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No Signal of Facial Paralysis Found for mRNA COVID-19 Vaccines

WEDNESDAY, April 28, 2021 -- mRNA COVID-19 vaccines do not display a signal of facial paralysis compared with other viral vaccines, according to a research letter published online April 27 in JAMA Internal Medicine.

Lucie Renoud, from the Grenoble Alpes University Hospital in France, and colleagues performed four analyses with two control groups (all other viral vaccines and restricted to influenza vaccine) and two facial paralysis definitions (broad and narrow) to examine the potential safety signal for facial paralysis associated with mRNA COVID-19 vaccines through a disproportionality analysis using the World Health Organization pharmacovigilance database.

The researchers identified 844 (0.6 percent) facial paralysis-related events among 133,883 cases of adverse drug reactions reported with mRNA COVID-19 vaccines on March 9, 2021, including 683, 168, 25, and 13 cases of facial paralysis, facial paresis, facial spasms, and facial nerve disorders, respectively. Overall, 749 and 95 cases were reported with the Pfizer-BioNTech vaccine and the Moderna vaccine, respectively. Most of the patients (67.8 percent) were female, and the median age was 49 years. Time to onset was a median of two days. Among the 1,265,182 cases of other viral vaccines and the 314,980 cases reported with influenza vaccines, 5,734 (0.5 percent) and 2,087 (0.7 percent) cases of facial paralysis were reported, respectively. No signal of disproportionality of facial paralysis was detected for broad or narrow definitions versus other viral vaccines or influenza vaccines alone.

"To conclude, if an association between facial paralysis and mRNA COVID-19 vaccines exists, the risk is likely very low, as with other viral vaccines," the authors write.

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