Delayed skin reaction after mRNA-1273 vaccine against SARS-CoV-2: a rare clinical reaction

Norman-Philipp Hoff, Noemi F Freise, Albrecht G Schmidt, Parnian Firouzi-Memarpuri, Julia Reifenberger, Tom Luedde, Edwin Bölke*, Stephan Meller, Bernhard Homey, Torsten Feldt, Björn Erik Ole Jensen, Verena Keitel, Livia Schmidt, Kitti Maas, Jan Haussmann, Balint Tamaskovics, Wilfried Budach, Johannes C Fischer, Bettina Alexandra Buhren, Wolfram Trudo KnoefelMarion Schneider, Peter Arne Gerber, Alessia Pedoto, Dieter Häussinger, Olaf Grebe, Martijn van Griensven, Stephan A Braun, Stefan Salzmann, Amir Rezazadeh, Christiane Matuschek

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: The coronavirus disease 2019 (COVID-19) is associated with a wide clinical spectrum of skin manifestations, including urticarial, vesicular, vasculitic and chilblain-like lesions. Recently, delayed skin reactions have been reported in 1% individuals following mRNA vaccination against SARS-CoV-2. The exact pathophysiology and the risk factors still remain unclear.

PATIENTS AND METHODS: 6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database.

RESULTS: Eleven of 6821 vaccinated patients (0.16%) developed delayed skin reactions after either the first or second dose of the mRNA-1273 vaccine against SARS-CoV-2. Eight of 11 patients (73%) developed a rash after the first dose, while in 3/11 (27%), the rash occurred after the second dose. More females (9/11) were affected. Four of 11 patients required antihistamines, with two needing additional topical steroids. All the cutaneous manifestations resolved within 14 days. None of the skin reactions after the first dose of the vaccine prevented the administration of the second dose. There were no long-term cutaneous sequelae in any of the affected individuals.

CONCLUSION: Our data suggests that skin reactions after the use of mRNA-1273 vaccine against SARS-CoV-2 are possible, but rare. Further studies need to be done to understand the pathophysiology of these lesions.

Original languageEnglish
Article number98
Number of pages9
JournalEuropean Journal of Medical Research
Issue number1
Publication statusPublished - 25 Aug 2021


  • Inflammation
  • COVID-19
  • Dermatitis
  • Erythema
  • Edema

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