Palatal petechiae: an uncommon oral adverse effect of COVID-19 vaccine

BACKGROUND: The authors present an unusual, unreported oral adverse effect of COVID-19 vaccine as palatal petechiae lesions. CASE PRESENTATION: COVID-19 disease caused by severe acute respiratory syndrome coronavirus 2 has become a global health crisis and has caused millions of deaths worldwide. Vaccination programs have been initiated in many countries for COVID-19 prevention. The ChAdOx-nCoV-19 vaccine has been shown to provide a robust immune response in various clinical trials. It is well tolerated by recipients and has been associated with minor adverse effects. The COVISHIELD (ChAdOx-nCoV-19) vaccine developed by AstraZeneca/Oxford University is approved by the Government of India to be administered in a phased manner. We present the case of twin subjects who suffered various adverse effects after receiving the COVISHIELD vaccine; one of the twins presented with palatal petechiae lesions presumably caused by the vaccine. The lesions were self-limiting and required no treatment. CONCLUSION: Oral lesions reported first time in our case should be correlated with similar lesions found post-COVID vaccines globally. There is a further need to ascertain a high level of scientific evidence and explore the biological plausibility underlying oral complications and COVID vaccinations.