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Rare but serious: a published case of toxic epidermal necrolysis after Moderna COVID-19 vaccination

A 2023 case report in Case Reports in Immunology describes a 30-year-old woman who developed toxic epidermal necrolysis (TEN) after a first dose of mRNA-1273 (Moderna).

The rash began around the injection site within two days, then spread. She developed targetoid lesions, blistering, skin sloughing over an estimated 30–40% of her body, plus mouth and eye involvement. She needed hospital and burn-unit care and was discharged on day 21.

The authors judged the vaccine a likely trigger because the eruption started at the shot site. Several of her other medicines have been linked to SJS/TEN in other reports, but she had been on them for months. She later tolerated PEG 3350 without a reaction, so they considered a major vaccine excipient less likely.

This is one case report, not proof of how often this happens. SJS/TEN after vaccination is rare. Case reports still matter for awareness: severe cutaneous reactions can occur, they can start at the injection site, and they need urgent specialist care.

If you or someone you know has a spreading blistering rash, mucosal sores, or peeling skin after any medicine or vaccine, that is an emergency—not something to wait out.

Source: Hehr N, Davis BP. Case Reports in Immunology. 2023;8855665. DOI: 10.1155/2023/8855665

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