updated and other authorities, like the European Medicines Agency, are assessing urticaria currently [ 11 ].…”

Delayed onset urticaria and symptomatic dermographism following COVID‐19 booster vaccination: A case series

“…However, in recent literature we found case descriptions with delayed onset urticaria and marked dermographism after COVID mRNA-vaccines. [5][6][7] In the study by Prasad et al reporting 14 patients with urticaria after COVID-19 booster vaccination, 10 of these received Moderna vaccine. 4 In a case series by excipients in the Spikevax vaccine.…”

“…1 Cutaneous adverse events (CAE) following vaccination with the first two doses of COVID-vaccine have been increasingly reported, but lately also CAE following booster vaccination has been observed. [2][3][4][5] In private dermatology practice, we have noticed an increasing number of patients with delayed onset urticaria and symptomatic dermographism following booster vaccination with Pfizer-BioNTech and Moderna. This case series is based on 16 consecutive patients with delayed onset urticaria after vaccination cared for in a single private dermatology practice with a catchment area of 90,000 patients.…”