Herein, we present a case of a patient that developed pustular psoriasis flare after the second dose of mRNA COVID-19 vaccine who was successfully treated with IL-1 antagonist (anakinra) and we attempt to critically review the published case reports and case series of COVID-19 vaccine-associated pustular eruptions to aid proper and accurate diagnosis and efficacious treatment. Here, IL1B is linked to pustular psoriasis.