Radiation recall phenomenon after administration of the mRNA-1273 SARS-CoV-2 vaccine

Abstract

Several types of SARS-CoV-2 vaccine have been developed. However, the relationship between SARS-CoV-2 vaccine and radiation therapy (RT) is unclear. Recently, there have been some reports of radiation recall phenomenon (RRP) caused by a SARS-CoV-2 vaccine. We report a case of RRP after administration of the mRNA-1273 SARS-CoV-2 vaccine. A 51-year-old female was diagnosed with breast cancer (cT4N1M0, cStage IIIB) and underwent breast total mastectomy with axillary lymph node dissection after neoadjuvant chemotherapy. After mastectomy, the patient received RT with 50 Gy in 25 fractions. An acute side effect of grade 2 dermatitis according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. occurred after RT. The patient had not started any new systemic medication after RT; however, the patient received the mRNA-1273 SARS-CoV-2 vaccine (Moderna) 1 month after the end of the initial RT. Seven days after vaccination, the patient had a skin reaction with burning sensation and redness. This skin reaction was induced in an area corresponding to the irradiation field of the chest wall. There was no skin reaction in areas other than that described. The reaction was cured within 1 week with topical hydrocortisone. This report is an interesting case report with a RPP after administration of the mRNA-1273 SARS-CoV-2 vaccine.

Radiation recall dermatitis induced by COVID-19 vaccination in breast cancer patients treated with postoperative radiation therapy

“…With the increase of COVID-19 vaccination other case reports described similar findings, also for different vaccination platforms, i.e. viral vector-based vaccines [ [13] , [14] , [15] , [16] ].…”

Drug‐induced radiation recall reactions and non‐anticancer drugs: A descriptive analysis from VigiBase®

“…Concerning the focus on vaccines, data from the literature show an onset time of 5 ± 2 days (3 h to 10 days) [6, 7, 9, 10, 15–19] similar to our study. In their study of 361 patients treated with radiotherapy for breast cancer, Vinante et al report the occurrence of a recall phenomenon in 5.5% of patients, mainly after the first dose of vaccine [19].…”

“…Cases have also been described with antibiotics, antituberculosis drugs, and simvastatin [5]. Interestingly, since the beginning of the COVID‐19 pandemic, several case series of RRR to radiotherapy have also been reported following COVID‐19 vaccination [6–10].…”

“…several case series of RRR to radiotherapy have also been reported following COVID-19 vaccination [6][7][8][9][10].…”

Breast Radiation Recall Phenomenon After Astra-Zeneca COVID-19 Vaccine: A Case Series

“…Our cases are similar in the use of corticosteroid therapy, however, both indicate how RRP is a self-limiting condition that will improve over time. At the time of writing, all COVID-19 vaccines appear to be associated with some form of RRP, indicating the ubiquity of the condition and how important it is for clinicians to be aware of this complication [6].…”