Association between BNT162b2 vaccination and the development of delayed inflammatory reactions to hyaluronic acid-based dermal fillers—A nationwide survey

Background: Delayed inflammatory reactions (DIRs) to hyaluronic acid-based dermal fillers following COVID-19 vaccination has been reported in a few anecdotal reports and small series of cases. Aim: To evaluate the clinical characteristics, incidence, and management options relevant to BNT162b2 vaccination-associated DIR—A nationwide survey was conducted. Methods: An online self-administered survey was sent to physicians who actively practice tissue filler injections. The data acquired included demographic and clinical characteristics of relevant DIR cases. Results: Out of 262 responders, 20 cases with DIR following the vaccination were reported. 35% and 65% occurred shortly after the first and second vaccination dose, respectively. Overall, 65% of the DIRs appeared ≤5 days after vaccine administration and most DIRs resolved within 21 days. The filler's volume (p = 0.016) was associated with higher DIR severity, and the same tendency was noted among some filler types and locations of injection. Medical intervention was provided in 12 (60%) cases. Conclusion: DIR associated with BNT162b2 vaccination is rare and tends to resolve spontaneously or with short-term medical intervention.