Multiple evanescent white dot syndrome (MEWDS)-like reactions associated with coadministered COVID and influenza vaccination

Purpose: To report cases of multiple evanescent white dot syndrome (MEWDS)-like reactions in patients who received coadministered COVID and influenza vaccines. Methods: This case series considered patients seen at Massachusetts Eye and Ear with MEWDS and history of recent COVID and influenza vaccination. We identified three myopic patients aged 26, 27, and 79 with no history of autoimmune or inflammatory disease who presented with monocular blurred vision, floaters, and scotoma within 5 days to 2 weeks of coadministered COVID and influenza vaccination and were found to have posterior uveitis consistent with MEWDS. Results: Two patients were monitored without treatment and had self-resolving disease. One patient with poor presenting visual acuity was treated with a prednisone taper. Visual acuity in this patient’s affected eye remained counting fingers at 6-month follow up despite lesion resolution and normalization of imaging findings. Conclusions: We present three cases of MEWDS-like reaction in patients who received coadministered COVID and influenza vaccines. Some disease features were atypical, including poor visual recovery in one patient. The immunogenic stimulus from coadministered COVID and influenza vaccinations may be a trigger for MEWDS-like posterior uveitis.