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.
Experts such as the American Board of Cosmetic Surgery have stressed that the risk of inflammation should not deter patients from getting vaccinated.
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.
Filed Under: clinical trials, Drug Discovery
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.
How soon after the second vaccination can I get Botox/fillers?
Hi Yvette,
Please see the advice here from a dermatologist who has experience with Botox and fillers:
https://www.drugdiscoverytrends.com/facial-swelling-and-covid-19-vaccines-4-facts/
I am due to have the COVID injection on Friday the 5th March and then to have Botox injection in my bladder on the 8th March will I be ok
Hi Donna, did you have any side effects? I am getting Botox within 2 days of my vaccine as well. Thank you.
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?
What did you do?
fillers 11 months ago a problem? getting vaccine tomorrow!
If I get botox for cervical dystonia can I get the covid vaccine.
I had my vaccine Monday night will I be ok to have my cervical dystonia injection next Wednesday.
Should I receive the Covid vaccine if allergic to penicillin and thermosol ?
Thank you for your reply.
I am allergic to penicillin, aspirin and NSAIDS, got the second dose of vaccine two days ago no side effects other than mild headache. Received BOTOX three months ago no side effects.
I’m allergic to penicillin and had zero reaction to both injections of the Pfizer vaccine
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?
I received both doses of Pfizer vaccine and subsequently Botox (Jeuveau brand) in forehead 9 days after the second dose of Pfizer vaccine. A few hours after getting Botox I started having pain in my arm injection site where I had the vaccines (same side effect that occurred for me briefly after getting each vaccine dose), and mild headache which also occurred a few hours after Botox (which could just be a side effect of Botox). Otherwise no noticeable swelling or other issues. Will update with any changes.
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.
Study’s from this claim was 3 in 36,000 patients in the trials got inflammation. They got steroid shot or took Benedryl and we’re fine. Really people!! The news has blown this up and freaked people out. They need to shut it
Right. It was three patients. The number I saw for Phase 3 clinical trial participants was 30,351. It was not disclosed how many of those had dermal 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?
Have your headaches eased up now that it’s been a while since the vaccine or are they still persistent?
I have had a persistent headache since getting the vaccine last week. I get Botox injections for migraines.
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?
Yes! I’m in the same boat. I had volumna a year ago and botox five months ago.
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?
No. If you have any severe reaction to the first dose, you should not get the second.
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!
I had the Moderna vaccine on Jan. 6th and had no reaction. My last filler with Voluma and Juvederm was 1 year ago; I also had Botox in September 2020 and no reaction in the areas of my face. The only reaction I had to from the vaccine was pain and a little swelling in the deltoid muscle. The swelling lasted that one day of the injection. The pain lasted until the end of the day after the injection.
I had Sculptra on 12/17 and then received the Moderna COVID vaccine on 1/17. Woke up on /19 and my entire left under eye and cheek area are swollen and tender. Assuming this is a reaction to the vaccine. So want to let you know that it can happen with Sculptra as well.
Also I was due for Botox today but have postponed for 2 weeks.
Hi Willa, how long did that took for the reaction to come back normal after you had your Sculptra treatment?
So is my facial swelling considered a severe adverse event (See Willa above) and that I should not take 2nd dose of Moderna vaccine next month?
I had the first dose of Moderna vaccine and had 26 units of Botox in my forehead and glabella five days later. No complications or facial swelling. Please note, this was BOTOX injections and NOT fillers. They are not the same thing. I go back for my second dose of the Moderna vaccine in 3 weeks. I will update this if I have any issues.
The second dose of Moderna was no picnic. At the 18 hour mark, I had chills, muscle aches, generally felt like a truck hit me. By the 36 hour mark, I felt fine.
I have a reaction after the flu vaccine. Had filler injected in my chin 5 months ago and 10 days after getting the vaccine it started swelling and the acid in this place was hard as rock (soft before). What’s more interesting I also had lip filler 7 month before but the lips are fine.
Now I take prednisone and the swelling slowly gets better. I am so worried I will have the same reaction after Covid vaccine.
I’m having my Moderna shot tomorrow. The next day, I’m having surgery cleaning up the kidney stone in bladder and kidney and taking stent out.
Should I wait to get my shot?
I received my first dose of Moderna on 1/23 and had Botox injections in my forehead and 11’s on 12/14. I noticed that not even a week after my vaccine that the Botox had worn off and my wrinkles were back. This is not normal as Botox should last ~3 months. I went back to my Dermatologist today, 2/1 and he injected the same amount of Botox that he did in December. I will keep everyone posted if I have reactions. I also have Juvederm and Restylane fillers I my face and did not notice any reactions after the vaccine. Hope this is helpful!
Thank you for posting ! Was this the first dose or second ? How are you now?
I had no idea about the reactions until after I had my vaccine. I had Botox and dermal fillers 2 days before not realizing there were any issues. Thankfully I do not think I had any reactions. Normal facial swelling is expected with injections so I did have minimal swelling but not obvious and I believe this was just normal for the filler and nothing to do with the Moderna vaccine. (They did ask me at the time of vaccination if I recently had any injections. For whatever reason I didn’t connect injections to facial injections until that evening when I googled and panicked a bit after reading about the few reactions.)
I am getting my second dose of the vaccine tomorrow hoping the same. I did read it was very few cases and all were resolved with steroids or antihistamines so I’m not really worried. Will let you know if I do have a reaction but I do believe it is rare and nothing to be too concerned about from what I have read thankfully.
I had my first vaccine with no side effects. I do have DVT and Thrombosythemia. I also had Botox a2months before first vaccine.
I am having the second vaccine in three days. I am somewhat concerned as a friend posted on Facebook that she was very sick.
I feel that the risk is worth the consequences of getting Covid. However, I am nervous.
I just received gel injection on my knee 7 days ago can I still get the covid-19 vaccine?
I had lip fillers over a year ago, but I just woke up the second day after the vaccine with a fat lip. Should I report this to anyone for statistical reasons?
Hi Maria, you could report it to VAERS (https://vaers.hhs.gov).
I last had lip filler at the start of December 2020. And I got my vaccine today. Lips are severely swollen and blinding sore heads. Been told to take antihistamines
Hello, I have ‘Long Covid’ and besides fatigue and some brainfog that is still left, my skin and hair took a hit. I feel like i aged 20 years over the past 3 months. I am desperate for some help with fillers/botox, but i am wondering if it is safe.
Advice would be very welcome.
Since I get so much botox, I’m scared. I get in both eyes, across forehead, both jaws, vocal cords, superglottis, neck and a breathing form of Dystonia and Trigeminal Nerve pain rt side of face. So if any swelling, scary
I got my botox done about a month ago (forehead and 11s area). Yesterday I had shot #1 of Pfizer. First thing I noticed after the 15 min was a slight stiffness throughout my face, more in the forehead area. Nothing extreme…it just took me by surprise, like a tightness from what I assume was slight swelling. My face wasn’t noticeably puffy when I looked in the mirror though.
Today I noticed a line in my 11 area that I don’t see unless I go too long between botox treatments (like 4 months). I can feel more movement too.
I’m guessing I should wait until after #2 to get re-botoxed.
I had ombré brows done on Monday and I’m scheduled to receive the COVID-19 vaccine on Friday within the same week I got my brows done. Should I still get the vaccine?
I am booked for a Covid vaccine on the 17th of March and a Botulinum injection on the 19th , is it allowed
Hi Antonio,
Thanks for the comment. A dermatologist I interviewed recommended waiting two weeks to be extra cautious. Check out the post here:
https://www.drugdiscoverytrends.com/facial-swelling-and-covid-19-vaccines-4-facts/
I had Botox 12 years ago and got Johnson and Johnson vaccine Monday. Had headache, nausea and chills next day that resolved in 24 hours. Wednesday evening I noticed slight swelling in old Botox areas ( scowl lines) .
I got botox treatment for migrains 2 weeks before getting second Mederma. Second day after after virus injection face swelled up bad and was painful to touch also having right eye issues. Headaches are crazy bad and now wondering if second shot was a wise decision with crazy migraines.
I have never had fillers but today just over a week after my first Covid vaccine (Moderna) my top lip started to swell this afternoon. Now what?
I am having mild Botox on 8th of May forehead and around the eyes then a top up 2 weeks later then on 23rd May I’m booked in for my second vaccine is it ok having Botox in same month ?
so what do I do if I have had fillers and I had both shots of moderna and my face is red with a rash and its been for more then a week? So now I’m taking Benadryl. I’m really red