Pierre Fabre Eczema Foundation. The only question is whether the immune response mounted after the vaccine will be as strong as possible because of medications taken internally. If you are concerned about an allergic reaction you had to another vaccine, injectable medicine, or PEG, then speak to your doctor. You may experience common side effects associated with the vaccine, however, such as pain and swelling at the injection site or tiredness, headache, chills, muscle pain, fever, and nausea,. Symptoms can range from mild to severe. The registry showed a total of 10 flares, five after a first dose of Moderna. 2022 Aug 1:S0040-5957(22)00136-6. doi: 10.1016/j.therap.2022.07.008. In the pandemic era, psoriasis patients and physicians should acknowledge the possibility of fluctuation of disease activity when vaccinated against COVID-19. Learn what it looks like, how to treat it, and how to prevent, Cradle cap and eczema are two types of skin conditions that can affect a babys scalp. There are no additional risks from the COVID-19 vaccines, either primary shots or boosters, for people with eczema. Bekkali N, Allard T, Lengell C, Estve E. Therapie. sharing sensitive information, make sure youre on a federal While COVID-19 vaccines offer strong and lasting protection against severe . In addition, people with both eczema and asthma had 38% lower odds of infection. The benefits of being protected from COVID-19 and protecting others by getting the vaccine far outweigh the risk of getting a severe case of COVID-19. Can diet help improve depression symptoms? Tips for managing stress and eczema include: There have been anecdotal reports that the COVID-19 vaccine has worsened eczema symptoms or caused a flare-up in some patients. Frontiers | Exacerbation of Psoriasis Following COVID-19 Vaccination You can learn more about how we ensure our content is accurate and current by reading our. Check out our gallery to learn how to spot different types of psoriasis and eczema and how to tell them apart based on their unique symptoms. It sometimes occurs with mild or no symptoms, while some people experience severe symptoms and complications that can lead to hospitalization or death. Moderna: The Moderna vaccine is an mRNA vaccine. Psoriasis and COVID-19 Vaccine: Side Effects and Risks - Verywell Health A severe allergic reaction can cause: difficulty breathing or wheezing, a drop in blood pressure, swelling of the tongue or throat, or. In the rheumatology world, some are saying up to two weeks for methotrexate, and our team recommends just holding the dose for the week after the vaccine and then starting it up again (repeating for the second one). Successive flare-ups of the most common form of eczema may trigger an immune system overreaction, causing it to become a long-term condition. (2021). The symptoms of eczema may vary among individuals, and they can appear differently in different age groups. However, COVID-19 vaccines are unlikely to cause severe skin reactions. Lasted close to 6 months and took a month in a different more humid climate to properly heal. 2022 Nov 6;15:2369-2382. doi: 10.2147/CCID.S388245. Advice on coronavirus (COVID-19) for people with eczema. They use very different technologies. Learn more here. Most people with psoriasis should follow the same CDC guidelines for booster shots as the general public, says the NPF. Severe reactions to the COVID-19 vaccine are rare but include myocarditis, a serious inflammation in the heart muscle wall, and pericarditis, an inflammation of a membrane around the heart which usually goes away without treatment. Dr. Alexis: Per the American Academy of Allergy Asthma and Immunology (AAAAI) and the Center for Disease Control (CDC), the following are contraindications to receiving the SARS-CoV-2-mRNA vaccine: Immediate allergic reaction of any severity to a previous dose of an mRNA Covid-19 vaccine or any of its components, including polyethylene glycol (PEG).[1], If one falls into the above category, one should not receive mRNA Covid-19 vaccination at this time unlessthey have been evaluated by an allergist/immunologistand it is determined that the person can safely receive the vaccine (e.g., under observation, in a setting with advanced medical care available).1, Anyone who has an immediate allergic reaction to the first dose of an mRNA vaccine should not receive additional doses of either of the mRNA Covid-19 vaccines. 8600 Rockville Pike Sourced from the FDA. While the root cause of eczema isn't fully understood, identifying and avoiding potential. Dr. Alexis: Although data are not available, immunosuppressive treatments (off-label oral immunosuppressives for AD such as cyclosporine, methotrexate, mycophenolate mofetil, azathioprine) may theoretically affect the effectiveness of the vaccination. Doctors may prescribe the following medications to treat eczema: A doctor may also recommend skin care strategies such as moisturizing after showering or bathing and avoiding harsh skin care products or products with strong scents. We also consider treatment and prevention for COVID-19 and eczema and when to consult a doctor. Accessibility All data and statistics are based on publicly available data at the time of publication. The National Eczema Society acknowledged multiple reports of peoples worsening eczema symptoms after getting the COVID-19 vaccine. Epub 2021 Aug 4. If you take medications that affect the immune system, it isn't yet known how that may affect your risks or impact your response to COVID-19 vaccines. If you take immunosuppressants, systemic, or biologic medication for your eczema and are concerned about whether you are more at risk from COVID-19, then speak to your healthcare professional for support and advice. -. (n.d.). "All of the COVID-19 vaccines are very safe and effective," says Dr. Sparks. What can I do to help prevent it from getting worse? Noteworthy we report the first case of EBV viral reactivation associated with cutaneous manifestations in an immunocompetent patient after the COVID-19 vaccine. In some cases, the skin can also blister and weep. Clin Cosmet Investig Dermatol. A 2022 systematic review identified 16 cases of facial swelling after COVID . [3] Pfizer-BioNTech COVID-19 Vaccine. COVID-19 can still be serious and deadly, however, especially in high-risk people like those age 65 and older, those with weakened immune systems, or those with existing serious health conditions. Eczema and Coronavirus (COVID-19): Risks, Complications - Verywell Health April 19, 2023 - New research is shedding light on how an infection with COVID-19 may reactivate, or even cause, psoriasis. J Am Acad Dermatol 2021; 85: 4655. If you get a COVID-19 vaccine and you think you might be having a severe allergic reaction after leaving the vaccination provider site, seek immediate medical care by calling 911. Here is how they are manufactured: After the vaccines stimulate the antibody reaction, your cells discard the vaccine ingredients, which is a normal bodily process. Many doctors emphasize that the benefits of the vaccine outweigh the risks for most patients, even if you're experiencing a disease flare when you get the vaccine. (2021). They include: People with eczema should moisturize soon after bathing to keep the skin hydrated and prevent it from drying out. If you recently had COVID-19, consider delaying your vaccine dose, whether it's your first or a booster, for three months from when you had symptoms or a positive test. Though eczema does not make it more likely that you will have a serious case of COVID-19, you are at the same risk for severe COVID-19 if you have other risk factors. You'll be protecting yourself and others. Try implementing relaxation techniques into your daily routine such as. 2021;64:103268. doi:10.1016/j.ebiom.2021.103268, Yiu Z, HardingOredugba G, Griffiths C, Warren R, McMullen E, Hunter H.Risk of COVID19 infection in adult patients with atopic eczema and psoriasis: a singlecentre crosssectional study. Are there any eczema treatments that might interfere with the COVID-19 vaccine? To reduce eczema flare-ups during the pandemic, a person should maintain a skin care routine that includes frequent moisturizing, washing hands in lukewarm water, moisturizing after washing, managing stress as best they can, and investing in a soft, high quality face mask. Overall, researchers consider the COVID-19 vaccines to be safe and well-tolerated. How do you treat eczema on the face and eyes after getting a COVID-19 vaccine? and transmitted securely. It's essential to be aware that the impact of COVID-19 on your life could be increasing your stress levels. A cross-sectional research study carried out in the United Kingdom found that atopic eczema and psoriasis were not associated with an increased risk of testing positive for COVID-19. For example, for the first vaccination with the Pfizer vaccine, the most commonly reported side effects included fatigue, headache, muscle pain, chills, joint pain and fever. And, additionally, the ingredients of the Moderna vaccine are listed here, in addition to the mRNA: lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]), tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose. Possible Connection Found Between Skin Rashes and COVID-19 eCollection 2022 Sep-Oct. Tan LJ, Koh CP, Lai SK, Poh WC, Othman MS, Hussin H. Forensic Sci Int. Exacerbation of Psoriasis Following COVID-19 Vaccination - PubMed Read our. COVID-19 vaccination in atopic patients. Understanding risk. Delayed skin rashes after vaccines - American Academy of Allergy Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. 2023 Healthline Media UK Ltd, Brighton, UK. People who are moderately or severely immunocompromised should talk to their healthcare provider about the COVID-19 vaccination. He is also professor of dermatology at the Icahn School of Medicine at Mount Sinai and Director of the Skin of Color Center. Online ahead of print. Eczema and Vaccines: Your FAQs - Healthline Advice on coronavirus (Covid-19) for people with eczema Atopic dermatitis: Diagnosis, treatment, and steps to take. Possible side effects after getting a COVID-19 vaccine. Anju Goel, MD, MPH. As a continuation of our Ask the Ecz-perts series on Covid-19 and eczema, we reached out to Dr. Anna Fishbein, associate professor of pediatrics (allergy and immunology) at Northwestern Universitys Feinberg School of Medicine, to get the scientific background on whether Covid-19 could directly lead to flaring eczema. There are steps a person can take to help prevent eczema and COVID-19. Most people with eczema and allergies can have the COVID-19 vaccine. A 2022 study with 480 participants found that 2.7% of people who were receiving treatment with dupilumab experienced exacerbated eczema symptoms after the COVID-19 vaccine. Leasure AC, et al. Scientists use genetic rewiring to increase lifespan of cells, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, sores that can open and ooze when a person scratches them, lighter or darker patches of skin which may last even when other symptoms have gone away, moisturizing creams to help repair the skin barrier, following a skin care routine and moisturize with appropriate products regularly, preventing irritations to the skin by avoiding harsh products and clothing that rubs or irritates, maintaining comfortable temperatures that are not too hot or cold, avoiding poorly ventilated areas and crowds, eczema is affecting their day-to-day life, over-the-counter medication is ineffective, eczema lesions cover a large area of the body. Anasiewicz N, Seeli C, Brggen MC, Mhrenschlager M. Allergo J Int. COVID19 vaccines and the skin: the landscape of cutaneous vaccine reactions worldwide. Even if you are on an injectable medication for eczema, you can still get the COVID-19 vaccine safely. Advice on coronavirus (COVID-19) for people with eczema. COVID-19 is highly contagious and can present in different ways. If you do not use a computer or smartphone, you can call 800-232-0233. Delayed large local reactions to mRNA1273 vaccine against SARSCoV2. New Onset of Severe Plaque Psoriasis Following COVID-19 Vaccination: A Case Report. Shakoei S, Kalantari Y, Nasimi M, Tootoonchi N, Ansari MS, Razavi Z, Etesami I. Dermatol Ther. J Eur Acad Dermatol Venereol 2021; 35: e483e485. Is the COVID-19 Vaccine Safe and Effective for People With Eczema? Research has found atopic diseases, including eczema, are associated with 23% lower odds of developing COVID-19. Dermatol Ther. Healthcare workers with eczema may experience even greater trauma to the skin on their hands due to constant washing and infection-prevention practices. We do not think that there is suppression of the immune system from applying anything to skin. Are There Side Effects of the COVID-19 Vaccine? Researchers continue to investigate this. Most people with eczema and allergies can have the COVID-19 vaccine. Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. ROSEMONT, Ill. (April 7, 2021) As COVID-19 vaccination ramps up globally, new research published today in the Journal of the American Academy of Dermatology demonstrates the wide variety of skin rashes, including full-body rashes, observed after COVID-19 vaccination. Dr. Spergel: I would talk to your healthcare provider, as the exact details depend on your dosage. doi: 10.1001/jamanetworkopen.2022.17375. Last medically reviewed on September 29, 2022. The temporal association had been reported between vaccination and exacerbation of psoriasis, and episodes of psoriasis flare-up have recently been attributed to COVID-19 vaccines. eCollection 2022. Messenger RNA (mRNA) vaccines: Pfizer and Moderna, Viral vector vaccines: Johnson and Johnson (J&J). Psoriasis flare-up after AZD1222 and BNT162b2 COVID-19 mRNA vaccines: report of twelve cases from a single centre. The https:// ensures that you are connecting to the Hand eczema was . Helen Massy, BSc, is a freelance medical and health writer with over a decade of experience working in the UK National Health Serviceas a physiotherapistand clinical specialist for respiratory disease. Johns Hopkins Coronavirus Resource Center. Most of the ingredients in COVID-19 vaccines are fats, sugar, and salts like those in food. Ask the ecz-perts: the latest about COVID-19 and eczema. What people with eczema need to know about the Covid-19 vaccines J Eur Acad Dermatol Venereol. Disclaimer. Eczema is a common condition that affects more than 31 million people in the United States. Accessed 1/13/21. This is why it is vital to take care of yourself and take measures to protect your skin and reduce stress levels. Eczema should not prevent a person from receiving a safe and effective COVID-19 vaccine. However, the current research does not indicate a connection between the vaccines and eczema symptoms in people who dont already have the skin condition. Before -, Corbeddu M, Diociaiuti A, Vinci MR et al. Epub 2022 Feb 4. If you believe you are experiencing an adverse reaction to the COVID-19 vaccine, contact your physician immediately. Psoriatic Arthritis and COVID Vaccines: What You Should Know. The authors note that they do not know what the relationship is between the vaccines and eczema symptoms. Centers for Disease Control and Prevention. Andrew F. Alexis, MD, MPH, is the chair of the department of dermatology at Mount Sinai Morningside and Mount Sinai West. To help lessen the effect of handwashing and sanitizing gel on your eczema symptoms, you can apply the following tips: Stress can also exacerbate eczema symptoms through its effects on immune response and skin barrier function. The Centers for Disease Control and Prevention (CDC) recommends that you don't mix types of vaccines for your primary shots. Some cases, however, described eczema flare-ups and symptoms in people who received a COVID-19 vaccine. Meo SA, Bukhari IA, Akram J, Meo AS, Klonoff DC. Atopic dermatitis: Diagnosis, treatment, and steps to take. There are no additional risks from the COVID-19 vaccines, either primary shots or boosters, for people with eczema. If your eczema worsens or you suspect your skin is infected, then contact your healthcare provider for advice. (2021). If you have never had a COVID-19 vaccine, you can start by getting the primary vaccination. How to protect yourself & others. In addition to her extensive health and wellness writing, Nancy has written about many general interest topics for publications as diverse as Newsweek, Teen Vogue, abcnews.com, and Craftsmanship Quarterly. This is the conclusion of a new study using mathematical modelling to analyse how the most common form of eczema, atopic dermatitis (AD), progresses. Managing the risk of COVID-19 through handwashing and mask-wearing can cause eczema symptoms to flare up. The cutaneous side effects of COVID-19 vaccines are being studied and their immunogenicity is most likely linked to the pathophysiology of psoriasis. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. We avoid using tertiary references. Jonathan M. Spergel, MD, PhD, is director of the Center for Pediatric Eosinophilic Disease and professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. National Institute for Health Research (NIHR) Biomedical Research Centre. 2021 Mar 17. doi:10.1111/bjd.20062. In addition to topical delivery, these JAK inhibitors also offer effective oral therapy for severe widespread cases with minimal side-effects. doi:10.1111/jdv.17964. A dermatologist or doctor may treat eczema with a combination of treatments. The skin condition affects about 7.5 million adults in the United . Epub 2022 Jul 4. What to Know About Cystic Fibrosis and COVID-19. Before you get the vaccine: If you take dupilumab for eczema, consider waiting two to three days after getting a COVID-19 vaccination before your next injection to avoid a potentially higher risk of mild side effects. EBioMedicine. N Engl J Med 2021; 384: 12731277. Get lots of rest, drinks lots of fluids, and try your best to keep your eczema under good control. There are many types of eczema, each with different characteristics and triggers. Generalized eczematous reaction on the back and shoulder. White spots on the skin can occur with many different skin conditions, including vitiligo. An overview of the different types of eczema. But as experts began to understand the disease . Dermatology advice regarding medication acting on the immune system: Adults, children and young people. A handful of people had an eczema flare after having the vaccine, which was easily treated. Your healthcare professional can assess your skins degree of inflammation and irritation to determine the appropriate treatment, which could include: Your eyes are a sensitive and vulnerable part of your body because the surrounding skin is thin. To contribute to the literature on this intriguing topic, we present three cases of de novo psoriasis in adult patients following COVID-19 vaccination. Common side effects after the COVID-19 vaccination include: Those side effects typically go away within a few days. The cutaneous side effects of COVID-19 vaccines are being studied and their immunogenicity is most likely linked to the pathophysiology of psoriasis. Where Does the COVID-19 Vaccine Come From? Epub 2022 Sep 20. Put an ointment or moisturizer on your hands and cover them with clean cotton gloves overnight to rehydrate hands if they are sore and dry. Read more about symptoms, diagnosis, treatment, and more about adults with. This article discusses what eczema is, whether COVID-19 vaccines can cause it, and how to treat the condition. But research does not show that the vaccines cause eczema in people who dont already have it. Wu PC, Huang IH, Wang CW, Tsai CC, Chung WH, Chen CB. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Over time, the vaccine's protection weakens, and booster shots will reinforce it. Researchers consider the COVID-19 vaccines to be safe and well-tolerated. Atopic dermatitis: Diagnosis, treatment, and steps to take. NEA is a qualified 501(c)(3) EIN 93-0988840. Generalized eczematous reactions to the PfizerBioNTech COVID19 vaccine. A letter to the editor showed that some researchers recorded cases of eczema flare-ups in adults who received a COVID-19 vaccine, but the researchers shared that the symptoms were easily manageable and not severe or dangerous. If you believe the COVID-19 vaccine has exacerbated your eczema, speak to your healthcare professional and discuss whether it needs to be reported to the Vaccine Adverse Event Reporting System (VAERS). Careers. 2021 Nov;35 (11):e716-e717. Risk of COVID19 infection in adult patients with atopic eczema and psoriasis: a singlecentre crosssectional study. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Centers for Disease Control and Prevention (CDC), National Institute of Arthritis and Musculoskeletal and Skin Diseases, https://www.bmj.com/company/newsroom/allergic-conditions-linked-to-lower-covid-19-infection-risk, https://nationaleczema.org/blog/ask-ecz-perts-covid-update, https://www.niams.nih.gov/health-topics/atopic-dermatitis/diagnosis-treatment-and-steps-to-take, https://evidence.nihr.ac.uk/collection/childhood-eczema, https://www.cdc.gov/mentalhealth/stress-coping/cope-with-stress/index.html, https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(21)00061-X/fulltext, https://skinofcolorsociety.org/patient-dermatology-education/eczema, https://nationaleczema.org/eczema/causes-and-triggers-of-eczema, https://nationaleczema.org/research/eczema-facts, https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis, https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis/symptoms, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html, https://www.niams.nih.gov/health-topics/atopic-dermatitis, https://www.aad.org/public/everyday-care/itchy-skin/rash/rash-101, https://onlinelibrary.wiley.com/doi/full/10.1002/ski2.59, https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html, https://onlinelibrary.wiley.com/doi/10.1111/bjd.20062, A safer blood thinner? This site needs JavaScript to work properly. Patient 2: erythematous demarcated papules and plaques and scaling on trunk and extremities with mild onycholysis (C, D). I would probably stop just for two days and restart with cyclosporine (or treat through). Emotional stress may trigger an eczema flare-up. Dr. Paller: There is no contraindication against getting the vaccine if your eczema is flaring. Take steps to reduce stress, manage itching, and improve your sleep hygiene. eCollection 2022. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic. It is possible, although rare, that breakthrough symptoms of eczema can occur in people who have the skin condition before receiving the COVID-19 vaccination. COVID-19 vaccines may be taken safely unless you have had an allergic reaction to the vaccine or one of its components. The COVID-19 vaccines available in the United States have been rigorously tested and proven safe and effective. -, Sun Q, Fathy R, McMahon DE, Freeman EE. 2022 Nov 28:1-2. doi: 10.1007/s40629-022-00234-5. 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Epub 2022 Feb 17. Centers for Disease Control and Prevention. Therefore, to help prevent eczema flare-ups, you can practice techniques to reduce stress levels. Pramoxine is a topical medication that can provide effective relief from the itching and pain relating to eczema. The J&J vaccine has a very rare incidence of blood clots, in about four of each one million people who receive the vaccine. -, Teijaro JR, Farber DL. The only potential issue is an allergy to an ingredient of the vaccine itself. Eczema does not suppress your immune system, though your treatment may if you take systemic medications rather than use topical treatments on your skin. 2022 Aug;35(8):e15651. Federal government websites often end in .gov or .mil. Here's what to know about getting the COVID-19 vaccine if you have eczema. Learn more about eczema on skin of color. New onset of mainly guttate psoriasis after COVID-19 vaccination: a case report. None of the COVID-19 vaccines authorized for use in the United States contain a live virus. Centers for Disease Control and Prevention. Methotrexate (depending on the dose) can be immunosuppressive, yes. Is the ketogenic diet right for autoimmune conditions? We also have evidence that dupilumab (Dupixent), the new monoclonal antibody for eczema, allows an expected response to vaccines (although the Covid-19 vaccine has not been tested previously, of course). Despite experiencing generalized reactions, neither patient developed serious adverse events after the first or second vaccine dose. Scientists use genetic rewiring to increase lifespan of cells, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. COVID-19 is a type of coronavirus caused by the SARS-CoV-2 virus. Thank you, {{form.email}}, for signing up. COVID-19 Resource Center - National Psoriasis Foundation Effect of COVID-19 (SARS-CoV-2) Vaccination on Patients with Atopic Dermatitis Treated with Dupilumab: A Multicenter, Observational Study. Whether you have eczema that you treat with a topical substance or a systemic medication that you take as a pill or injection, it is safe to have a COVID-19 vaccine. People may experience more severe eczema symptoms more regularly because of COVID-19-related circumstances. The best way to stay safe with eczema during the pandemic is to follow public health guidance to lower the risk of catching COVID-19: Having eczema does not place a person in a high-risk category to become infected with COVID-19 or have a severe case or complications. This article reviews the. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. In summary, be sure to consult with your healthcare provider about whether you should receive a booster. Amy Paller, MD, is chair of the department of dermatology at Northwestern University Feinberg School of Medicine and pediatric dermatologist at the Ann and Robert H Lurie Childrens Hospital of Chicago. Treatment for COVID-19 happens on a case-by-case basis, as the severity and symptoms of the virus differ between people. Potestio L, Napolitano M, et al. Allergic Reactions after COVID-19 Vaccination | CDC (n.d.). The authors have no conflict of interest to declare. Although uncommon, several cases of exacerbation and new onset of psoriasis have been reported globally after vaccination. Try to stay in touch with your friends and family in a safe, socially distanced, or virtual manner. However, it is not fully understood how COVID-19 affects people with eczema or if certain types of eczema medication may affect their response to the virus. That said, studies with methotrexate suggest that with the flu and pneumococcus (no info on Covid-19, of course) there is still good protection. The major risk factor is elderly, diabetes, heart disease and obesity. Apply moisturizer to your hands once hand sanitizer is dry if it is causing our eczema to worsen. These immunosuppressant drugs do not PREVENT developing immunity but they might REDUCE immune reactivity and protection. "We are seeing a lot of flaring patients right now due to what's going on around us," says Friedman. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. The COVID-19 vaccines do not contain any of the live SARS-CoV-2 virus, so they do not cause eczema vaccinatum.
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