A narrative review and clinical anatomy of herpes zoster infection following COVID-19 vaccination

Clin Anat. 2022 Jan;35(1):45-51. doi: 10.1002/ca.23790. Epub 2021 Oct 1.


Introduction: In this review, cases of herpes zoster (HZ) infection following receipt of COVID-19 vaccines will be analyzed. We also present two cases of oral HZ following the COVID-19 vaccine and discuss this clinical anatomy.

Materials and methods: A database search using PubMed was conducted in August 2021 and 20 articles were found to be eligible for review. Patient data and vaccine information were analyzed. In addition, two cases of oral HZ infection following the receipt of COVID-19 vaccines are presented.

Results: A total of 399 cases were identified. The affected dermatomes mimicked the regular distribution of HZ. For the dermatomes of the face, the various reports used different ways to describe the areas involved; CNV, CNV1, CNV2, CNV3, lower jaw, forehead, and under the eyebrow (CNV, 2 cases; CNV1, 4 cases; CNV2, 3 cases; and CNV3, 3 cases). Some patients who had a history of varicella zoster virus vaccination had HZ following the COVID-19 vaccination. Two patients with oral HZ following vaccination were found to have involvement of the greater palatine nerve.

Conclusions: Vaccine-related HZ cases have been reported worldwide. Although many studies with a larger number of cases are ongoing, detailed information can be obtained from case reviews as reported herein.

Keywords: COVID-19; clinical anatomy; complications; infection; oral herpes zoster; palate; pandemic; reactivation; vaccination; varicella zoster virus.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines / adverse effects
  • COVID-19*
  • Herpes Zoster Vaccine* / adverse effects
  • Herpes Zoster* / etiology
  • Humans
  • SARS-CoV-2
  • Vaccination / adverse effects


  • COVID-19 Vaccines
  • Herpes Zoster Vaccine