Incidence rates of bullous pemphigoid, herpes zoster and urticaria following the start of the COVID-19 vaccination programme in the UK: a population-based cohort study

Journal article

Lay Summary: Following the start of COVID-19 immunization programmes worldwide, serious skin reactions were reported after getting the COVID-19 vaccines. These included bullous pemphigoid (‘BP’ for short), shingles and hives. BP is a rare autoimmune skin disease that mainly affects older people. About 8 in 100,000 people a year in the UK develop BP. The cause of BP is unknown. Symptoms often start with very itchy skin and a rash. Over time, these develop into painful blisters and open sores. Shingles typically results in a painful rash over the chest and abdomen. The condition is most common in people older than 80 years of age. About 1,100 in 100,000 people a year in the UK develop shingles. Hives presents as a rash with raised bumps. Around 8% to 10% of the UK’s population will get hives at least once in their lives, mostly between the ages of 20 and 40 years old. Previous studies found links between COVID-19 vaccines and BP, shingles and hives. However, the people included in the studies were not representative of the UK’s population. Accurate estimates of the risks of developing these diseases with a sample representative of the UK are important. More accurate information will help healthcare professionals and inform those who are hesitant about vaccines. In this study, we used information gathered by more than 2,000 general practices in the UK to compare changes in how often BP, shingles and hives were seen before and after the COVID-19 vaccination programme. We found that the number of cases of BP did not change after the vaccination programme. Cases of shingles and hives increased. However, the increases were not large. The benefits of vaccination will probably outweigh the potential risk of developing hives and shingles for many people. Future research should explore whether the increases in BP, shingles and hives that we found are driven by the COVID-19 vaccines or other reasons.

Authors: Swiderski, M; Lewis, S; Vinogradova, Y; Ridd, MJ; Yiu, ZZN

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: British Journal of Dermatology
• Volume: 193
• Issue: 5
• Pages: 889-897
• Publication date: 2025-06-19
• Acceptance date: 2025-06-16
• DOI: 10.1093/bjd/ljaf237
• EISSN: 1365-2133
• ISSN: 0007-0963
• Language: English