COVID-19 Vaccine and Filler Reactions

So, what is the scoop on the Moderna vaccine reactions associated with fillers?
Gloved hand holding syringe

So, what is the scoop on the Covid vaccine reactions associated with fillers?

What we know:

In the Moderna phase three trials (of over 30,000 patients), 3 patients (0.01%) had facial or lip swelling after the vaccine. We do not know exactly how long after nor which fillers these patients had. We do know that two patients had fillers within six months of receiving the vaccine and one patient with lip swelling had the filler one day after getting the vaccine (she has had similar lip swelling after getting the flu shot one month prior). In all cases the swelling resolved with steroids and antihistamines. We also do not know how many other filler recipients there are in this cohort in general (i.e., what is the incidence of swelling associated with the vaccine in the filler recipient subgroup). We also did not get a report stating these were true inflammatory nodules. There is a difference between swelling and nodules.

My Take:

1. The swelling in these patients was likely due to a strong general immune response to the vaccine (a good thing) and an associated and EXPECTED swelling in and around the filler areas. This could be from immune complex reaction to the filler, general tissue inflammation, or both. When tissue is inflamed, it holds onto water. HA fillers love water, so will hold onto that water when they sees lots of fluid in tissues. It does not seem as though any of the patients developed real inflammatory “nodules” which would be a more significant event.

Regular transient tissue swelling from filler injections happen routinely, in some patients more than others, and resolve in a day to a week after injection; this is from some inflammation. More pronounced inflammatory immune-mediated reactions also can and do happen with certain HA fillers in certain patients, albeit rarely. I do not see this any differently and thus is not a huge cause for alarm.

As an immunobiologist keenly interested in the topic, I have had specific protocols in place to minimize these reactions, which has really paid off over the years. Anyone with an auto-immune or inflammatory condition, or a “trigger-happy” immune system, receives only the least reactive fillers. While the whole topic is behind the scope of this blog, it is important to note that certain group of HA fillers, have a higher rate of delayed inflammatory reactions and nodules, so I avoid using these fillers in patients with such conditions, which include autoimmune medical conditions of all kinds, and especially Lyme disease or tick-borne illnesses which also cause an auto-immune inflammatory response in the body. COVID-19 itself very much behaves like this. So, since the beginning of the pandemic, I have also avoided using these specific fillers in anyone who has had COVID-19 for six months after the end of their inflammatory symptoms.

  1. This is absolutely no reason to avoid getting the COVID-19 vaccine. I would suggest to:

-Delay filler treatments for at least 2-3 weeks after the vaccine.

-Avoid certain category of fillers for a period of time before and after receiving the vaccine in consultation with your aesthetic physician. There are many other choices.

-If you have had filler, it is still ok to get the vaccine.

-If you have had fillers recently and have the opportunity to get vaccinated, remember that most do not have any reaction of significance and even if you do have a reaction like swelling or nodules, we can take care of that in a satisfactory way.  

-Inflammation and swelling of filler can happen in response to any of the vaccines, even though the reports are from the Moderna vaccine trial. There is no real reason based on data to date, to specifically avoid one vaccine type or brand , over another for this reason.


The cost-benefit is in favor of getting vaccinated regardless. Everything in medicine is about cost-benefit and there are no free lunches.

Ask yourself: Would you rather get sick with COVID-19 and end up in the ICU? Or have some swelling for a day that goes down, or the worst-case scenario, nodules that can be dissolved?

We need data among filler recipients with filler details who are vaccinated to see what the true incidence of different reactions are and which fillers or which patients are more prone.

This is no time for sensationalism nor irrational decision-making. I urge everyone to educate themselves about the vaccine and make the best decision for themselves regardless of filler treatments. The timing and modifications for aesthetic treatments can be done intelligently in conjunction with a smart, board-certified core physician. This is the time to use a real expert specialist for your cosmetic fillers and treatments. These are medical procedures, as I always say! Rethink beauty intelligently…