TABLE 1.
Post‐COVID‐19 vaccine HZ cases seen at the Las Vegas Dermatology clinic and cases reported via social media.
| Age at time of initial vaccination (years old) | Sex | Presentation | Vaccine Type | Days until symptom onset post‐vaccination (PV) | Days until unilateral dermatomal herpetiform skin eruption post‐vaccination (PV) & Location | Comorbid conditions | Comorbid dermatologic conditions | Treatment | Confirmatory Tests |
|---|---|---|---|---|---|---|---|---|---|
| 77 | M | Evaluated in clinic | Moderna, 1st dose | 2 days PV: "odd feeling" and pain | 4 days PV: mid‐ABD, R flank, R mid‐back | Crohn's Disease, h/o treated Aspergilloma | Psoriasis | Valacyclovir, Gabapentin, LMX | Clinically diagnosed |
| 56 | M | Evaluated in clinic | Moderna, 1st dose | None | 4 days PV: R chest | None | Atopic Eczema | Valacyclovir, Gabapentin, LMX | VZV IgG (+), IgM (‐) |
| 54 | F | Evaluated in clinic | Moderna, 1st dose | 4 days PV: itchiness and deep pain | 5 days PV: L back, L shoulder, L triceps | Thyroidectomy, Hysterectomy, Cholecystectomy | Melanoma x3: Tx Wide Local Excision | Valacyclovir, Gabapentin, LMX | VZV PCR (+) |
| 65 | M | Evaluated in clinic | Pfizer, 2nd dose | 14 days PV: itchiness, 17 days post‐vaccine: pain | 38 days PV: L axilla, L shoulder, L triceps | HTN | History of Shingles, no previous shingles vaccination | Valacyclovir, Gabapentin, LMX | VZV PCR (+) |
| 43 | F | Social media | Pfizer, 2nd dose | 1 day PV: severe pain at injection site and body aches | 4 days PV: "bump" on R neck; 8 days PV: R collarbone & R lower jaw | HTN | None | Valacyclovir & Terrasil Shingles cream | Clinically diagnosed |
| 69 | F | Social media | Moderna, 1st dose | 4 days PV: severe pain in upper L back | 4–7 days PV: worsening blistering of L axilla and L upper breast | Polycythemia Vera treated with Jakfi, HTN, Dyslipidemia, Osteopenia | Psoriasis, Actinic keratosis, BCC, SCC, previously vaccinated with Zostavax and Shingrix, | Antiviral | Clinically diagnosed |
| 42 | M | Social media | Moderna, 1st dose | 14 days PV: tingling, mild “skin irritation sensation” radiating from R lower chest to mid‐ABD. 21 days: burning and itchiness | 21 days PV: scattered blistering | None | Childhood chickenpox, No history of shingles | Clinically diagnosed | |
| 47 | F | Social media | Moderna, 1st dose | 12 days PV: burning pain to R axilla and R chest | 15 days PV: T1 dermatome | "Vascular issues to my extremities" | No history of Shingles | Valacyclovir, Gabapentin, Prednisone | Clinically diagnosed |
| 39 | F | Social media | Moderna, 1st dose | 2 days PV: itchiness | 5 days PV: R back and R flank | DM, HTN | None | Valacyclovir | Clinically diagnosed |
| 74 | M | Evaluated in clinic | Pfizer, 2nd dose | None | 3 days PV: Mid‐chest, R arm | Kidney failure, Anemia, HTN, Gout, Heart failure, A‐Fib. | None | Valacyclovir & Mupirocin | Clinically diagnosed |
| 48 | M | Evaluated in clinic | Pfizer, 1st dose | Arm Soreness from Vaccine | 12 days PV: Unilateral Dermatomal L Flank and altered skin sensation | None | Chickenpox at 8 y/o | Valacyclovir, Gabapentin, LMX | VZV PCR (+) |
| 68 | F | Social media | Moderna, dose, 1st dose |
L shoulder injection site pain; 8–9 days PV: CP & tachycardia |
12 days PV: "red blotches erupted" L axilla, L triceps, L scapula |
Hypothyroidism, HTN, adrenal fatigue |
Chickenpox in 2nd grade, "hives from stress", no previous shingles vaccination, childhood rubella, measles at 47 y/o |
Valacyclovir, Tramadol | Clinically diagnosed |
| 46 | M | Social media | Pfizer, 1st dose | Within 7 days PV: Pain at site of future skin eruption | 9 days PV: Unilateral Dermatomal R Flank | None | None | Valacyclovir, Gabapentin, Hydrocodone/acetaminophen | Clinically diagnosed |
| 60 | F | Social media | Moderna, 2nd dose | 24–26 days PV: itching and burning at site of future skin eruption | 26–28 days PV: R forehead along hairline | Treated thyroid cancer, Gout | None | Valacyclovir | Clinically diagnosed |
| 43 | M | Social media | Moderna, 1st dose | 2 days PV: hotness and altered skin sensation at site of future skin eruption | 3 days PV: Unilateral Dermatomal R Flank and back | None | Chickenpox 4–5 y/o, no previous shingles vaccination | Valacyclovir and Gabapentin | Clinically diagnosed |
| 65 | F | Social media | Moderna, 1st shot | 2 days PV: injection site pain | 11 days PV: tingling, itching, burning, and eruption around and under right eye | None | Shingles 10 years prior to current episode, vaccinated for shingles in 2015 and 2019 | Valacyclovir | Clinically diagnosed |
| 44 | M | Social media | Pfizer, 1st dose | 3 days PV: itchiness | 5 days PV: L eyebrow | None | None | Acyclovir, Desonide cream | Clinically diagnosed |
| 37 | F | Social media | Moderna, 1st dose | 2 days PV: nerve pain | 4–5 days PV: L back and L ABD | None | None | Valacyclovir | Clinically diagnosed |
| 69 | M | Social media | Moderna, 1st dose | None | 14 days PV: Unilateral R back and R arm | Hypercholesterolemia | "Susceptible to poison ivy," vaccinated for shingles in July 2020 | Valacyclovir | Clinically diagnosed |
| 72 | F | Social media | Moderna, 2nd dose | 3–4 days PV: 2 in raised, red spot at injection site with accompanying pain; 4–5 days PV: itching and burning at site of future skin eruption | 5–6 days PV: L arm, L upper back, L breast | HTN, treated R breast cancer | "no, but am often itchy" | Valacyclovir | Clinically diagnosed |
Vaccine Used→Shingles: 14 Moderna & 6 Pfizer‐; Mean 6.85 Days Post‐Vaccine→Shingles; Median 4 Days Post‐Vaccine→Shingles; Mode 2 Days Post‐Vaccine→Shingles; Mean 10.2 days→Eruption.
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