"Original Antigenic Sin" in SARS-CoV-2 Vaccination Followed by Infection

• Published in: Curēus (Palo Alto, CA) Vol. 14; no. 12; p. e32548
• Main Authors: Castillo-Aleman, Yandy M, Villegas-Valverde, Carlos A, Ventura-Carmenate, Yendry, Suarez-Formigo, Gisela M, Bencomo-Hernandez, Antonio A
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 15.12.2022; Cureus
• Subjects: Allergy/Immunology; Antibodies; Antigens; Asthma; Case reports; Coronaviruses; COVID-19 vaccines; Immunology; Infections; Infectious Disease; Internal Medicine; Pandemics; Pathogens; Pruritus; Severe acute respiratory syndrome coronavirus 2; Stem cells; Abu Dhabi United Arab Emirates; United Arab Emirates; covid-19; antigenic variation; vaccine; adverse events; sars-cov-2
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.32548

Although the (OAS) effects have been predicted against new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), only a few pieces of evidence are available regarding its impact on the safety and effectiveness of coronavirus disease 2019 (COVID-19) vaccines. This article aims to provide an immunological explanation for the delayed side effects of a SARS-CoV-2 vaccine during an episode of natural infection. We reported a case of a 39-year-old male healthcare worker who complained about pruritus and discomfort around the injection site of an inactivated SARS-CoV-2 vaccine administrated 18, 17, and 13 months earlier. Those symptoms resembled the side effects previously experienced with one of the booster doses, and a sole erythematous papule was also documented. The patient was diagnosed with COVID-19 one or two days after noticing these local signs and symptoms, and high serum titers of immunoglobulin M (IgM) and immunoglobulin E (IgE) were found five weeks after the onset, along with SARS-CoV-2-specific immunoglobulin G (IgG) antibodies. Therefore, the OAS might be a plausible phenomenon to consider in individuals immunized with inactivated vaccines and exposed secondarily to a wild virus with antigenic variations.