Table 1.
Selection of COVID-19 vaccines and the most common ADRs, with a focus on cutaneous side effects, as of July 2021. Pain or tenderness at the injection site is very common with all available agents, and is therefore excluded in this tabular overview. Please note that further vaccines have entered clinical trials [3]. Abbreviations: mRNA—messenger ribonucleic acid; UK—United Kingdom; USA—United States of America; DRESS—drug reaction with eosinophilia and systemic symptoms.
| Vaccine (Developing Institution) |
Vaccine Type | First Approval | General ADRs | Cutaneous ADRs |
|---|---|---|---|---|
| BNT162b2 Tozinameran, Comirnaty (BioNTech/Pfizer) |
mRNA | December 2020 in UK |
>10%: Fatigue, headache, musculoskeletal pain, fever [4] | 1–10%: Local injection site reaction: erythema, swelling; <1%: delayed local reactions (“COVID-arm”), morbilliform rash, urticarial reactions, pityriasis rosea; singular cases: Rowell’s syndrome, lichen planus |
| mRNA-1273 Spikevax (Moderna) |
mRNA | December 2020 in USA |
>10%: Fever, headache, fatigue, myalgia, arthralgia, nausea, chills [5] | 1–10%: Local injection site reaction: erythema, swelling; <1%: delayed local reactions (“COVID-arm”), morbilliform rash, urticarial reactions, pityriasis rosea, erythema multiforme, erythromelalgia, herpes simplex, herpes zoster, perniones/chilblains; singular cases: reactions to cosmetic fillers, purpuric/petechial rash |
| AZD1222/ChAdOx1 nCoV-19 Vaxzevria, Covishield (AstraZeneca) |
Viral vector vaccine (adenovirus) |
December 2020 in UK |
>10%: Fatigue, nausea, musculoskeletal pain, headache, subfebrile temperatures [6] | 1–10%: Local injection site reaction: erythema, swelling; <1%: itch, rash, sweating; singular cases: psoriasis, rosacea, vitiligo, Raynaud’s phenomenon, cellulitis, pityriasis rosea, delayed large local reactions |
| Gam-COVID-Vac/Sputnik V (Gamaleya Research Institute) |
Viral vector vaccine (adenovirus) |
August 2020 in Russia |
1–10%: Flu-like illness, headache, asthenia [7] | 1–10%: Local injection site reactions, not further specified; <1%: indeterminate rash, petechial rash, “allergic rash”, itching, eczema/dermatitis; singular cases: abscess, alopecia, acneiform dermatitis |
| Ad26.COV2.S/JNJ-78436735 COVID-19 Vaccine Janssen (Johnson & Johnson) |
Viral vector vaccine (adenovirus) |
February 2021 in USA |
>10%: fatigue, headache, myalgia, nausea, pyrexia [8] | 1–10%: Local injection site reaction: erythema, swelling; singular cases: widespread annular eruption, DRESS-syndrome |
| Ad5-nCoV Convidecia (CanSinoBIO) |
Viral vector vaccine (adenovirus) |
February 2021 in China |
>10%: fatigue, fever, headache, muscle pain, joint pain [9] | 1–10%: Local injection site reaction: redness, swelling, itch; singular cases: non-infective gingivitis, buccal ulcerations, herpes simplex |
| CoronaVac (Sinovac) |
Inactivated whole virus (aluminum adjuvant) |
February 2021 in China |
1–10%: fatigue, diarrhea, fever, muscle pain, headache, nausea, cough [10] | 1–10%: Local injection site reaction: swelling, redness, pruritus, discoloration, induration; <1%: urticaria, petechial rash, flare of pustular psoriasis |
| BBIBP-CorV (Sinopharm) |
Inactivated whole virus (aluminum adjuvant) |
December 2020 in China |
1–10%: fever, fatigue, inappetence, nausea, constipation, headache [11] | 1–10%: Local injection site reaction: erythema, swelling, induration, “mucocutaneous abnormalities”; <1%: “rash”, itch, herpes simplex, buccal ulcer |
| NVX-CoV2373 (Novavax) |
Recombinant protein subunit (saponin adjuvant) |
Not yet approved | >10%: arthralgia, fatigue, headache, myalgia, nausea, malaise [12] | 1–10%: Local injection site reaction: erythema, induration or swelling |
| CVnCoV Zorecimeran (CureVac) |
mRNA | Not yet approved | “Dose dependent effects included fever, headache, fatigue, chills, myalgia, arthralgia, nausea/vomiting, diarrhea” [13] | 1–10% local injection site reaction: swelling and itching (preliminary data) |
|
VAT00002 Sanofi–GSK COVID-19 vaccine (Sanofi/ GlaxoSmithKline) |
Recombinant protein subunit (AS03 adjuvant) |
Not yet approved | No data available, yet (NCT04762680) Phase III trial launched in May 2021 |
No data available, yet |