The COVID-19 Vaccine Blind Spot

According to a global survey undertaken by Ipsos, the number of people who would be vaccinated with a COVID-19 vaccine outweighs the number who wouldn't in most countries, but some European countries ranked quite low in terms of public confidence in vaccine safety (5). [...]overcoming misgivings and improving confidence in vaccination programmes are of critical importance to ensure overall success. [...]this complacency may be a result of the eradication of certain diseases, such as polio and smallpox, which could lead to forgetfulness as to how vaccines are effective tools in epidemics.

Primary immunodeficiency associated with a SAMD9L mutation

Background: SAMD9L is a tumor suppressor involved in regulating the proliferation and maturation of cells, particularly those derived from the bone marrow, and appears to play an important role in cerebellar function. It can be activated in hematopoietic stem cells by type I and type II interferons. It has been hypothesized to act as a critical antiviral gatekeeper regulating interferon dependent demand driven hematopoiesis. Gain of function mutations can present with an immunodeficiency due to transient severe cytopenias during viral infection. Case presentation: We report a 3-year-old boy born full term with a history of severe thrombocytopenia requiring transfusions, developmental delay, ataxia, seizure disorder, and recurrent severe respiratory viral infections. His infectious history was significant for respiratory syncytial virus with shock requiring extracorporeal membrane oxygenation complicated by cerebral infarction and a group A streptococcus empyema, osteomyelitis requiring a left below the knee amputation, and infections with rhinovirus, COVID-19, and parainfluenza requiring hospitalizations for respiratory support. Initial immunologic evaluation was done during his hospitalization for parainfluenza. His full T cell subsets was significant for lymphopenia across all cell lines with CD3 934/microL, CD4 653/microL, CD8 227/microL, CD19 76/microL, and CD1656 61/microL. His mitogen stimulation assay to phytohemagglutinin and pokeweed was normal. Immunoglobulin panel showed a mildly decreased IgM of 25 mg/dL, but normal IgA and IgG. Vaccine titers demonstrated protective titers to 12/22 pneumococcus serotypes, varicella, diphtheria, mumps, rubella, and rubeola. Repeat full T cell subsets 6 weeks later revealed marked improvement in lymphocyte counts with CD3 3083/microL, CD4 2101/microL, CD8 839/microL, CD19 225/microL, and CD1656/microL. A primary immunodeficiency genetic panel was ordered and positive for a heterozygous SAMD9L c.1549T>C (p.Trp517Arg) mutation classified as a variant of unknown significance. Discussion(s): This patient's history of severe viral infections, ataxia, thrombocytopenia, and severe transient lymphopenia during infection is suggestive of a SAM9DL gain of function mutation. Protein modeling done by the laboratory suggests this missense mutation would affect protein structure. The mutation found has been observed in individuals with thrombocytopenia. This case highlights the importance of immunophenotyping both during acute illness and once recovered.Copyright © 2023 Elsevier Inc.

Viruses and the risk of lung cancer: prevention and treatment

Lung cancer is the most common cancer in males and the second most common among females both in Europe and worldwide. Moreover, lung cancer is the leading cause of death due to cancer in males. The European region accounts for 23% of total cancer cases and 20% of cancer-related deaths. Relationships have been described between a number of infectious agents and cancers, but our knowledge of the role of viruses, both respiratory and systemic, in the pathogenesis of lung cancer is still rudimentary and has been poorly disseminated. In this chapter, we review the available evidence on the involvement of HPV, Epstein-Barr virus, HIV, cytomegalovirus and measles virus in the epidemiology and pathogenesis of lung cancer.Copyright © ERS 2021.

It's Worth a Shot

The presentation contained information about the virus, how it spreads, the vaccine, who should and should not take it, when it is recommended to be taken, how it invokes an immune response on a cellular level, and what role protein synthesis plays in the vaccine. Students and their partners were given one of seven viruses to research: measles, mumps, rubella, influenza, hepatitis B, rabies, or COVID-19. Students researched the disease and its vaccine type using credible sources, such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), Johns Hopkins University, etc. Students answered the following questions: * How does the virus spread? * What are the symptoms of the virus? * How common is the virus? (statistical number) * What does the virus look like? (include picture with antigens shown) * When is the vaccine recommended by the CDC? * How often does the booster for the vaccine need to be taken? * Who should not receive the vaccine? * How does the vaccine work on a cellular level? (Be specific about the type of vaccine and how it invokes an immune response) * What role does protein synthesis play in the vaccine? * What is the vaccine efficacy or effectiveness? * Does the vaccine do any of the following: * Change the host cell's DNA? * Give the person the disease?

UNICEF highlights urgent need to resume child immunizations

UNICEF states more data collection is needed to better monitor vaccine confidence on a broader level. According to the report, lessons can be learned from the pandemic, as "vast resources can be mobilized, and new vaccines can be developed rapidly and introduced around the world," authors wrote. According to the report, a similar effort is needed now.

Treating pneumothorax . . . and other stories

[...]a longitudinal study from Australia finds little convincing evidence that there are any long term implications for mental health (Arch Dis Child doi:10.1136/archdischild-2019-318014). At the age of 10, children who had persisting severe sleep problems in their first year were no more likely to meet diagnostic criteria for a psychiatric disorder than a comparison group of children who slept well as infants. A retrospective analysis of electronic health records from the US identified several features of viral pharyngitis, which the investigators believe are reliable enough to identify children in whom testing for streptococcal infection can be avoided (J Pediatr doi:10.1016/j.jpeds.2020.01.030).

Epidemiological and Clinical Characteristics of Measles in Jinan, Shandong Province, China, from 1991 to 2022.

Objective: This study aimed to analyze the epidemiological and clinical characteristics of measles in Jinan, Shandong, China, over a 32-year stage to facilitate measles prevention in the future. Methods: Data on measles cases from 1991 to 2022 were obtained from the public health department and medical records of patients at Shandong Public Health Clinical Center. Retrospective analysis was conducted on the distribution of measles cases in different years, months, and age groups, and observation of the differences in clinical manifestations and complications among different age groups. Results: From January 1991 to December 2022, 7531 measles cases were recorded at Shandong Public Health Clinical Center. During the 32-year period, there were two outbreaks of measles in 2008 and 2016, respectively. During the COVID-19 pandemic period from 2020 to 2022, the number of cases reached the lowest point in the past 30 years. The number and percentage of cases in the 0-1y groups was significantly higher than in other age groups, and 97.75% patients in this group did not receive measles vaccine. Complications such as pneumonia and myocarditis appeared more frequent in patients under 12 years of age, but liver function damage is more common in adult patients. Conclusion: Although the measles epidemic has been greatly controlled since the use of measles vaccine, intermittent outbreaks still exist, so there is still a long way to go to eliminate measles. The proportion of infants under the age of 1 without measles vaccine and adults over 24 years old accounts for nearly 80% of the total. This group of people should be of concern, and feasible measures should be designated to protect these susceptible populations.

Dengue virus, measles, TBI and TB disease: Are they being overlooked because of the pandemic?

[...]many elementary and secondary schools were closed in 2020;when they reopened in 2021, masks and social distancing were in place. [...]these factors may have significantly reduced children and unvaccinated families from contracting and spreading the measles virus. Pediatric tuberculosis A diagnosis of pediatric tuberculosis (TB), for either latent TB (referred to as tuberculosis infection [TBI]7) or TB disease (active TB), is made for patients aged less than 15 years who have either a positive tuberculin skin test or a positive interferongamma release assay.7,8 Both tests have a high positive predictive value when used for children who have had a direct contact exposure to an adult with TB disease.7 Infants and young children are at increased risk of developing life-threatening forms of the disease, including TB meningitis and disseminated TB, compared with older children and adults.8 The greatest numbers of TB cases occur in children under 5 years old, with 38% of pediatric cases occurring within this age range.7 In addition, in 2020, 28% of the 10- to 14-year-old population had a diagnosis of pediatric TB.8 Data from TB cases in children aged less than 18 years living in the United States from 2010 to 2017 revealed that 32% of children with TB disease were born in other countries.9 Adults who have the TB bacterium, Mycobacterium tuberculosis, spread the organism via airborne transmission by coughing, speaking, or singing. [...]children with pediatric TB do not spread the organism as readily as adults, because pediatric TB is less infectious than the adult form.8 Children may present with a cough, weakness, weight loss, fever, change in playtime behaviors, and/or night sweats.8 Children younger than 4 years are at the highest riskof progressing from TBI to TB disease, with data showing a risk of 40% to 50% for infants less than 1 year old and 25% for 1- to 2-year-olds.8 However, children with a diagnosis of TBI who receive drug therapy and whose parents adhere to the regimen have a 90% reduced risk of developing TB disease.8 Adolescents older than 12 years have a risk of progression to adult-type TB disease. Providers need to be aware that the Centers for Disease Control and Prevention does not recommend the 4-month rifapentine-moxifloxacin TB regimen for children younger than 12 years.8 Best practices for pediatric providers include consulting a TB expert prior to beginning the treatment course, based on the available data showing that young children have a high risk of developing life-threatening TB disease.8 Conclusions Pediatric health care providers are on the frontlines for identifying infectious diseases and, to prevent poor outcomes, must react quickly to diagnose and treat cases in children and adolescents.

Re-Emergence of Measles

In 2018-19, even before the pandemic, the world experienced major outbreaks of measles with 140,000 reported deaths mostly in low income countries where children suffer from malnutrition and overcrowding. In areas recovering from natural disasters and conflict areas and most children remain unvaccinated, outbreaks occur. The Philippines suffered similarly, with a devastating outcome and deaths of more than 800 children, even adults, in more than 40,000 hospitalized cases reported in 2019 over a 2 month period. A massive loss of vaccine confidence in 2018, brought about by the controversial introduction of a dengue vaccine reduced childhood vaccination coverage at an all-time low of 40-50%. Previous rates were in the 80-90% and measles was almost on the verge of elimination with no deaths and no cases between 2005-2009. The basic elements of complacency, convenience and confidence plus frequent occurrence of natural disasters over the years contributed much to these measles outbreaks. As a strategy, the government went into a massive supplementary immunization program with measles campaign including home visits to prevent another outbreak in the next 2 years after the pandemic begun. It has been implemented but targets are still wanting. The lessons learned from Measles resurgence are echoing all throughout the world and as the global response to the COVID19 continues, the measles as well as polio and other vaccine- preventable diseases need to be addressed with strategies that each country would find appropriate for them. Without sustained attention, the gains that have been achieved previously could easily get lost.Copyright © 2023

Systemic Viral Infections and the Eye

Ocular manifestations of systemic viral infections are common. Because viral infection syndromes may be nonspecific, diagnosis of a particular viral infection often requires understanding of the risk factors and transmission modes of viral pathogens. Careful review of both history of the disease and the ocular exam findings can be helpful in narrowing down the differential diagnosis for the systemic condition and vice versa. A history of exposures, including animal exposures, sexual exposures, and travel, as well as the vaccination history and general medical history helps guide the workup and treatment of viral infections. Diagnostic testing for viral infections may include blood testing for serologic studies and viral detection, samples from involved extraocular organs, as well as ocular samples that can confirm a diagnosis and facilitate initiation of optimal therapy while minimizing side effects from exposure to unnecessary antiviral agents. Importantly, patients with HIV or other immunocompromising conditions may simultaneously have more than one active infection and also may manifest with syndromes that are atypical and have serologic testing that is less accurate. Careful and aggressive diagnostic evaluation of ocular symptoms is especially important in these patients, as are efforts to improve immune function while monitoring for the possible impact of immune reconstitution on the clinical course. © Springer Nature Switzerland AG 2022.

Pandémie de rougeole, 1988-1992. Virus, vaccinations de masse et vulnérabilités contemporaines

At the turn of the 1990s, measles swept the world. Vaccine-preventable since 1963, the "first disease" is nevertheless one of the great absentees of a pandemic century that is slow to come to an end, if not to make it the incarnation of a rampant anti-vaccinationism. Through a chronicle of the "crisis" of 1988‑1992, we will return to the process of coproduction between the infection and the technologies that protect against it. In particular, we will address the social dimension of the viral infection in order to understand why mass vaccination, at the heart of a strong eradication effort, is not enough to revent measles and even contributes to increasing health inequalities that influence its epidemiology in return. The COVID‑19 experience urges us to conduct this kind of retrospective work and to mobilize history as a discipline of public health to better understand the place of vaccination in the viral and contagious past and present. WHO documentation, scientific literature and ethnographic fieldwork will together force an "equal" approach to the spaces and actors involved, bringing together very local experiences and international policies to reveal the pitfalls of an ultratechnologized and very vertical global (public) health.Alternate :A principios de los años 1990, el sarampión asoló al mundo. Evitable con la vacuna desde 1963, la «primera enfermedad» es sin embargo una de las grandes ausentes de un siglo pandémico que tarda en acabarse, si no es para encarnarse en una anti-vacunación galopante. A través de una crónica de la «crisis» de 1988-1992, retornaremos el proceso de coproducción entre la infección y las tecnologías de protección. Abordaremos en particular la dimensión social de la infección viral para comprender por qué la vacunación masiva, en el centro de una campaña de erradicación apoyada, no basta para evitar el sarampión e incluso contribuye al aumento de ciertas desigualdades en salud que influyen sobre su epidemiología. La experiencia de la COVID‑19 nos exhorta a realizar este tipo de trabajo retrospectivo y a movilizar la historia de la salud pública para comprender mejor el lugar de la vacunación en el pasado y el presenta viral y contagioso. Documentos de la Organización Mundial de la Salud (OMS), literatura científica y trabajo de campo etnográfico contribuirán conjuntamente a una perspectiva «a partes iguales» de los espacios y los actores para mostrar los obstáculos de una salud (pública) global ultra-tecnologizada y muy vertical.Alternate :Au tournant des années 1990, la rougeole a balayé le monde. Évitable par la vaccination depuis 1963, la « première maladie » est pourtant une des grandes absentes d'un siècle pandémique qui tarde à s'achever, si ce n'est pour en faire l'incarnation d'un antivaccinationisme rampant. Au travers d'une chronique de la « crise » de 1988-1992, nous reviendrons sur le processus de coproduction entre l'infection et les technologies qui en protègent. Nous aborderons plus particulièrement la dimension sociale de l'infection virale pour comprendre pourquoi la vaccination de masse, au coeur d'une entreprise d'éradication appuyée, ne suffit pas à éviter la rougeole et participe même à accroître certaines inégalités en santé qui influent sur son épidémiologie. L'expérience de la COVID‑19 nous exhorte à mener ce genre de travail rétrospectif et à mobiliser l'Histoire en discipline de santé publique pour mieux saisir la place de la vaccination dans le passé et le présent viraux et contagieux. Documentation de l'OMS, littérature scientifique et terrain ethnographique forceront ensemble une approche « à parts égales » des espaces et des acteurs concernés, faisant dialoguer les expériences très locales et les politiques internationales pour révéler les écueils d'une santé (publique) globale ultra-technologisée et très verticale.

Outbreaks of different viral etiologies amidst COVID-19 pandemic

The COVID-19 pandemic has severely affected public health system and surveillance of other communicable diseases across the globe. The lockdown, travel constraints and COVID phobia turned down the number of people with illness visiting to the clinics or hospitals. Besides this, the heavy workload of SARS-CoV-2 diagnosis has led to the reduction in differential diagnosis of other diseases. Consequently, it added to the underlying burden of many diseases which remained under-diagnosed. Amidst the pandemic, the rise of emerging and re-emerging infectious diseases was observed worldwide and reported to the World Health Organization i.e., Crimean Congo Hemorrhagic Fever (2022, Iraq;2021 India), Nipah virus (2021, India), Zika virus (2021, India), and H5N1 influenza (2021, India), Monkeypox (2022, multicountry outbreak), Ebola virus disease (2022, DRC, Uganda;2021, DRC, Guinea;2020, DRC), Marburg (2022, Ghana;2021, Guinea), Yellow fever (2022, Uganda, Kenya, West and Central Africa;2021, Ghana, Venezuela, Nigeria;2020, Senegal, Guinea, Nigeria, Gabon;2020, Ethiopia, Sudan, Uganda), Dengue (2022, Nepal, Pakistan, Sao Tome, Temor-Leste;2021, Pakistan), Middle east respiratory syndrome coronavirus (2022, Oman, Qatar;2021, Saudi Arabia, UAE;2020, Saudi Arabia, UAE), Rift valley fever (2021, Kenya;2020, Mauritania), wild poliovirus type 1 (2022, Mozambique), Lassa fever (2022, Guinea, Togo, Nigeria;2020, Nigeria), Avian Influenza (H3N8) (2022, China), Avian Influenza (H5N1) (2022, USA), H10N3 influenza (2021, China), Hepatitis E virus (2022, Sudan), Measles (2022, Malawi, Afghanistan;2020, Burundi, Mexico), Mayaro virus disease (2020, French Guiana), Oropouche virus disease (2020, French Guiana). All these diseases were associated with high morbidity and burdened the public health system during the COVID-19 pandemic. During this critical public health menace, majority of the laboratory workforce was mobilized to the SARS-CoV-2 diagnosis. This has limited the surveillance efforts that likely led to under diagnosis and under-detection of many infectious pathogens. Lockdowns and travel limitations also put a hold on human and animal surveillance studies to assess the prevalence of these zoonotic viruses. In addition, lack of supplies and laboratory personnel and an overburdened workforce negatively impacted differential diagnosis of the diseases. This is especially critical given the common symptoms between COVID-19 and other pathogens causing respiratory illnesses. Additionally, the vaccination programs against various vaccine preventable diseases were also hampered which might have added to the disease burden. Despite these challenges, the world is better prepared to detect and respond to emerging/re-emerging pathogens. India now has more than 3000 COVID-19 diagnostic laboratories and an enhanced hospital infrastructure. In addition, mobile BSL-3 facilities are being validated for onsite sampling and testing in remote areas during outbreak situations and surveillance activities. This will undoubtedly be valuable as the COVID-19 pandemic evolves as well as during future outbreaks and epidemics. In conclusion, an increase in the emergence and re-emergence of viruses demonstrates that other infectious diseases have been neglected during the COVID-19 pandemic. Lessons learned from the infrastructure strengthening, collaborations with multiple stakeholders, increased laboratory and manufacturing capacity, large-scale COVID-19 surveillance, extensive network for laboratory diagnosis, and intervention strategies can be implemented to provide quick, concerted responses against the future threats associated with other zoonotic pathogens.

Evolution in Infectious Causes of Death in Liveborn Children in a Major Tertiary Children's Hospital: A Retrospective Autopsy Review of over 1200 Cases

Background: Infections have historically been a leading cause of death, particularly in children. Medical advances, including vaccines and antimicrobials, have significantly decreased infection-related deaths, but infections remain a cause of pediatric mortality, especially in premature infants. The types of infections implicated in childhood deaths have changed with these advances, for example, meningitis and meningococcal infections were leading causes in 1981 but not in the later period. The incidence and etiologies of infection- related deaths may be altered by major events that modify not only medical practices but also societal attitudes and activities. Examples of such events include the HIV/AIDS epidemic that began in the early 1980s and the more recent COVID-19 pandemic. In order to investigate changes in infection-related pediatric deaths over time, we analyzed and compared autopsy cases performed during 5-year span prior to both the HIV/AIDS epidemic and the COVID-19 pandemic in which infections contributed to death. Method(s): Review of all autopsy cases performed at our institution between 1/1/1975-1/1/1980 and between 1/1/2015-1/1/2020 was performed to identify cases in which infection directly contributed to death, comprising 1262 cases. Only liveborn children were considered, and neonatal sepsis from amniotic sac infections was excluded. Comparison of decedent characteristics and infectious etiologies between the two time periods was performed, identifying age, race, sex, gestational age (for decedents less than 3 months of age), and etiologic class of agent (bacterial, viral, fungal or parasitic). TORCH infections and vaccine-preventable illnesses were specifically assessed. Proportions were compared using 1 (assessing TORCH, vaccine-preventable, and prematurity deaths)- or 2-tailed (all others) z-tests, with significance calculated at the < 0.05 level. Result(s): In the 1970s cohort, 300 infectious autopsy cases were identified in liveborn children;73 were identified in the 2010s. Compared to the 2010s cohort, the 1970s decedents were more likely to be white (85% v 53%, p=0.012), comprise children aged 1-5 and 13+ (22% v 6.8% [p=0.003] and 16.4% v 8.3% [p=0.036]), and were less likely to be premature (66.7% v 80.4%, p=0.039). Vaccine-preventable illnesses (for example: measles) accounted for 36 deaths in the 1970s cohort but only 2 in the 2010s cohort (p=0.009). Thirteen children died of TORCH infections (CMV, toxoplasmosis and HSV) versus 5 in the 2010s (CMV and HSV), which did not reach statistical significance. Conclusion(s): Pediatric mortality secondary to infections has decreased significantly compared to fifty years ago, especially in younger children and in relation to vaccine-preventable infections such as meningococcal disease. This drop is largely attributed to medical advances, including vaccines and antimicrobial medications. Additional contributing factors could include practices adopted post-HIV/AIDS, especially in the community. Further exploration of how such changes in medical and social practice impacted mortality and comparing them to changes occurring in the intra/post-COVID-19 era, is helpful. Yet, with the increased survival of premature infants, they remain at risk of devastating consequences from infections.

Covid-19 Infection Presenting as Acute Pancreatitis

Purpose of study Introduction COVID-19 emerged at the end of 2019 as an epidemic of respiratory disease in Wuhan, China that later spread globally and was declared as pandemic. The common clinical manifestations of COVID-19 infection include fever, cough, myalgias, headache, sore throat, anosmia, nasal congestion, fatigue and chest pain. The most serious complications include bilateral multifocal pneumonia and acute respiratory distress syndrome. Acute pancreatitis is rarely reported in association with COVID-19 infection. We report a case of acute pancreatitis secondary to COVID-19 infection. Case Report: A 69-year-old man with past medical history of hyperlipidemia and seizure disorder presented with two days of epigastric pain radiating to back. The patient reported fever, malaise and dry cough for the last 3 days. Home medication included atorvastatin and carbamazepine for 10 and 15 years respectively. The patient denied smoking and alcohol use. COVID- 19 PCR was positive. Labs showed WBC of 3800/muL, hgb 11.8 g/dL, calcium 8.4 mg/dL , lipase 426 U/L, D-Dimer 179 ng/ml DDU, High sensitivity C-reactive protein 27.5 mg/L (normal <5 mg/L) ALT 26 U/L, AST 31 U/L, alkaline phosphatase 103 U/L and total bilirubin 0.3 mg/dL. Ultrasound of the right upper quadrant and CT abdomen showed normal pancreas, common bile duct and gallbladder with no evidence of gallstones. Triglyceride level was 70 mg/dL (<149 mg/dL) on the lipid panel. The patient was diagnosed with acute pancreatitis and received treatment with IV fluids and pain medication. The symptoms improved gradually and the patient was discharged home with resumption of home medications. Methods used Case Report Summary of results The common differentials for acute pancreatitis include alcohol use, gallstones, hypertriglyceridemia, viral infections like mumps and measles, hypercalcemia and medication-related, etc. Normal AST, ALT, alkaline phosphatase and total bilirubin along with absence of gallstones and normal common bile duct ruled out alcoholic and biliary pancreatitis. Normal calcium level and triglyceride level rule out hypercalcemia and hypertriglyceridemia as the cause of pancreatitis. Carbamazepine has rarely been reported to cause acute pancreatitis typically soon after the initiating the therapy or with increase in the dose. The use of carbamazepine for more than 15 years without any recent dose change makes this unlikely as the cause of pancreatitis. The onset of acute pancreatitis during the timeline of COVID-19 constitutional symptoms and absence of other risk factors suggests that COVID-19 infection is responsible for acute pancreatitis in our patient. Conclusions We report a case of acute pancreatitis secondary to COVID-19 infection. Further studies are warranted to better understand the etiology and the pathophysiology of acute pancreatitis secondary to COVID-19 infection.

Erlang-Distributed SEIR Epidemic Models with Cross-Diffusion

We explore the effects of cross-diffusion dynamics in epidemiological models. Using reaction–diffusion models of infectious disease, we explicitly consider situations where an individual in a category will move according to the concentration of individuals in other categories. Namely, we model susceptible individuals moving away from infected and infectious individuals. Here, we show that including these cross-diffusion dynamics results in a delay in the onset of an epidemic and an increase in the total number of infectious individuals. This representation provides more realistic spatiotemporal dynamics of the disease classes in an Erlang SEIR model and allows us to study how spatial mobility, due to social behavior, can affect the spread of an epidemic. We found that tailored control measures, such as targeted testing, contact tracing, and isolation of infected individuals, can be more effective in mitigating the spread of infectious diseases while minimizing the negative impact on society and the economy.

Cutaneous reactions associated with vaccination against SARS-CoV-2.

BACKGROUND: Since the first reports in November 2019, coronavirus 2 has represented a priority health problem causing severe acute respiratory syndrome and other extrapulmonary manifestations, originating a pandemic with millions of deaths. Therefore, vaccines represent the most effective means of controlling the COVID-19 pandemic. Skin reactions to COVID-19 mRNA vaccines have been observed. The objective of this paper is to evaluate the morphology of the cutaneous manifestations and to carry out a review on the current recommendations for their management. CLINICAL CASE: Case 1: A 25-year-old male patient who presented a morbilliform rash after the first dose of the Pfizer vaccine against SARS-CoV-2, which remitted without sequelae at 24 hours. Case 2: A 65-year-old female patient with erythema at the puncture site 10 days after the first dose of the Modern vaccine against SARS-CoV-2 with complete remission on the 4th day after its onset. CONCLUSION(S): Some of the dermatological manifestations to the mRNA COVID-19 vaccines were identified as mimicking the SARS-CoV-2 infection itself. As the administration of vaccines increases, it is essential to recognize and understand their adverse effects.Copyright © 2022 Comunicaciones Cientificas Mexicanas S.A. de C.V.. All rights reserved.