I have read the article by Austria et al. titled “Transient Eyelid Edema Following COVID-19 Vaccination” with great interest.[1] I have a couple of concerns on their description of cases having transient eyelid edema as a pediatric allergist in practice.First, according to their description, the case with eyelid edema in the figure of the article, it does not look like a true/typical eyelid edema (angioedema) rather a finding of “allergic shiner (dark circles)” of atopic disease such as in patients with allergic rhinitis.[2,3] Especially, discoloration (hyperpigmentation) around eye makes me think of allergic shiner. Allergic shiners are dark circles especially under the eyes caused by congestion of the nose and sinuses. There are many possible reasons of dark circles under your eyes, but they are called as allergic shiners since allergies are well known for triggering them. Allergic shiners are also sometimes named as “allergic facies” and “periorbital hyperpigmentation.” Therefore, these 3 patients should have been questioned again particularly for allergic symptoms such as sneezing, nasal congestion, and sinus pressure as well as atopic sensitization against house dust mite species (Dermatophagoides farinae and Dermatophagoides pteronyssinus). Even, these patients should have been tested for allergic sensitizations in the beginning after consultation with allergy clinic. If the authors have better pictures for eyelid edema (angioedema) due to vaccination, they ought to show those ones or put in the article.Second, as said in the article, they each happened on day 1 or 2 following their first or second dose of the Pfizer-BioNTech COVID-19 vaccine.[1] As expected, if eyelid edema is a type I hypersensitivity reaction, it should happen a couple of hours after the vaccination. However, when the authors try to explain the precise etiology and pathophysiology of these patients’ eyelid edema, they describe immuno-complex mechanism (type III hypersensitivity reaction) of Gell-Coombs’ classification.[4] In that case, eyelid edema cannot happen 1 day after the vaccination and will probably take some more time to occur. These pathologic explanations and the patients’ clinical picture do not fit with the reality.Third, I think that this kind of self-limited/resolved adverse effects can raise a possibility to cause general people to avoid/hesitate routine COVID-19 vaccinations.[5] I think that we have to be careful about reporting these cases and first consult with allergology.