{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:20:59Z","timestamp":1783520459807,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T00:00:00Z","timestamp":1675987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Reactivation of the scar resulting from intradermal injection of bacillus Calmette\u2010Gu\u00e9rin (BCG) is a common specific reaction in Kawasaki's disease. It has also sporadically been associated with viral infections, multisystem inflammatory syndrome in children, influenza vaccination and mRNA COVID\u201019 vaccination. In this case series, characteristics of BCG scar reactivation after different COVID\u201019 vaccinations are presented and possible mechanisms are discussed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected from the spontaneous reporting system of the Netherlands Pharmacovigilance Centre Lareb. Descriptives were made for the case reports in which a BCG scar reactivation was detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Since the start of the COVID\u201019 vaccination campaign in January 2021, the Netherlands Pharmacovigilance Centre Lareb has received 22 case reports of BCG reactivation after vaccination with a COVID\u201019 vaccine. In 20 case reports, it concerned mRNA COVID\u201019 vaccines Moderna (14) and Pfizer (6). In two case reports, the viral vector COVID\u201019 vaccine AstraZeneca was administered. Erythema and pain were the most frequently reported symptoms and the size of the inflammation was between 1.5 and 5 cm. BCG scar reactivation occurred with a median time to onset of 2 days after the second or booster COVID\u201019 vaccination, whereas the median time to onset was 7 days after the first COVID\u201019 vaccination. None of the BCG scar reactivations were treated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The exact mechanism of the occurrence of BCG scar reactivation remains unknown, but involvement of heat shock protein 65 is suggested. BCG scar reactivation is a nonserious, self\u2010limiting reaction that can occur after vaccination with both mRNA and viral vector COVID\u201019 vaccines.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15678","type":"journal-article","created":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T03:34:11Z","timestamp":1675136051000},"page":"2113-2121","source":"Crossref","is-referenced-by-count":4,"title":["A case series of bacillus Calmette\u2010Gu\u00e9rin scar reactivation after administration of both mRNA and viral vector COVID\u201019 vaccines"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3815-9434","authenticated-orcid":false,"given":"Leontine","family":"van Balveren","sequence":"first","affiliation":[{"name":"Netherlands Pharmacovigilance Centre Lareb  's\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eug\u00e8ne P.","family":"van Puijenbroek","sequence":"additional","affiliation":[{"name":"Netherlands Pharmacovigilance Centre Lareb  's\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Davidson","sequence":"additional","affiliation":[{"name":"Netherlands Pharmacovigilance Centre Lareb  's\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8965-3224","authenticated-orcid":false,"given":"Florence","family":"van Hunsel","sequence":"additional","affiliation":[{"name":"Netherlands Pharmacovigilance Centre Lareb  's\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)32661\u20101"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2035389"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101544"},{"key":"e_1_2_9_6_1","unstructured":"RIVM.Richtlijnen preventie BCG vaccinatie[updated 01\u201012\u2010202121\u201007\u20102022]. 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