Herpetic Eye Disease Following the SARS-CoV-2 Vaccinations

Abstract

Purpose: To describe herpetic ocular infections following SARS-CoV-2 vaccinations.

Methods: A retrospective study of herpetic ocular infections after BNT162b2mRNA vaccination and a literature review.

Results: A cohort of five patients: three varicella zoster virus (VZV) and two herpes simplex virus (HSV) cases, as well as 19 literature cases: 9 cases of VZV and 10 cases of HSV post BNT162b2mRNA, AZD1222, mRNA-1273, and CoronaVac vaccinations. All cases presented within 28 days post vaccination. Most VZV and HSV cases (15/19) reported in the literature presented post first vaccine dose, while in our cohort 2 VZV cases presented post second dose and both HSV cases and one VZV case post third dose. The most common presentations were HZO with ocular involvement and HSV keratitis. All eyes had complete resolution; however, one had retinal detachment and three corneal scars.

Conclusion: Herpetic ocular infections may develop shortly after SARS-CoV-2 vaccinations. Overall, the outcome is good.

Keywords: Herpes simplex virus; SARS-CoV-2 vaccinations; herpes zoster ophthalmicus; herpetic uveitis; keratitis; kertouveitis; ocular herpes; varicella zoster virus.