New-onset discoid lupus erythematosus after Oxford-AstraZeneca adenoviral (Covishield^™) vaccination in a paediatric patient

Oxford Astra-Zeneca adenoviral vaccine (Covishield ™ ) is a viral vector vaccine that uses an attenuated, non-replicating strain of Chimpanzee adenovirus as a vector to carry the spike glycoprotein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into human cells. Although highly effective against SARS-CoV-2 infection coronavirus disease 19 (COVID-19), COVID-19 vaccines have been implicated in triggering and exacerbating various autoimmune diseases due to their role in inciting antigen-specific immune responses. There have been various reports of the development or exacerbation of dermatomyositis and systemic lupus erythematosus (LE) following COVID-19 vaccine. Here, we present the rare case of the development of discoid LE (DLE) in a 14-year-old female patient 3 weeks following the administration of the first dose of Covishield ™ (ChAdOx1 nCoV-19 vaccine). The patient also had positive anti-nuclear antibody titres. The temporal relationship of her symptoms after vaccine administration could suggest a possible association between the vaccine and the development of DLE, as this is the time interval for antibody formation post-vaccine.