Facial paralysis can be observed in the context of many conditions, such as viral infections, traumatic injury, cancers, or hormonal changes during pregnancy. Idiopathic causes, also known as Bell palsy, are unilateral, generally reverse spontaneously, and cause partial or complete acute weaknesses of the face. Isolated facial paralysis after vaccination has been reported as case reports for decades with almost all viral vaccines, and it is thought to be immune-mediated or induced by viral reactivations (i.e., reactivation of a herpes virus infection). However, to date, pharmacoepidemiological studies have failed to identify a higher risk of facial paralysis after vaccination.

When compared with other viral vaccines, mRNA COVID-19 vaccines did not display a signal of facial paralysis. As of March 9, 2021, more than 320 million COVID-19 vaccine doses had been administered worldwide. Therefore, despite selective reporting and a potential delay in reporting and transferring cases among pharmacovigilance databases, the reporting rate of facial paralysis after mRNA COVID-19 vaccination found in a recent JAMA published study is not higher than that observed with other viral vaccines. If an association between facial paralysis and mRNA COVID-19 vaccines exists, the risk is likely very low, as with other viral vaccines.

Bottom line, if you have a resident exhibiting new onset of unilateral facial drooping, report it to your pharmacy provider who managed your vaccine clinics. Fortunately most recover from the paralysis however, this information is critical to tracking adverse reactions for future use! Stay well, mask up indoors and stay tuned!