Vaccine site posts inquiry on dermal face fillers

Those who have made vaccine appointments via the VAMS site, have seen an inquiry about dermal face fillers on the pre-appointment questionnaire.

“Do you have any dermal fillers (a cosmetic injection to diminish facial lines and restore volume and fullness in the face),” the CDC site asks. This is in reference to a rare and non-life threatening reaction that has been observed in patients with such fillers — including lip fillers, but not including Botox, which is not a dermal filler.

As of December 2020, two reactions had been reported after the Moderna vaccine. But last week, the Journal of the American Academy of Dermatology published a study that found a total of nine reactions in people with dermal fillers to both the Moderna and Pfizer vaccines (Johnson & Johnson had not been approved for use at the time of the study, so it was omitted). According to Dr. Esther Freeman, an associate professor at Harvard Medical School, principal investigator for the COVID-19 Dermatology Registry and one of the authors of the report, the study looked at 2,000 people. Out of that sample, 414 people had delayed skin reactions in general and nine of them were in response to dermal fillers, she said.

“Reactions to filler is something we do see, but it's still extremely rare. When it does happen, it has not been life threatening or severe. No anaphylaxis,” Freeman said. “So even if you have had a reaction, you can go ahead and get a second shot. It’s not a reason not to get the shot.”

The negative reaction may consist of swelling and nodules at the site of the dermal fillers and typically lasts a few days. Treatment varies from taking over-thecounter antihistamines to seeking medical attention (corticosteroid therapy, according to the CDC). Freeman said the reaction occurs many hours after taking the vaccine, which is why it is classified as “delayed.”

Dr. Robin Evans, a dermatologist at Southern Connecticut Dermatology in Stamford, has not had any patients who have reported reactions. However, she does know of one case involving someone who is not one of her patients. Evans and Freeman said reactions to fillers have been observed with other vaccines (aside from COVID) in rare instances as well.

Evans said she is advising her patients to hold off getting fillers until they receive their vaccine. She also stressed that people should not be discouraged from getting the COVID vaccine as risk of reaction is low and also not severe.

“What I’m saying to my patients is if you're here today for filler and you tell me you’re getting the vaccine this week or next week, wait a couple weeks for the filler,” Evans said. “Even though it’s a rare event, if it happens to you, it doesn't feel very rare, so why take the chance? Wait a couple weeks to get the filler.”

Freeman pointed out those who have had dermal fillers in the past, even if it was months earlier, could be at risk. The study found that the reaction happened to a patient whose last filler procedure was a year prior. She advises anyone who is thinking about getting filler for the first time to wait until after getting the vaccine. She also advises that patients contact their dermatologist immediately if they experience a reaction.

“This gives all the more reason to make sure you’re getting your (dermatological) treatment where there is a physician on board — to manage complications,” Evans said. “Make sure whoever you decide to start putting needles in your face knows how to handle an event.”