This Month in JAAD International: August 2022: Cutaneous reactions to COVID-19 messenger RNA booster dose vaccination.

This month in JAAD International, Prasad et al describe the range of cutaneous reactions to the third dose of messenger RNA SARS-CoV-2 vaccine using the American Academy of Dermatology or International League of Dermatologic Societies registry. The authors present their data as a follow-up to earlier registry-based results that highlighted a range of cutaneous reactions, none of which were considered life threatening. In this manuscript, the authors specifically address cutaneous reactions to third (booster) dose vaccination, noting that only 49 out of 1000 records in their dataset reflected information on booster dose vaccination. Of these 49, 73% had reactions to the booster dose, and 72% of those with reactions to the booster dose reacted only to the booster dose, after having no reaction to the first 2 doses of the vaccine.

Far more is unknown than known about the cutaneous reactions to SARS-CoV-2 vaccines, and although registry-based studies have many shortcomings, they may provide insights for future work. These data suggest 3 useful takeaway points for our patients and colleagues. First, although cutaneous reactions occur, they are rarely serious. Second, cutaneous reactions are not a contraindication to future vaccination. Third, most patients in whom a reaction to the booster dose developed reacted to the booster dose alone, suggesting that a history of no cutaneous reactions to vaccination is not a guarantee of no reactions in the future. More research is needed in this important area, particularly given the varied presentation of cutaneous reactions , and the theoretical potential for such visually dramatic reactions to contribute to vaccine hesitancy.

Conflicts of interest

None disclosed.