Public health efforts over the past few months have been aimed at vaccinating young adults. Moderna and Pfizer COVID-19 vaccines are widely available options. Cutaneous reactions to these vaccines have been described as self-limiting and relatively immediate after vaccine administration. In this case report, we present a young adult who received the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine and developed chronic, spontaneous urticaria.