VALENCIA, VENEZUELA - JUN 22: An aesthetic doctor gives woman patient a botox injection, on June 22,...
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Botox, fillers and the COVID-19 vaccine: What you should know

Dermal filler injections can lend your face that smooth, sculpted look that so many of us covet. But recently, reports have surfaced associating fillers with a not-so-pretty potential side effect of the Moderna COVID-19 vaccine: temporary facial swelling. The phenomenon is rare, though, and should not deter you from getting vaccinated, Carolyn Treasure, a physician and co-founder of wrinkle prevention studio Peachy, tells Mic.

First, allow us to fill you in (sorry) on this popular procedure: Simply put, it involves injecting gel-like substances, or dermal fillers, beneath the skin in order to plump your lips, smooth your under-eye circles, and lift your cheekbones, among other cosmetic enhancements, according to Harvard Medical School. Fillers can consist of a number of synthetic or natural substances. Hyaluronic acid, which occurs naturally in skin, ranks among the most common.

Fillers aren’t to be confused with Botox, which works by blocking specific nerves, or weakening or paralyzing specific muscles, according to the U.S. National Library of Medicine. “It does not occupy any space," Treasure explains. "It has a mechanism of action that targets the muscles,” and then essentially dissipates. In contrast, filler “is very thick, very viscous. It stays right where it’s injected. It’s not an active protein. It doesn’t have a mechanism of action other than just taking up space. Those products really cannot be any more different.” (Peachy offers Botox, but not filler, injections.)

In December, STAT reported that two Moderna trial participants, both of whom had a prior history of dermal filler injections in their cheeks, experienced facial swelling post-vaccination. One had received filler injections two weeks before getting the vaccine, while the other did so around six months before getting the vaccine. A third participant, who’d previously received lip filler injections, developed lip swelling around two days post-vaccination.

The swelling is thought to be what’s known as a delayed hypersensitivity reaction, so “we’re looking at days rather than hours when people start to notice this effect,” Treasure explains.

Keep in mind, though, that we're talking about three people out of more than 15,000 enrolled in the vaccine arm of the trial. Treasure believes it's fair to consider this a rare side effect. It may be a local immune reaction, but the mechanism hasn’t been fully unraveled. And it’s not unexpected. Sometimes this local inflammatory response can occur with the flu vaccine, probably because filler is “a space-occupying foreign substance,” she says, prompting the immune system to react to it.

Indeed, the Moderna trial participant who'd experienced lip swelling reported that something similar had happened after receiving a flu shot, according to STAT. An FDA review of the literature also revealed other, earlier reports of people with filler injections experiencing temporary swelling in response to vaccinations.

The good news is, the swelling in the three Moderna trial participants with dermal fillers remained localized and subsided after treatment with steroids or antihistamines, STAT pointed out. But Treasure says scientists still need more data to confirm the association between the Moderna vaccine and the swelling observed in these individuals.

Although you should still get vaccinated even if you have, or plan to get, filler injections, she notes that it’s important to discuss the localized swelling observed in the three Moderna trial participants with your provider as one of the possible side effects that could occur.

No adverse events have been reported in patients who've received injections of Botox, or any of the three other FDA-approved wrinkle-relaxing neuromodulators (Xeomin, Dysport, and Jeuveau) before or after getting any of the currently available COVID-19 vaccines, Treasure says. People who are scheduled for vaccination often call Peachy confusing these agents with fillers, asking them if it's safe for them to get the vaccine if they, say, have Botox. Again, they're not the same thing.

But regardless of whether you have fillers, or Botox or other wrinkle-relaxing neuromodulators, the take-home message is to get vaccinated. The reports of the three Moderna trial participants aren’t a cause for serious alarm. “This doesn’t diminish or demur the efficacy of the Moderna vaccine or any of the three available COVID-19 vaccines,” Treasure says.