Varicella zoster virus-induced neurological disease after COVID-19 vaccination: a retrospective monocentric study

J Neurol. 2022 Apr;269(4):1751-1757. doi: 10.1007/s00415-021-10849-3. Epub 2021 Nov 1.


The description of every possible adverse effect or event related to vaccines is mandatory during the ongoing worldwide COVID-19 vaccination program. Although cases of cutaneous varicella zoster virus (VZV) reactivation after COVID-19 vaccination have been increasingly reported in literature and database sets, a description of VZV-induced neurological disease (VZV-ND) is still lacking. In the present study, we retrospectively evaluated patients admitted to our clinic and diagnosed with VZV-ND during the COVID-19 vaccination campaign (January-April 2021) and in the same months in the previous two years. We identified three patients with VZV-ND after COVID-19 vaccination and 19 unvaccinated VZV-ND cases as controls. In the case-control analysis, the two groups showed no difference in clinical features, results of diagnostic investigations, and outcome. Thus, VZV reactivation with neurological involvement might be a possible event triggered by COVID-19 vaccination, but the benefit following COVID-19 vaccination overcomes significantly the potential risk associated with a VZV reactivation.

Keywords: COVID-19; SARS-CoV-2; Vaccination; Vaccine; Varicella; Zoster.

MeSH terms

  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Herpes Zoster* / diagnosis
  • Herpes Zoster* / etiology
  • Herpesvirus 3, Human
  • Humans
  • Retrospective Studies
  • Vaccination / adverse effects


  • COVID-19 Vaccines