A suspected case of drug-induced lung injury due to a change in the composition of the COVID-19 vaccine (BNT162b2)

Abstract

A 66-year-old woman presented with persistent fever and cough after the administration of the COVID-19 vaccine (BNT162b2) that had undergone a change in composition from the previous vaccine. Chest computed tomography (CT) showed consolidation in the lower lobes of both lungs and the right upper lobe. Cell fractionation of bronchoalveolar lavage fluid showed lymphocyte proliferation. She was treated with steroids, which improved symptoms and imaging findings, but her symptoms flared up while the steroid dose was being reduced. Based on the clinical course, she was judged to have drug-induced lung injury caused by the COVID-19 vaccine. Caution should be exercised because drug-induced lung injury can occur even after multiple COVID-19 vaccinations due to changes in composition.