• Yoshiko Ishioka, Tomonori Makiguchi, Masamichi Itoga, Hisashi Tanaka, Kageaki Taima, Shintaro Goto, and Sadatomo Tasaka.
• Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
• Chest. 2022 Dec 1; 162 (6): e311e316e311-e316.

AbstractAn acute exacerbation of interstitial lung disease (ILD) is an acute deterioration that can occur at any time and is associated with significant morbidity and mortality rates. We herein report three patients with ILD who experienced acute respiratory failure after SARS-CoV-2 messenger RNA vaccination. All the patients were male; the mean age was 77 years. They had a smoking history that ranged from 10 to 30 pack-years. Duration from the vaccination to the onset of respiratory failure was 1 day in two patients and 9 days in one patient. In an autopsied case, lung pathologic evidence indicated diffuse alveolar damage superimposed on usual interstitial pneumonia. In the other two cases, CT scans showed diffuse ground-glass opacities and subpleural reticulation, which suggests acute exacerbation of ILD. Two patients were treated successfully with high-dose methylprednisolone. Although benefits of vaccination outweigh the risks associated with uncommon adverse events, patients with chronic lung diseases should be observed carefully after SARS-CoV-2 vaccination.Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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