Dear Editor,

We would like to share ideas on the publication “Large-vessel vasculitis following the Pfizer-BioNTech COVID-19 vaccine [1]”. Gilio and De Stefano mentioned that “The pathogenesis of post-vaccination vasculitis remains unclear. To our knowledge, this is the first report of large vessel vasculitis following by BNT162b2 vaccination…… [1].” We concur that COVID-19 vaccination can have negative consequences, with large-vessel vasculitis being one example. However, as Gilio and De Stefano pointed out, no clear pathophysiology has been provided in this case. Atypical immunological responses are frequently cited as a source of several of the COVID-19 vaccine’s side effects. There is also no information on the patient’s immunological status or vascular health prior to vaccination. We should be aware that large-vessel vasculitis in a COVID-19 vaccination recipient could be caused by an underlying disease or a concomitant medical issue. Dengue fever could emerge in a vaccine recipient as an example of a concomitant medical illness [2]. Dengue is also a possible cause of large vessel vasculitis [3].