Reactivation of BCG vaccination scars after vaccination with mRNA-Covid-vaccines: two case reports

BMC Infectious Diseases

Anne Marie Rosendahl Madsen¹  Frederik Schaltz-Buchholzer¹  Christine Stabell Benn²  Anne Ostenfeld³  Mihai G. Netea⁴  Libin Mohamed⁵  Poul-Erik Kofoed⁵ 

[1] Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, 5000, Odense, Denmark;Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark and Odense University Hospital, 5000, Odense, Denmark;Danish Institute of Advanced Science, University of Southern Denmark, 5230, Odense, Denmark;Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, Dyrehavevej 29, 3400, Hilleroed, Denmark;Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands;Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany;Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark;

关键词: BCG;    mRNA Covid-19 vaccination;    Cross-reaction;    Case report;   

DOI  :  10.1186/s12879-021-06949-0

来源: Springer

【 摘 要 】

BackgroundFrom May 2020 to January 2021, we enrolled 1233 health care workers (HCW) from Danish Hospitals in a randomized trial evaluating whether Bacille Calmette-Guérin (BCG) provides protection against COVID-19. Participants were randomized 1:1 to BCG vs saline and followed for 6 months. From December 2020, Covid-19 vaccines were offered to the HCW. In most cases, BCG vaccination results in a characteristic scar. Reactivation of the BCG scar has been described in children during viral infections and following influenza vaccination, but is mostly associated to Kawasaki’s disease, a disease entity with pathogenesis likely similar to the child Covid-19 complication MIS-C: Multi-System Inflammatory Syndrome. Reactivation of scars after neonatal BCG vaccination has recently been described in four women after Covid-19 mRNA vaccination. Two of our trial participants experienced reactivation of their novel BCG scars after receiving mRNA Covid-19 vaccination 6 to 8 months post-BCG.Case presentationsTwo female HCW participants that had been randomly allocated to BCG in the BCG-DENMARK-COVID trial, spontaneously reported itching and secretion at the BCG scar site after having received mRNA Covid-19 vaccination (Moderna and Pfizer-BioNTech) 6 to 8 months following inclusion and BCG vaccination. One participant, who had a larger BCG skin reaction, noticed re-appearing symptoms after both the first and the second COVID-vaccine dose, while the other participant only noted symptoms after the second dose. Both had been BCG vaccinated during childhood, and no reactivation was noted in the older scars. No treatment was needed or provided.ConclusionsThe reactivation of the BCG scar after receiving mRNA vaccine might have been caused by cross-reactivity between BCG and SARS-CoV-2. In both cases, the symptoms were bothersome, but self-limiting and left no sequelae. The risk of reactivation at the scar site is thus not a reason to avoid vaccination with either vaccine.

【 授权许可】

CC BY