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An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
In a retrospective single center study involving 265 patients with various rheumatic diseases who received at least one dose of primary SARS-CoV-2 vaccine at a rheumatology clinic in Taiwan between July 2021 and September 2021, 10 patients (7 women and 3 men) aged 23−80 years were described who developed reactivation of herpes zoster virus during treatment with elasomeran, celecoxib, colchicine, etoricoxib, hydroxychloroquine, methotrexate, prednisolone, rituximab, sulfasalazine or varicella-zoster-virus-vaccine-live [routes not stated; not all dosages and durations of treatments to reaction onset stated].
Case 1: A 58.5-year-old woman with spondyloarthritis, had been receiving disease-modifying antirheumatic treatment with hydroxychloroquine, sulfasalazine and celecoxib. Subsequently, she received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, eight days later, she experienced reactivation of herpes zoster virus at left cranial nerve V2+IX. She received treatment with valaciclovir, and the condition resolved. Reactivation of herpes zoster virus was attributed to hydroxychloroquine, sulfasalazine, celecoxib and elasomeran.
Case 2: A 53.9-year-old woman with systemic lupus erythematosus, had been receiving disease-modifying antirheumatic treatment with hydroxychloroquine. She also had been receiving prednisolone 10 mg/day. Subsequently, she received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, eight days later, she experienced reactivation of herpes zoster virus at right T8. She received treatment with valaciclovir and the condition resolved. Reactivation of herpes zoster virus was attributed to hydroxychloroquine, prednisolone and elasomeran.
Case 3: A 23.9-year-old woman with Hashimoto thyroiditis, had been receiving disease-modifying antirheumatic treatment with rituximab and hydroxychloroquine. Subsequently, she received the second dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, nine days later, she experienced reactivation of herpes zoster virus at right cranial nerve V3+IX. She also developed a complication of severe mucositis with ulcers. She received treatment with valaciclovir and moderate-dose of unspecified glucocorticoids and the condition resolved. Reactivation of herpes zoster virus was attributed to rituximab, hydroxychloroquine and elasomeran.
Case 4: A 72.6-year-old man with spondyloarthritis, had been receiving disease-modifying antirheumatic treatment with etoricoxib. Subsequently, he received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, 47 days later, he experienced reactivation of herpes zoster virus at right L4+L5. He also developed a complication of toxic epidermal necrolysis. He received treatment with valaciclovir and moderate-dose unspecified glucocorticoids and the condition resolved. Reactivation of herpes zoster virus was attributed to etoricoxib and elasomeran.
Case 5: A 66.8-year-old woman with rheumatoid arthritis had been receiving disease-modifying antirheumatic treatment with celecoxib, colchicine and hydroxychloroquine. She also had been receiving prednisolone 5mg/day. Subsequently, she received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, seven days later, she experienced reactivation of herpes zoster virus at left T7. She received treatment with valaciclovir, and the condition resolved. Reactivation of herpes zoster virus was attributed to celecoxib, colchicine, hydroxychloroquine, prednisolone and elasomeran.
Case 6: An 80.7-year-old man with rheumatoid arthritis had been receiving disease-modifying antirheumatic treatment with colchicine and hydroxychloroquine. He also had been receiving prednisolone 5 mg/day. Subsequently, he received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, 11 days later, he experienced reactivation of herpes zoster virus at left cranial nerve V1+V3. He also developed complication of severe mucositis with ulcers. He received treatment with valaciclovir and moderate-dose unspecified glucocorticoids and the condition resolved. Reactivation of herpes zoster virus was attributed to colchicine, hydroxychloroquine, prednisolone and elasomeran.
Case 7: A 42.1-year-old woman with spondyloarthritis, had been receiving disease-modifying antirheumatic treatment with hydroxychloroquine. She had a history of herpes zoster. She had also received varicella zoster virus vaccine live [Zostavax]. Subsequently, she received the second dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, 10 days later, she experienced reactivation of herpes zoster virus at right T3+T4. She received treatment with valaciclovir and the condition resolved. Reactivation of herpes zoster virus was attributed to hydroxychloroquine, varicella zoster virus vaccine live and elasomeran.
Case 8: A 74.9-year-old man had antineutrophil cytoplasmic antibody associated vasculitis. Subsequently, he received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, 13 days later, he experienced reactivation of herpes zoster virus at right S1. He received treatment with valaciclovir and the condition resolved. Reactivation of herpes zoster virus was attributed to elasomeran.
Case 9: A 72.3-year-old woman with rheumatoid arthritis, had been receiving disease-modifying antirheumatic treatment with methotrexate and hydroxychloroquine. Subsequently, she received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, 51 days later, she experienced reactivation of herpes zoster virus at left T4. She received treatment with valaciclovir and the condition resolved. Reactivation of herpes zoster virus was attributed to hydroxychloroquine, methotrexate and elasomeran.
Case 10: The 64.3-year-old woman with mixed connective tissue disease had been receiving disease-modifying antirheumatic treatment with sulfasalazine, hydroxychloroquine and celecoxib. Subsequently, she received the first dose of COVID-19 vaccination with elasomeran [mRNA-1273; Moderna]. However, 47 days later, she experienced reactivation of herpes zoster virus at left S1. She received treatment with valaciclovir and the condition resolved. Reactivation of herpes zoster virus was attributed to hydroxychloroquine, sulfasalazine, celecoxib and elasomeran.