New Delhi:
Justin Bieber was recently diagnosed with Ramsay Hunt Syndrome
Justin Bieber was recently diagnosed with Ramsay Hunt Syndrome
which resulted in a partial facial paralysis. There were speculations doing round on the social media that this is the result of a possible reaction from a Covid-19 vaccine.
We were unable to find any positive resource on the internet that certified the claim
whether Justin Bieber actually took a shot of Covid-19 vaccine. So we went on to decipher the cause of Herpes Zoster following the inoculation. We came across a research paper which does not certify this claim but it certainly hints towards a possibility of this actually happening to a person.
Read this report to fully understand what the research was all about and what actually did it conclude in the end.
In a paper published on
PubMed Central
, titled “Herpes Zoster after COVID vaccination”, there are indications that it might be possible to reactivate the Varicella-Zoster virus (VZV) which substantially is the cause of the Herpes Zoster (HZ).
The vaccination programs against Covid-19 have been rolled out throughout the world, after the corona virus outbreak was initiated from Wuhan in China.
There are some commonly reported adverse effects like fever, nausea, myalgia, and fatigue. This is in concordance with the side-effects as mentioned in the product information for tozinameran
(the Pfizer BioNTech Covid-19 mRNA vaccine).
The paper had published two case studies which led to a rare side-effect in the form of Herpes Zoster (HZ) in two adults following the inoculation of tozinameran
.
Case 1:
A 29-year-old female healthcare professional with no noteworthy medical history, except for three instances of being diagnosed with chickenpox as a child, and once during her adolescence years. Although she was diagnosed with chickenpox 4 times, she was never diagnosed with Herpes Zoster (HZ).
She received her first dose of tozinameran for prevention against Covid19 on January 8, 2021. There were no adverse events reported until January 23 when she noticed painful grouped vesicles on the left lateral of the ox coccyges (dermatome S3). This is clinically diagnosed as Herpes Zoster (HZ).
However, she was inoculated with the second dose of vaccine on January 29. At that time there were traces of any relapse of Herpes Zoster (HZ) post the second dose was administered.
Two weeks later there was no relapse of Herpes Zoster (HZ) and the disease subsided without any medical intervention.
Female patient with grouped vesicles in dermatome S3
Case 2:
A 34-year-old male who had a medical history of ulcerative colitis for which he was taking prescribed drug
infliximab,
for almost 4-years without any infectious complications. He was also diagnosed with chickenpox as a child; however, he was never diagnosed with Herpes Zoster (HZ).
He was inoculated with the first dose on January 12, 2021, with no notable adverse reactions in the days that followed. On January 25, he noticed a painful and swollen inguinal lymph nodes, following which he saw a rash on his right leg. Following this, he visited the ER (Emergency Room), where a papulovesicular rash was identified in dermatome S2. The analysis of blood returned normal result. A PCR test which was done on vesical fluid returned a positive result for VZV.
He was prescribed to take valacyclovir; 1 gram thrice daily, for 10 days, and recovered completely. On February 2, he was inoculated with the second dose of vaccine without any further complications.
Further discussions
Herpes Zoster is characterised by multiple, painful, and/or itching unilateral vesicles and ulcerations, typically occurring in a single dermatome. The disease stays for 7 to 10 days, and recovery is possible without any sort of medical intervention.
Although it is a self-limiting disease, it can be progress to disseminated cutaneous eruptions, encephalomyelitis, and pneumonia, especially in immunocompromised individuals.
At the time of writing, the European EudraVigilance database had reported 4103 cases of HZ after receiving tozinameran, accounting for 1.3% of total reported events following this vaccination
.
For mRNA-1273 (the Moderna vaccine), 590 (0.7%) cases had been reported, for CHADOX1 NCOV-19 (the Oxford-AstraZeneca vaccine) 2143 (0.6%) cases, and for AD26.COV2.S (the Janssen vaccine) 59 cases (0.3%). The United States Vaccine Adverse Event Report System (VAERS) reported 2512 HZ cases (1.3% of total reported events) after tozinameran, 1763 (0.9%) after mRNA-1273, and 302 (0.7%) after AD26.COV2.S (
https://wonder.cdc.gov/vaers.html
https://wonder.cdc.gov/vaers.html
).
The Dutch pharmacovigilance center Lareb reported 300 cases (0.8% of total reported events) after vaccination with tozinameran (
https://coronameldingen.lareb.nl
https://coronameldingen.lareb.nl
). Whether these numbers are disproportionate or not requires further analysis. However, combined with the case reports describing HZ simultaneously with COVID-19 infection, the vaccination data do suggest a possible relationship.
HZ is caused by reactivation of VZV, which tends to remain in a latent state in the dorsal root ganglia of cutaneous nerve endings following a primary episode of chicken pox. Reactivation occurs when the immunological mechanisms that suppress VZV replication fail to contain the virus.
Classic risk factors include advanced age, use of immunosuppressant medication, immunocompromising conditions (e.g. HIV, autoimmune disease), and psychological stress. Both cases presented here had chicken pox in childhood, yet never suffered from HZ. While subject 2 had other risk factors for HZ (use of immunosuppressive agents), subject 1 did not. Both subjects received the vaccination as healthcare professionals and were completely free of any symptoms at the time of vaccination.
The occurrence of HZ after vaccination could be a simple coincidence
.
However, recent reports have described similar cases, mostly involving known risk factors for HZ reactivation.
Conclusion
In conclusion, two cases were reported who developed herpes zoster after vaccination with tozinameran. While frequently a harmless condition, disseminated zoster can have fatal consequences. In the context of vaccinating older and/or immunocompromised adults, our observations require further evaluation of the possible relationship between COVID-19 and herpes zoster.
Here is the link to the research paper.
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