The fact that these reports are still relatively few, now that public vaccinaation has been online for months, suggests that it’s a pretty rare occurrence. —Arianne Shadi Kourosh, MD, MPH
Explore This IssueAugust 2021
The three reactions reported among the approximately 15,000 patients who participated in the phase 3 trial of the Moderna vaccine and who received at least one dose of the vaccine included facial swelling in a 51-year-old female that appeared two days postvaccination (and two weeks after dermal filler placement), facial swelling one day after vaccination in a 46-year-old female who had dermal filler placed six months prior, and lip angioedema two days after vaccination in a 29-year-old female who had filler placed an unknown length of time previously (ModernaTX. Vaccines and Related Biological Products Advisory Committee Meeting December 17, 2020; American Society for Dermatologic Surgery. Guidance Regarding SARS-CoV-2 mRNA Vaccine Side Effects in Dermal Filler Patients. December 28, 2020). Two of the patients in the trial’s placebo group also reported facial swelling (Int J Womens Dermatol. 2021;7:209-212).
According to the United Kingdom’s Drug Safety Research Unit and JAAD Case Reports, facial swelling has also been reported in patients with a history of dermal filler injections who received the Pfizer-BioNTech COVID-19 vaccine (JAAD Case Rep. 2021;10:63-68). No incidents of facial swelling or possible filler/vaccine reactions following receipt of the Johnson & Johnson COVID-19 vaccine have been reported yet in the literature.
It’s impossible to determine the true prevalence of COVID-19 vaccine/filler reactions without knowing how many patients have previously undergone filler injections. The three reactions reported in the Moderna trial were likely a tiny minority. “Given national statistics on the order of millions of filler injections done in the U.S. annually, there were probably more than three people in that clinical trial who had filler in their face,” said Dr. Kourosh. “The fact that these reports are still relatively few, now that public vaccination has been online for months, suggests that it’s a pretty rare occurrence.”
L. Mike Nayak, MD, a board-certified facial plastic surgeon in Missouri, said his large practice hasn’t noticed a significant uptick in DIRs in recent months, despite increasing COVID-19 vaccination rates.
“I’ve been seeing more questions and attention to it than actual responses,” Dr. Nayak said. “Personally, I can’t think of a single incident where someone got a vaccine and told me the next day, ‘Suddenly my face blew up.’” However, he noted that DIRs may be under-reported, as many patients, particularly those who experience a mild reaction, may not mention the reaction to a healthcare provider.