As COVID-19 vaccines are being authorized and recommended for use worldwide, it is important to understand what is known about them, particularly in terms of effectiveness and safety.[1] Common side-effects from these vaccines include mild grade fever, fatigue, headache, myalgia, and pain at the injection site,[2] but information available about them is still limited. Herein we report a patient who presented with supraclavicular reactive lymphadenopathies after receiving the COVID-19 BNT162b2 vaccine (Pfizer-BioNTech).
A previously healthy 29-year-old woman presented with a two-day history of mild discomfort and a lump in her left supraclavicular region. Seven days earlier she had received the first dose of above mentioned COVID-19 vaccine in ipsilateral deltoid muscle. On examination she was in good health. Two lymphadenopathies, 1.5 cm and 1 cm in diameter respectively, were noted in her left supraclavicular region [Figure 1]. Mild pain on pressure was also present in the vaccine injection site.
Figure 1.
Lymphadenopathies in the left supraclavicular region
Her routine investigations, including blood cell counts, biochemistry and serologies, was normal. Chest radiograph was normal. Ultrasound examination disclosed two left supraclavicular lymphadenopathies [Figure 2] with no other abnormalities found in the neck or axillary regions. As the patient was otherwise asymptomatic, she uneventfully received the second dose of the same COVID-19 vaccine, 21 days after the first dose. She required no specific treatment. The lymphadenopathies progressively diminished in size and finally disappeared over the next few weeks.
Figure 2.
Lymphadenopathies in the left supraclavicular region
Lymphatic vessels from the deltoid region drain in the axillary and supraclavicular lymph nodes, and both axillary and supraclavicular lymphadenopathies have been previously described as side effect of different vaccines.[3,4] Recently two other cases of reactive lymphadenopathies following COVID-19 vaccinations, presenting as a lump in the neck, have been reported.[5] But this a barely known side effect of COVID-19 vaccines.[2] Since a diagnosis of malignancy is considered in patients presenting with left supraclavicular lymphadenopathies, awareness of this side effect of COVID-19 vaccines is particularly important to avoid unnecessary evaluation and reduce anxiety of affected patients.[6]
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Conflicts of interest
There are no conflicts of interest.
References
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