Sex: M
Vaccine: COVID19
Symptoms: Antibody test, Herpes zoster
Clinical narrative: HZ dermatitis; This is a literature report for the following literature source(s): "Herpes zoster dermatitis in a COVID-19 vaccinated healthy man after 1 dose of varicella vaccine.", Case Reports, 2022; Vol:22, pgs:102-103, DOI:10.1016/j.jdcr.2021.12.043.  A 35-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history was not reported. Concomitant medication(s) included: VARIVAX [VARICELLA ZOSTER VACCINE LIVE (OKA/MERCK)] taken for immunisation as dose 1, single. Vaccination history included: Bnt162b2 (Dose 1), for COVID-19 immunization. The following information was reported: HERPES ZOSTER (medically significant), outcome "recovered", described as "HZ dermatitis". The patient underwent the following laboratory tests and procedures: Antibody test: no antivaricella IgG antibodies. Therapeutic measures were taken as a result of herpes zoster which includes Methocarbamol, topical diclofenac gel, and valacyclovir at 1 g thrice daily.  Publication: A 35-year old healthy man who presented with severe stinging pain from the right side of the abdomen to his back. He had received the first dose of the live attenuated varicella vaccine (VARIVAX) 3 weeks earlier because he was a health care worker with no antivaricella IgG antibodies. He had also received his second dose of the BioNTech-Pfizer COVID-19 vaccine 6 weeks earlier. At the time of presentation, the patient denied any recent trauma, medical or cosmetic procedures, or foreign travel. Methocarbamol and topical diclofenac gel were prescribed. Three days later, he developed multiple mildly tender plaques on an erythematous base corresponding to a T5 to T11 dermatomal distribution. He had no history of immunodeficiency, malignancy, or immunosuppressive therapy. He was initiated on valacyclovir at 1 g thrice daily. In 3 days, the erythema began to resolve. Both pain and rash completely resolved after 2 weeks. The authors report a case of HZ dermatitis after BioNTech- Pfizer and varicella vaccinations in an immunocompetent person who was previously seronegative and who had no history of chickenpox. In this case, the COVID-19 vaccination may have influenced the development of HZ after the varicella vaccination. The pathogenesis of this reaction is currently unclear, but it is possible that the immune dysregulation caused by the COVID-19 vaccine may have contributed to HZ after the varicella vaccine in the case.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Based on the information provided, known drug safety profile and plausible temporal association, the causality between the suspect drug and the event cannot be excluded. The impact of this report on the benefit-risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, ethics committees and investigators, as appropriate.