{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:33:21Z","timestamp":1794360801830,"version":"4.9.0"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>The term \u201cCOVID arm\u201d has been coined to describe a harmless delayed hypersensitivity reaction occurring approximately a week after administration of the novel SARS-CoV-2 mRNA vaccine. It appears as a red, warm, pruritic, indurated, or swollen area in the vicinity of the vaccine site. These reactions, especially if accompanied by systemic symptoms, have been mistaken for cellulitis. We report 3 cases of COVID arm, 2 of which were mistaken for cellulitis. Distinguishing features of COVID arm from cellulitis include pruritus as a common finding, occurrence approximately a week after vaccination, a lack of progression of symptoms, rapid response to topical steroids, and\/or spontaneous resolution usually over 4 to 5\u2009days.<\/jats:p>\n                  <jats:p>Practice Points:<\/jats:p>\n                  <jats:p>\u2022\u2003Patients receiving SARS-CoV-2 vaccines may experience delayed hypersensitivity reactions characterized by erythema, swelling, and itching occurring near the vaccination site (COVID arm), approximately a week after vaccination.<\/jats:p>\n                  <jats:p>\u2022\u2003Clinicians can distinguish SARS-CoV-2 vaccine reactions from cellulitis by the time of onset (approximately a week vs 5\u2009days), by the lack of progression of symptoms, and resolution over 4 to 5\u2009days.<\/jats:p>\n                  <jats:p>\u2022\u2003Severe cases of COVID arm may be treated with topical steroids.<\/jats:p>","DOI":"10.1177\/21501327211024431","type":"journal-article","created":{"date-parts":[[2021,6,12]],"date-time":"2021-06-12T04:27:48Z","timestamp":1623472068000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["COVID Arm: Delayed Hypersensitivity Reactions to SARS-CoV-2 Vaccines Misdiagnosed as Cellulitis"],"prefix":"10.1177","volume":"12","author":[{"given":"Aleksandra L.","family":"Lindgren","sequence":"first","affiliation":[{"name":"University of Queensland \u2013 Ochsner Clinical School, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Hui","family":"Austin","sequence":"additional","affiliation":[{"name":"Bay Area Cosmetic Dermatology, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-902X","authenticated-orcid":false,"given":"Kathleen M.","family":"Welsh","sequence":"additional","affiliation":[{"name":"Bay Area Cosmetic Dermatology, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,12]]},"reference":[{"key":"bibr1-21501327211024431","unstructured":"Vaccine Types. 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Emergency Use Authorization (EUA) of the Moderna COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19) in Individuals 18 Years of Age and Older [fact sheet]. Moderna US, Inc. 2021. https:\/\/www.fda.gov\/media\/144638\/download#page=2"},{"key":"bibr19-21501327211024431","unstructured":"U.S. Food and Drug Administration. Fact Sheet for Recipients and Caregivers. Emergency Use Authorization (EUA) of the Janssen COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19) in Individuals 18 Years of Age and Older [fact sheet]. Janssen Biotech, Inc. 2021. https:\/\/www.fda.gov\/media\/146305\/download"},{"key":"bibr20-21501327211024431","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1690"},{"key":"bibr21-21501327211024431","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1978.tb03759.x"},{"key":"bibr22-21501327211024431","unstructured":"Vaccine Safety and Monitoring - Delaware\u2019s Coronavirus Official Website. Delaware\u2019s Coronavirus Official Website. 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