Herpetic Eye Disease After SARS-CoV-2 Vaccination: A CDC-VAERS Database Analysis

Area of Science:

• Ophthalmology
• Vaccinology
• Infectious Diseases

Background:

• Ophthalmic complications following SARS-CoV-2 vaccination, specifically herpes simplex ophthalmicus (HSO) and herpes zoster ophthalmicus (HZO), require thorough investigation.
• Understanding the incidence and clinical presentation of HSO and HZO post-vaccination is crucial for patient safety and vaccine surveillance.

Purpose of the Study:

• To evaluate the occurrence of herpes simplex ophthalmicus (HSO) and herpes zoster ophthalmicus (HZO) after SARS-CoV-2 vaccination.
• To analyze the clinical presentations and identify potential associations between vaccine types and ophthalmic outcomes.

Main Methods:

• Retrospective analysis of 1180 cases of HZO and HSO reported to the CDC VAERS between December 2020 and July 2022.
• Inclusion of patients vaccinated with BNT162b2, mRNA-1273, or Ad26.COV2.S, with descriptive analysis and statistical tests (ANOVA, Chi-squared, Kaplan-Meier) to assess associations.

Main Results:

• A total of 1180 cases (983 HZO, 180 HSO) were reported, with most cases occurring in women and after the first vaccine dose, predominantly within two weeks post-vaccination.
• The BNT162b2 vaccine was associated with the highest number of reported HZO and HSO cases.
• A significantly shorter onset interval for HZO was observed with BNT162b2, and a higher 30-day risk of HZO was noted compared to other vaccines.

Conclusions:

• Herpes simplex ophthalmicus and herpes zoster ophthalmicus are rare adverse events following SARS-CoV-2 vaccination.
• The study suggests a potential temporal association and a slightly elevated risk of HZO with the BNT162b2 vaccine.
• Further research is warranted to elucidate the immunological mechanisms underlying these ophthalmic conditions post-vaccination.