The majority of recipients of the COVID-19 vaccine from Moderna (NSDQ:MRNA) have had mild side effects such as headache, fatigue and pain at the injection site.
Temporary facial swelling may be another side effect for vaccine recipients who have had prior dermal fillers, which are not to be confused with Botox injections.
Related: Facial swelling and COVID-19 vaccines: 4 facts
In Moderna’s Phase 3 trial, three people developed facial or lip swelling after they received the vaccine, said FDA medical officer Dr. Rachel Zhang in today’s Vaccines and Related Biological Products Advisory Committee focused on the Moderna COVID-19 vaccine. Two of those patients had prior dermal fillers in their cheeks within six months before vaccination. The other had received dermal filler in the lip two days after receiving the vaccine.
FDA classified the two incidents of facial swelling as severe adverse events, although the incidents resolved.
The agency determined that the lip swelling incident was medically significant but not a severe adverse event. The patient with the lip swelling reported similar swelling in the past after receiving a flu vaccine.
COVID-19 and other viral infections themselves could possibly trigger such immunogenic reactions in individuals who have received recent dermal fillers. FDA concluded in a briefing document that “it is possible the localized swelling in these cases is due to an inflammatory reaction from interaction between the immune response after vaccination and the dermal filler. This phenomenon has been reported after natural infection (e.g., after an influenza-like illness).”
Zhang noted that the swelling in the three clinical trial volunteers resolved following treatment with steroids or antihistamines.
“I do want to point out that for these three subjects [with the facial and lip swelling], the swelling was only localized,” Zhang said. “There were no systemic symptoms observed.”
Physicians have linked injectable hyaluronic acid (HA)–based dermal fillers themselves to occasional late-onset inflammatory reactions.
The American Academy of Dermatology is tracking dermatologic adverse events related to COVID-19 vaccines. CDC is keeping tabs on severe allergic reactions.
Can you get still an allergic reaction to moderna if the fillers are over 3 years old?
Most fillers are no longer present at 3 years, so you should be fine.
I have not seen this with biostimulators – so if you have had Sculptra of Bellafill you can rest easy.
What about botox? Are people that get regular botox treatments having pain with the Moderna vaccine?
I got Xeomin (botox) last Friday and got my vaccine yesterday and my glabella is swollen but not too bad.
What about HA in the knees? I’m getting it for osteoarthritis. I assume my knees would flare?
I am getting HA knee injection today and I am wondering the same thing
Read the article! Do not confuse Botox as filler..
I just had my knee injected in mid December and I’m also wondering what will happen….???
Had Botox this morning and scheduled to get vaccine tonight.. thoughts? Should I postpone
What did you end up doing ?
Did you get your vaccine? I am scheduled for my vaccine and I recently had Juvaderm.
Hi, did you get it done? What was your reaction?
fillers 11 months ago a problem? getting vaccine tomorrow!
If I get botox for cervical dystonia can I get the covid vaccine.
Should I receive the Covid vaccine if allergic to penicillin and thermosol ?
Thank you for your reply.
I had permanent fillers done under my eyes 15 years ago, therefore I still have them, I am scared of a bad reaction because of the vaccine although I had the flue vaccine for the first time 2 months ago and all went well.
Please advise
I am not sure if there any documented cases in such immunogenic reactions happening 15 years after a filler procedure. The upper end appears to be more than one year, but less than two years.
Anyone have any problems with Botox and Pfizer vaccine?
For those of us who work in this industry and now have people CANCELLING their treatments, I would appreciate hearing WHICH COMPANY AND FILLER the problems have come from…There are way too many options and to generalize that ALL DERMAL FILLERS cause this is damaging.
There is small risk of swelling related to both hyaluronic acid or non-hyaluronic acid fillers.
I get Botox every 12 weeks for migraines. I have also had viral meningitis twice in the past and have cervical myelopathy. Are there any of the Covid vaccines I should not take?
I got the vaccine a couple of weeks ago & I didn’t know about the Botox issue until now. My headaches have been pretty bad starting almost a week after the vaccine. I get Botox for migraines. Not sure if it’s related?
How long would I have to wait to get lip fillers if I am getting the 2nd dose of the COVID vaccine on the 6th?
Hi Priscilla,
A board-certified dermatologist I interviewed recommended waiting four weeks, although waiting two weeks is more common advice.
I received moderna vaccine yesterday and I woke up with chills, low grade fever and swelling in on my eyelids and right side of my top lip and I had fillers exactly one year ago.
I’m going to take over the counter antihistamines for swelling, hopefully this subsides.
Any one else w similar symptoms?
Received injectable filler injections in smile lines around my mouth about 3 months ago.
Had Moderna vaccine 4 days ago and noticed swelling in the area today. Nothing alarming, and prob not noticeable to others, but distinctly there.
Dermatogists say wait 2 weeks after filler? is that enough? How long does swelling last?
From FDA materials I’ve seen (see page 43 here: https://www.fda.gov/media/144434/download), one patient in the clinical trial had facial swelling 6 months before receiving the vaccine. The other had the dermal filler two weeks before the vaccine. I’ve heard reports of such interactions occurring even after 12 months. The patient with lip swelling had filler injected two days before receiving the vaccine.
As for how long the swelling lasts, it depends on what the patient does to treat it and if the patient has a rare allergic reaction to the vaccine. Antihistamines and prednisone can generally speed up the reduction in swelling.
All of the three swelling cases mentioned in the above FDA document resolved.
Am taking cortisone for my allergy Diprofos injection once a month.can i take covid vaccine is their any contradection?
Have any issues been noted with prosthetics ie: total joint replacements?
Not that I’ve seen. The FDA summary document on the vaccine notes the following adverse events related to the Moderna mRNA-1273 vaccine: injection site pain (91.6%), fatigue (68.5%), headache (63.0%), muscle pain (59.6%) and joint pain (44.8%).
Is the swelling in the area mean the injection site or the area with the filler?
I got the Moderno vaccine – 2 days later I had a red rash on my cheeks. It got worse. My face was hot and red – no fever. My throat skin then became like sand paper. My chest broke out in red bumps like hives and red rash under my breasts. I had a dermal filler around my mouth 2 months ago. I called my doctor said not to worry – it was only temporary. It didn’t get better. I went to the ARPN at my Derm’s office. She didn’t have a clue. She gave me a prescription for Mometason . It has helped but still having skin problems so I called my doctor. She prescribed prednisone. I’m on my 2nd day. My face is better, chest is better, under boobs still bad, and skin on my arms is rough. Just wish this would all go away. I’ve never had this much trouble with my skin. It worries me. I’m suppose to get my 2nd Moderno shot on January 27. Is it safe for me to get it?
I am scheduled for my second Moderna vaccine on February 3rd and suppose to get my Botox injections for my migraines two weeks later. Should I delay my Botox injections due to possibly having an issue with facial swelling? I had a reaction to the Botox injections above my eyebrows and thus I now have one droopy eyelid and that is permanent. How long should I wait between the vaccine and the Botox injections?
Hi Judy,
Please see the response from a dermatologist we recently quoted here (which is, of course, not a replacement for personalized medical advice):
https://www.drugdiscoverytrends.com/facial-swelling-and-covid-19-vaccines-4-facts/
How can one opt for Pfizer brand vaccine only?
Hi Whitney, it would likely be difficult to opt for one vaccine over another given the shortage of supplies right now. The facial swelling issue is rare in any case, and could be triggered by viral infections as well.
I have a face full of fillers and had no reaction. Didn’t even know this was a concern until a friend asked if I was afraid of swelling.
Should I cancel my botox apt (forehead/eye area) on friday now that I’m scheduled for the monday after to get my first covid vaccine?
Hi Kim, please see the response from a dermatologist here (which is not a substitute for personalized medical advice):
https://www.drugdiscoverytrends.com/facial-swelling-and-covid-19-vaccines-4-facts/
Briefly summarizing, she said she is unaware of any problems from Botox for COVID-19 vaccines, but she still advises waiting two weeks after Botox injections to receive COVID-19 vaccination just in case there is a potential risk.
Thank you! I postponed my botox apt for two weeks after the 28 day after second dose. I’d prefer to not bombard my body with too much at a given time!