Letter from the CEO: Let's Talk About the Vaccine and Filler Issue

Posted By Mike Meyer, Tuesday, January 5, 2021


By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

As many of us return to work in medical aesthetics after the holidays, we'e been greeted by the news that a few people who have dermal fillers have had adverse reactions to a COVID-19 vaccine. You may even have received some worried questions from your patients about what they should do.

Here's the bottom line, right at the top—while we should never minimize potential side effects, this story should absolutely not stop people with fillers from receiving the vaccine. We spent some time looking at all the available information from the U.S. Food and Drug Administration (FDA) and other available sources, and we can confidently say that patients should not be concerned about getting the vaccine after receiving fillers. Yes, you should be prepared to discuss the issue with your patients using facts and available data, and yes, it's always wise to document those conversations with signatures (i.e. consent forms), but in the end, based upon the available information, your patients should have nothing to worry about and you should feel comfortable treating them. Here's why:

First, the reactions so far have only been reported in patients receiving the COVID-19 vaccine developed by Moderna; there are currently no reported reactions of this type to the Pfizer vaccine. (If you'd like to review this data yourself, these facts were all taken directly from the briefing documents from the FDA Advisory Committee meetings for the Pfizer and Moderna vaccines, which can be found here and here, respectively.) Second, the reactions are rare—only three cases were reported out of a pool of 30,420 during clinical testing of the Moderna vaccine. (However, there has been no indication of how many of those in the trial have received dermal fillers.) Third, the reactions so far have been minor and have been easily treatable—two of the patients experienced facial swelling around where they had received the filler treatments, and the third experienced swelling of the lip (angioedema); all were treated successfully with oral steroids and/or antihistamines. The patients had received filler injections between two weeks and six months prior to being vaccinated. According to the FDA and other experts, these are relatively minor risks that are effectively treated without long-term consequences.

There really is no controversy here—according to the available information, this story should not prevent anyone from receiving the vaccine, nor should it prevent anyone from receiving filler. The sooner we are all vaccinated, the sooner this pandemic will be under control and we can return to more normal times.

However, practitioners should absolutely discuss these risks, the same way they discuss other risks, as part of obtaining informed consent from the patient. (For sample consent language related to this issue, see below.) Not only is informed consent critical to the compliant practice of medicine, it also is important in setting expectations with your patient. And, for what it's worth, the reported reactions with the vaccines are not dissimilar to common reactions from receiving dermal filler treatments and even other vaccinations. (The person who said they'd experienced swelling of the lip said they'd had a similar reaction to a flu shot.) Patients who experience any type of complication are going to have a higher level of trust and satisfaction with your treatment if they know what to expect and are not caught off-guard.

This story has made enough news that you're likely going to have to discuss it with anyone who's considering undergoing treatment with fillers, and people do tend to get caught up in worst-case scenarios. However, it is far more important to their personal health and the public's health that they receive the vaccine as soon as it's made available to them. We made it through 2020—the possibility of a little swelling and discomfort shouldn't faze anyone at this point.

For those of you interested, here is sample consent language you can use with your patients regarding this issue (as always, this should be used as an informational guide only—check with your lawyer for more information):

COVID-19 Vaccine Adverse Reaction

I understand that some patients who have had dermal filler treatments have experienced a rare non-life-threatening reaction after receiving a COVID-19 vaccine (Moderna). Those patients experienced swelling and allergic reactions to the filler treatment sites. The reactions were not severe and in all cases were resolved quickly with the use of oral steroids and/or antihistamines resulting in no long-term adverse effects. I understand that while this reaction is rare, it has occurred before and may occur in myself. I will be observant and seek appropriate medical attention should I experience any similar side effect following my COVID-19 vaccination.

Our friends at ByrdAdatto are developing a full COVID-19 vaccine/filler consent form that should be available soon. Stay tuned for this, as well as more developments in this story when and if they occur.

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