Drug Interaction Report

MONITOR: The following interaction applies only to products containing hyaluronic acid for use as a dermal filler. It does not apply to products containing hyaluronic acid that are used for other purposes.

Messenger RNA based SARS-CoV-2 (COVID-19) vaccines may increase the risk of a delayed hypersensitivity or inflammatory reaction to occur at or near the site of a hyaluronic acid dermal filler. The exact mechanism is unknown, but has been hypothesized to relate to the vaccine acting as an immunogenic trigger and/or hyaluronic acid acting as an adjuvant and enhancing the antigen-specific immune response to the vaccine. Case reports of this reaction exist, but a causative relationship has not been established and the incidence is believed to be infrequent. Data are not available for non-mRNA COVID-19 vaccines.

MANAGEMENT: Patients who have received dermal fillers (e.g., Juvederm Ultra XC) should be counseled to monitor for swelling at or near the site of the dermal filler following the administration of a SARS-CoV-2 (COVID-19) mRNA vaccine. Should the patient experience this reaction, treatment with intralesional or systemic corticosteroids with or without intralesional hyaluronidase (to dissolve the filler) has been proposed in the medical literature. Some authorities suggest that patients wait at least 3 weeks after completing their vaccine course before undergoing any elective cosmetic procedures involving hyaluronic acid-containing products.