TABLE 1.

Female genital mucosa lesions associated with COVID‐19 vaccines

Author, year	Country/region	Age (years)	Vaccine type	Latency after vaccination (days)	Treatment	Genital mucosa finding	Detailed description of genital findings	Comorbidities	Time to resolution
Salusti‐Simpson et al., ⁶ 2022	USA	22	BNT162b2 booster vaccine	2	Prednisone, clobetasol ointment, mupirocin ointment	Acute vulvar ulcers	Vulvar edema and extensive ulceration bilaterally, with yellow, grey purulent drainage and pseudomembrane	History of oral aphthous ulcers and 2 previous episodes of acute vulvar ulcers	Improvement in discomfort after 3 weeks
Wojcicki et al., ⁷ 2022	USA	16	Second dose of BNT162b2 vaccine	1	Topical clobetasol, ibuprofen, acetaminophen, oral norethidrone	Vulvar ulcers	Well demarcated ulcerated lesion with adherent yellow and grey fibrinous exudate and a necrotic‐appearing border. Desquamation of the surrounding tissue	Soft palate cleft, club foot, syndactyly of her left foot, and congenital hearing impairment in the right ear, history of recurrent oral ulcerations	Improvement in symptoms at 2 weeks follow‐up
Hsu et al., ¹⁰ 2022	USA	12	Second dose of BNT162b2 vaccine	2	Topical clobetasol ointment, lidocaine jelly, oral acetaminophen, ibuprofen	Vulvar ulcers	Well‐circumscribed, shallow ulcers with yellowish sloughing and purulent exudate, labial edema	None	Complete healing after 2 weeks
	USA	14	Second dose of BNT162b2 vaccine	3	Clobetasol ointment, lidocaine gel, ibuprofen, oral nortriptyline, oral prednisone	Vulvar ulcers	Labial swelling, labial ulcers with overlying grey eschar	History of genital ulceration	Almost complete ulcer resolution after 4 weeks
	USA	29	First and second doses of Moderna SARS‐CoV‐2 vaccine	1 (after 1st dose) and 2 (after 2nd dose)	Clobetasol ointment	Vulvar ulcers	Erythematous erosions	Recurrent genital ulcers, asthma, recurrent oral aphthous ulcers	Complete resolution (time not reported)
Wijaya et al., ¹¹ 2022	Australia	16	Second dose of the BNT162b2 vaccine	4	Oral prednisolone	Vulvar aphthosis	Multiple well‐demarcated vulvar ulcers with yellow‐grey exudate	None	No symptoms at 4‐week follow‐up
	Australia	14	Second dose of the BNT162b2 vaccine	5	Oral prednisolone	Vulvar aphthosis	Vulvar ulcers and edema	Medical history of monthly oral ulcers	Full resolution at 1‐week follow‐up
	Australia	19	First dose of AstraZeneca (Vaxzevria) ChAdOx1 nCoV‐19 vaccine	3	Ibuprofen	Vulvar aphthosis	Mild vulvar aphthosis	None	Full resolution at 1‐week follow‐up
Drucker et al., ¹² 2022	USA	14	Second dose of the BNT162b2 vaccine	2	Topical lidocaine	Vulvar aphthous ulcers	Purple‐pink shallow‐based ulcerations with sloughing yellow roof at the core and surrounding edema	Type I von Willebrand disease	Ulcer resolution after 10 days
González‐Romero et al., ⁴ 2021	Spain	24	AstraZeneca vaccine (dose not specified)	3	Prednisone and analgesics	Acute noninfectious genital ulcer	Ulcers with an erythematous border and a fibrinous, nonsuppurative centre	Vulvar ulcers 9 months earlier	Complete resolution after 3 weeks
	Europe	18	AstraZeneca vaccine (dose not specified)	1	Not reported	Acute noninfectious genital ulcer	Not reported	None	Not reported
	Europe	25	AstraZeneca vaccine (dose not specified)	2	Not reported	Acute noninfectious genital ulcer	Not reported	None	Not reported
	Europe	24	AstraZeneca vaccine (dose not specified)	1	Not reported	Acute noninfectious genital ulcer	Not reported	None	Not reported
	Europe	25	AstraZeneca vaccine (dose not specified)	2	Not reported	Acute noninfectious genital ulcer	Not reported	None	Not reported
Popatia et al., ¹³ 2022	USA	12	Second dose of the BNT162b2 vaccine	2	Lidocaine jelly, triamcinolone ointment, acetaminophen, ibuprofen	Vulvar aphthous ulcer	Ulcers with a red rim and a white‐grey necrotic crust	None	Complete resolution after 10 days