In this post I will cover the top 5 questions related to the COVID-19 vaccine and dermal filler swelling.

1. Is swelling from the Moderna COVID-19 vaccine a real side effect?
2. I have facial fillers should I be worried about getting the vaccine?
3. If swelling occurs, where is it most likely to happen?
4. How could the vaccine given in my arm trigger swelling in my face where I’ve had dermal fillers?
5. Should I get the vaccine if I have fillers?

Let’s get to it!

1. Is swelling from the Moderna COVID-19 vaccine a real side effect?

Yes and here’s the data.

Rachel Zhang, an FDA medical officer who presented the agency’s analysis of the Moderna clinical trial data to the Vaccines and Related Biological Products Advisor Committee (VRBPAC),  reported that “two people (46 yo, 51 yo) developed facial swelling in 1 day and 2 days post dose 2, respectively, both having had prior dermal filler”. 

 A third person was mentioned as, “having formerly received lip injections” who developed swelling in the lips 2 days after vaccination.  “Interestingly, the subject reported a similar reaction after a previous influenza vaccine,” Zhang stated. 

All three people reported that the swelling resolved after treatment with an antihistamine or a steroid. Zhang stated the intent to have these finding noted in the prescribing information for the vaccine.

Want more?
Moderna VRBPAC briefing
Moderna VRBPAC briefing CSPAN video coverage
Pfizer VRBPAC briefing

2. I have facial fillers should I be worried about getting the vaccine? 

The short answer is no but keep reading.

First, you should understand what is meant by “filler”

Check out my blogs on cosmetic fillers to get to get up to speed: FDA Approved Dermal Fillers and What is an HA filler?

Knowing there are many types of dermal fillers and many brands within those types is important. So…which type and brand did the 3 people reporting the swelling in the clinical trials have? Further, how bad was the swelling…worse than the day after a filler treatment?  I’d love to share these answers but unfortunately, we don’t yet have the data to answer them (sigh). But let’s keep pressing on. Taking an educated guess based on popularity in the U.S., let’s assume that the type of filler those folks were treated with was an FDA approved hyaluronic acid (HA).

The great news is HAs are reversible and can be removed if necessary.  This happens almost immediately after an injection of hyaluronidase (an enzyme the dissolves the HA).  The better news is it is unlikely you would need to do this since the 3 people experiencing swelling had resolution with either an antihistamine or a steroid (anyone ever heard of the little gem, prednisone…but I digress). Both are standard go-tos in medicine for swelling and inflammation with well-studied doses and courses that are commonly used across all fields of medicine.

3. If swelling occurs, where is it most likely to happen?

Swelling would be expected to be localized in the area(s) previously treated with a dermal filler.

4. How could the vaccine given in my arm trigger swelling in my face where I’ve had dermal fillers?

Let’s review some basics first.

The COVID-19 vaccine is different than conventional vaccines we have had.  Conventional vaccines usually contain a weakened pathogen (the disease we are trying to prevent), an inactivated pathogen or part of a pathogen in a form we call an antigen once in the body.

The COVID-19 vaccine is an mRNA vaccine.  In simplest terms, this means the vaccine contains a messenger RNA (no actual viral particle present) that tells the body to produce specific proteins and these proteins act as the antigen. Then, when we are exposed to the real virus the body says, hey I have seen this before and instantly begins to fight it off. For those of you who want to get all science-y get the deets here: https://www.youtube.com/watch?v=LcTEmHlvY10 

After the vaccine we have antigens in our body for a period of time (just like in a conventional vaccine) and our body mounts an intended hyper-immune response as it is learning the antigen and making antibodies (what neutralizes the antigen) again it.

Now let’s consider how fillers may choose to join the party.

Cosmetic dermal fillers, even HA’s which are naturally occurring in our bodies, are still considered “foreign” since they are made in a lab and injected with clean procedure, not sterile. In the areas treated with cosmetic injectables, our body is called to attention and takes a closer look at them (swelling) during this hyper-immune period.

Certain brands of dermal fillers, anecdotally, have a higher propensity for swelling. Aesthetic practitioners can attest to cosmetic swelling behaviors normally seen in practice (without a vaccine) and will likely treat any post vaccine swelling similarly any new onset swelling.

5. Should I get the vaccine if I have fillers?

Yes! Having dermal fillers should not preclude you from being vaccinated. I am getting the vaccine and I am also due to have a bit of HA under my eyes and I intend to proceed. That being said, you should consult your medical provider about the risks and benefits of the COVID-19 vaccine as well as any cosmetic treatments you have had or are considering. 

Take a ways:

·      There were 30,000 people in the Moderna COVID-19 Vaccine Trials and 3 of them developed swelling in areas previously treated with cosmetic fillers. In all three cases the swelling was localized and resolved after antihistamine or steroid treatment.

·      Moderna’s clinical trials took place in the U.S. and there are currently 19 soft tissue fillers that are FDA approved for the face. The most popular type of filler is hyaluronic acid (HA). We do to know which type or brand the study subjects received prior to vaccination.

·      HAs are reversible and have established treatment protocols for reduction of excessive swelling. Should swelling occur post vaccination, it is treatable.  

·      We should be watchful, not alarmed, and continue to learn as more data is compiled regarding the COVID-19 vaccine and swelling in those previously having had treatments with cosmetic injectables. 

·      Check your sources as you peruse the web on this or any other aesthetic topic as there is an abundance of mis-information and negative attention grabbing headlines.

Please reach out with any questions through contact me or join the discussion on IG @ tracyholzmannp.

Disclaimer

The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding vaccination and healthcare treatments.