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Purpose: To describe a unique case of bilateral cataract formation in the setting of multisystem inflammation after the 1st dose of the BNT162b2 mRNA COVID-19 vaccination., Observations: A previously healthy 20-year-old male developed intumescent bilateral cataracts leading to visual decline from 20/20 to 20/300-20/400 in each eye, likely from systemic inflammation after vaccination., Conclusion and Importance: This is the first reported case of cataract formation following a COVID-19 vaccine. While ocular adverse effects associated with COVID-19 vaccination are rare, it is important to raise awareness of these entities amongst medical providers as the COVID-19 pandemic continues and vaccinations become widespread., Competing Interests: All authors have no financial disclosures., (© 2022 The Authors.)