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Case Reports
. 2021 Jul 15;110(4):957-961.
doi: 10.1016/j.ijrobp.2021.02.048. Epub 2021 Mar 4.

COVID-19 Vaccine-Induced Radiation Recall Phenomenon

Viacheslav Soyfer  1 , Orit Gutfeld  2 , Sivan Shamai  3 , Albert Schlocker  2 , Ofer Merimsky  3
Affiliations
Case Reports

COVID-19 Vaccine-Induced Radiation Recall Phenomenon

Viacheslav Soyfer et al. Int J Radiat Oncol Biol Phys. .

Abstract

Radiation recall phenomenon (RRP) is an uncommon, late occurring, acute inflammatory skin reaction that emerges in localized areas coincident with previously irradiated radiation therapy (RT) treatment fields. RRP has been known to be triggered by a number of chemotherapy agents. To the best of our knowledge, this report is the first description of RRP after administration of the Pfizer-BioNTech vaccine for COVID-19, or any other currently available vaccine against COVID-19. Acute skin reactions were observed in 2 RT patients with differing timelines of RT and vaccinations. In both cases however, the RRP presented within days of the patient receiving the second dose of vaccine. For each RT course, the treatment planning dosimetry of the radiation fields was compared with the area of the observable RRP. RRP developed within the borders of treatment fields where prescription dose constraints were prioritized over skin sparing. Our observation is currently limited to 2 patients. The actual incidence of RRP in conjunction with Pfizer-BioNTech vaccine or any other vaccine against COVID-19 is unknown. For patients with cancer being treated with radiation with significant dose to skin, consideration should be given to the probability of RRP side effects from vaccinations against COVID-19.

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Figures

Fig. 1
Fig. 1
(a) Posterior chest wall treatment plan (Patient 1). (b) Acute skin reaction after COVID-19 vaccination (Patient 1).
Fig. 2
Fig. 2
Stereotactic body radiation therapy (SBRT) dose distributions for lung treatments (Patient 1).
Fig. 3
Fig. 3
Timeline for Patient 1.
Fig. 4
Fig. 4
Lumbar spine treatment plan—oblique fields (Patient 2).
Fig. 5
Fig. 5
(a) Anterior chest wall treatment plan (Patient 2). (b) Acute skin reaction after COVID-19 vaccination (Patient 2).
Fig. 6
Fig. 6
Timeline for Patient 2.
See this image and copyright information in PMC

Comment in

  • Radiation Recall Phenomenon Following COVID-19 Vaccination.
    Stewart R, McDowell L. Stewart R, et al. Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3):835-836. doi: 10.1016/j.ijrobp.2021.06.023. Epub 2021 Jun 18. Int J Radiat Oncol Biol Phys. 2021. PMID: 34153381 Free PMC article. No abstract available.
  • In Regard to Soyfer et al.
    Ebner DK, Geno CS, Ma DJ. Ebner DK, et al. Int J Radiat Oncol Biol Phys. 2022 Mar 1;112(3):834-835. doi: 10.1016/j.ijrobp.2021.11.005. Int J Radiat Oncol Biol Phys. 2022. PMID: 35101198 Free PMC article. No abstract available.

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