26. Reactivation of Varicella-zoster virus following BNT162B2 mRNA COVID-19 vaccination: A case report
Main Article Content
Abstract
BNT162b2 mRNA is an mRNA-based COVID-19 vaccine that has been approved for use in children aged 5 years and older. Most side effects of this vaccine are usually mild, including pain at the injection site, low-grade fever and muscle aches. Recently, several reports have reported a rare side effect following BNT162b2 mRNA vaccination, which is reactivation of the Varicella zoster virus (VZV) causing Herpes zoster (Shingles) and neurological complications. We report a case of a 15-year-old boy with a healthy history and had chickenpox at 7 years old, who was admitted to the hospital with fever, headache, vomiting and vescicles on his back after receiving the second dose of the Pfizer vaccine. The child was diagnosed with VZV meningitis and responded to treatment with Acyclovir. Conclusion: After vaccination with BNT162b2 mRNA, it is necessary to monitor and detect neurological complications due to VZV reactivation in patients with suspected symptoms, even in healthy children.
Article Details
Keywords
BNT162b2 mRNA vaccine, Varicella zoster virus (VZV) meningitis, COVID-19
References
2. World Health Organization. Pfizer-BioNTech (BNT162b2) COVID-19 vaccine: What you need to know. Updated 21 January 2022, pursuant to updated interim recommendations. https://www.who.int/news-room/feature-stories/detail/who-can-take-the-pfizer-biontech-covid-19-vaccine-what-you-need-to-know.
3. Yasuda R, Minami K, Ogawa A, et al. Herpes zoster and meningitis in an immunocompetent child: a case report. J Med Case Rep. 2019;13:182. doi: 10.1186/s13256-019-2082-z.
4. Bosran E, Yalici-Armaga B. Herpes Zoster following inactivated COVID-19 vaccine: A coexistence or coincidence? J Cosmet Dermatol. 2021;20(6):1566-1567. doi: 10.1111/jocd.14035.
5. Maruki T, Ishikane M, Suzuki T, et al. A case of varicella zoster virus meningitis following BNT162b2 mRNA COVID-19 vaccination in an immunocompetent patient. Int J Infect Dis. 2021;113:55-57. doi: 10.1016/j.ijid.2021.09.055.
6. Psichogiou M, Samarkos M, Mikos N, Hatzakis A. Reactivation of Varicella Zoster virus after vaccination for SARS-CoV-2. Vaccines (Basel). 2021;9(6):572. doi: 10.3390/vaccines9060572.
7. Lazzaro DR, Ramachandran R, Cohen E, Galetta SL. Covid-19 vaccination and possible link to Herpes zoster. Am J Ophthalmol Case Rep. 2022;25:101359. doi: 10.1016/j.ajoc.2022.101359.
8. Rodríguez-Jiménez P, Chicharro P, Cabrera LM, et al. Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: Report of 5 cases. JAAD Case Reports. 2021;12:58-59. doi: 10.1016/j.jdcr.2021.04.014.
9. Koh S, Kim HN, Kim YS, Kim TJ. Varicella Zoster virus reactivation in central and peripheral nervous systems following COVID-19 vaccination in an immunocompetent patient. J Clin Neurol. 2022;18(1):99. doi: 10.3988/jcn.2022.18.1.99.
10. Gnoni M, Zaheer K, Vasser MM, et al. Varicella Zoster aseptic meningitis: Report of an atypical case in an immunocompetent patient treated with oral valacyclovir. IDCases. 2018;13:4. doi: 10.1016/j.idcr.2018.e00446.
11. Esposito S, Bosis S, Pinzani R, et al. A case of meningitis due to varicella zoster virus reactivation in an immunocompetent child. Italian Journal of Pediatrics. 2013;39(1):72. doi: 10.1186/1824-7288-39-72.
12. Kerr C, O’Neill S, Szucs A, et al. Zoster meningitis in an immunocompetent young patient post first dose of BNT162b2 mRNA COVID-19 vaccine, a case report. IDCases. 2022;27:e01452. doi: 10.1016/j.idcr.2022.e01452.
13. Shimabukuro T. COVID-19 vaccine safety update. CDC COVID-19 vaccine task force vaccine safe team. Adisory Committee on Immunization Practices (ACIP). January 27, 2021.
14. World Health Organization. Adverse Events Following Immunization (AEFI): Causality. Assessment. http://apps.who.int/iris/bitstream/handle/10665/191391/a87773_eng.pdf; jsessionid=CE9E6F1 FB4682E2846B5B18 FC5627653? sequence=1. Published July 2002.