Pandemic tattoos: A review of 329 #covidtattoo on Instagram.

CONFLICT OF INTEREST

None.

To the Editor,

Motivations for getting tattoos include expression of personal values, affection to loved ones, catharsis, milestones, and group affiliation. , Since January 2020, the COVID‐19 pandemic has been responsible for almost 291 million confirmed infections and 5.4 million deaths worldwide. To overcome or to commemorate this traumatic experience, some people have chosen to get a “pandemic” or “COVID tattoo.” The author explored their characteristics through a qualitative thematic analysis of tattoos posted on Instagram under the hashtag #covidtattoo.

A total of 567 still images posted from March 2021 to December 2021 were reviewed. Data collection was performed from 24th to 28th December 2021. Two hundred and thirty‐eight (41.9%) were excluded. Exclusion criteria included duplicate/triplicate of the same tattoos, paper models by tattooists, and tattoos that were unrelated to the pandemic, either by their content or by the description associated with the post. The characteristics of the 329 remaining images are summarized in Table 1. When a gender could be identified (n = 197), men featured in 56% of the images. When the anatomic body part could be identified (n = 239), tattoos were located on the upper arm in 69% of the cases. There was no significant difference between genders regarding either use of colors in the tattoos or localization on the body. One third of the tattoos represented the virus itself. Other COVID‐19‐associated depictions were related to vaccination: syringes, vaccine bottles, even pharmaceutical brands, or days when vaccinations were performed. Three patients had their own QR code tattooed. The second most frequent tattoos were healthcare providers, mainly a plague doctor or a female healthcare character, and the third surgical masks depicted alone. Other notable tattoos were toilet papers, respiratory tracts, the year 2020, and some COVID‐19 patients that recovered had the word “survivor” tattooed. At least, six percent of the tattoo recipients were healthcare providers themselves (nurses mainly, but also physicians). In four posts, romantic couples had done “matchy” tattoos and couples or groups of healthcare colleagues did. Six percent of the tattoos could be considered as humorous, and less than 5% were supportive of healthcare providers involved in taking care of COVID‐19 patients and supportive for vaccination.

TABLE 1

Characteristics of 329 #covidtattoo posts on Instagram

Total	n = 329 (%)
Gender
Men	111 (33.7)
Women	86 (26.1)
NA	132 (40.1)
Tattoo colors
Black	155 (47.1)
Multicolored (>1 color)	176 (52.9)
Tattoo topography
Upper limbs	164 (49.8)
Lower limbs	51 (15.5)
Trunk	23 (7.0)
Head and neck	1 (0.3)
NA	90 (27.4)
Designs a
COVID‐19
Coronavirus as such	106 (32.2)
Vaccination against coronavirus/COVID‐19 (syringes)	13 (4.0)
Vaccination against coronavirus/COVID‐19 (vaccine as such)	11 (3.3)
Lettering COVID‐19	12 (3.6)
Lettering F*ck COVID	3 (0.9)
QR code	3 (0.9)
Healthcare provider	76 (23.1)
Plague doctor	54 (16.4)
Healthcare provider with a mask	19 (5.8)
Healthcare provider without mask	3 (0.9)
Individual with a mask	37 (11.2)
Imaginary character with a mask	3 (0.9)
Mask	23 (7.0)
Surgical mask	17 (5.2)
Gas mask	5 (1.5)
Respiratory mask	1 (0.3)
Miscellaneous
Bandage with a heart	14 (4.3)
Skull or skeleton	10 (3.0)
Toilet paper	9 (2.7)
Lettering of the year “2020”	7 (2.1)
Lettering “Survivor”	4 (1.2)
Lungs	3 (0.9)
Themes
Humor	21 (6.4)
Supporting frontline healthcare workers	16 (4.8)
Supporting vaccination	10 (3.0)
Survivor	9 (2.7)
Lockdown/quarantine/boredom	7 (2.1)
Couple tattoos	4 (1.2)
Conspiracy theories	3 (0.9)
Tattoo recipient is a healthcare worker	20 (6.1)

Abbreviation: NA, Not available.

A tattoo may have several designs.

This study shows that some individuals have rapidly decided to keep a permanent mark of the pandemic, even though it is not over yet. The popularity of COVID tattoos in the population is unknown. According to Instagram, the number of posts with #covidtattoos is over 1000. However, tattoos can be posted under other hashtags and not everyone shares their tattoos on social media. Besides, we screened a small proportion of posts from the year 2021. Results for #covidtattoo in 2020 would be different, as vaccination was not available then. Topics, and sometimes even models, were recurrent. They summarize the key aspects of the pandemic: SARS‐CoV‐2 virus, vaccination, use of masks, involvement of healthcare providers, and lockdown. Some patients, who survived COVID‐19, engraved it for life in their skin, while some others prefer to remind of the 2020's toilet paper shortage in a humorous way. We even found a few tattoos with conspiracy theories' flavor. However, “mistakes” can be done. Vaccination brought hope, and some people were very quickly optimistic. People had tattooed their two first vaccination shots, without space for additional shots. Some foresaw the end of COVID‐19 after two shots of vaccination. Lastly, a few individuals had their own QR code tattooed after two shots. However, the QR code changes after the third shot and the final vaccination protocol is not yet established. COVID tattoos illustrate perfectly the milestones of the pandemic.