Commentary on Corneal Graft Rejection after COVID-19 Vaccination: Our Experience and Concerns

is among the most successful organ transplantations in humans due to its immune privilege. This owes to lack of blood and lymph vessels and the absence of major histocompatibility complex antigen presenting cells (MHC-II APCs) in the cornea. However, vaccination may trigger MHC-II response as well as antigenic cross reactivity, resulting in allograft rejection. This has been reported earlier in sporadic cases after influenza and yellow fever vaccines. With the rampant vaccination and booster doses against COVID-19, similar episodes of post-vaccination graft rejection in penetrating and lamellar keratoplasties have been reported. We had reported a case of corneal graft rejection post covid vector vaccine which recovered with steroid medications. Allograft rejection with various subtypes of vaccination opens the door to comprehend immune privilege mechanisms and prophylaxis against organ rejection. Clinicians and patients are advised to be alert to this possibility, for prompt recognition as well as treatment of post-vaccination corneal graft rejection.