Can You Get Vaccinated After Facial Nerve Paralysis? Expert Insights

Can a person who has had facial nerve paralysis receive a vaccine?

In early 2019, I experienced stiffness on the right side of my face, could not close my right eye, and my mouth was slightly crooked.
After receiving injections, medication, heat therapy, and facial exercises, my condition improved over the course of about one to two months.
However, since then, nearly three years have passed, and I still experience unusual sensations on the right side of my face, such as stiffness and tightness, and occasionally some twitching.
When I smile, the left side feels natural, while the right side feels tight.
In summary, the sensations on both sides of my face are different! I have consulted with clinics, and some doctors suggested that I could receive a vaccine, while others advised against it.
I would like to ask, "Given my current condition, can I receive a vaccine? Which type of vaccine would be appropriate for me? How should I make this decision? If I cannot receive a vaccine, are there any other protective injections I can take? I am hesitant to get vaccinated due to the potential side effects, such as facial nerve paralysis and thrombosis, which have made me reluctant to get vaccinated until now..."

Xiao Mi, 20~29 year old female. Ask Date: 2022/01/06

Dr. Jiang Junyi reply Neurology

Dear Ms.
Hsiao-Mi,
You mentioned, "Given my current situation, can I get vaccinated? Which vaccine should I choose? How should I decide? If I cannot get vaccinated, are there any other protective injections I can receive? I am hesitant to get vaccinated due to the side effects such as facial nerve paralysis and thrombosis..."
Currently, there are rare case reports linking facial nerve paralysis to mRNA vaccines, specifically BNT and Moderna.
The adverse reaction of thrombosis associated with the AstraZeneca vaccine is known as VITT (Vaccine-induced immune thrombotic thrombocytopenia), which is a vaccine-induced condition characterized by thrombocytopenia and thrombosis.
The incidence rate in Europe is approximately 1 in 10,000.
This usually occurs within 4 to 28 days post-vaccination.
Please be vigilant for symptoms such as leg swelling, shortness of breath, headache accompanied by blurred vision, and persistent abdominal pain lasting more than 24 hours.
Facial nerve paralysis is typically associated with viral infections.
I am unsure if you are currently taking hormone medications or if you smoke.
With the recent emergence of the Omicron variant, it is advisable to get vaccinated promptly to avoid severe COVID-19.
You may consider the AstraZeneca or High-End vaccines.
After vaccination, individuals are usually required to rest on-site for 15-30 minutes to monitor for any discomfort.
If you experience any adverse effects, please inform the healthcare staff immediately for prompt management of any severe allergic reactions.
The incidence of fever post-vaccination ranges from 8% to 16%, and it generally resolves within 48 hours.
It is recommended to stay hydrated and rest.
If fever persists or if you experience other discomforts, please seek medical attention and inform the physician of your symptoms, their onset, and the timing of your vaccination.
It may be helpful to have some single-ingredient acetaminophen on hand (avoid combination products) for any discomfort.
I hope your vaccination experience goes smoothly.
Thank you for your inquiry, and feel free to discuss any related questions further!
Wishing you good health and peace,
Dr.
Chien-Yi Tso, Tao Medical Center

Reply Date: 2022/01/06

More Info

When considering vaccination after experiencing facial nerve paralysis, it is essential to understand both the nature of your condition and the potential risks and benefits associated with vaccination. Facial nerve paralysis, such as that seen in Bell's palsy or other forms of peripheral facial nerve dysfunction, can lead to various symptoms, including facial asymmetry, difficulty closing the eye, and altered sensations on the affected side of the face. While these symptoms can be distressing, they do not inherently contraindicate vaccination.

Understanding the Relationship Between Facial Nerve Paralysis and Vaccination
1. Nature of Facial Nerve Paralysis: Facial nerve paralysis can result from various causes, including viral infections, trauma, or idiopathic reasons. In many cases, the paralysis is temporary, and patients can recover fully or partially over time. The lingering sensations you describe, such as stiffness or tightness on one side of your face, are not uncommon and may indicate residual effects from the initial nerve injury.

2. Vaccination Considerations: Vaccines, particularly mRNA vaccines like Pfizer-BioNTech and Moderna, have been associated with rare cases of facial nerve issues, but these occurrences are exceedingly uncommon. The benefits of vaccination, especially in the context of preventing serious illness from diseases like COVID-19, generally outweigh the risks, particularly for individuals with a history of facial nerve paralysis.

3. Consulting Healthcare Providers: Given the mixed opinions you've received from different healthcare providers, it is crucial to have a thorough discussion with a neurologist or a healthcare professional familiar with your medical history. They can assess your current health status, the severity of your facial nerve symptoms, and any other underlying conditions that may influence your vaccination decision.

Recommendations for Vaccination
1. Type of Vaccine: If you decide to proceed with vaccination, consider discussing which vaccine may be most appropriate for you. Some individuals may prefer viral vector vaccines (like Johnson & Johnson) or inactivated vaccines (like Sinovac or Sinopharm) if they have concerns about mRNA vaccines. Each vaccine has its own profile of efficacy and side effects, so it’s essential to weigh these factors with your healthcare provider.

2. Monitoring Post-Vaccination: After receiving a vaccine, it is advisable to stay at the vaccination site for 15-30 minutes to monitor for any immediate adverse reactions. This is standard practice and allows for prompt medical attention if needed.

3. Managing Anxiety About Side Effects: It is understandable to have concerns about potential side effects, especially given your history. While some vaccines have been associated with rare neurological side effects, the overall incidence is low. Discussing these concerns with your healthcare provider can help alleviate anxiety and provide clarity on the risks versus benefits.

4. Alternative Protective Measures: If you ultimately decide against vaccination, consider other protective measures against infectious diseases, such as practicing good hygiene, wearing masks in crowded places, and avoiding close contact with sick individuals. Discussing preventive medications or treatments with your healthcare provider can also be beneficial.

Conclusion
In summary, while facial nerve paralysis can lead to lingering symptoms, it does not automatically preclude you from receiving vaccinations. The decision to get vaccinated should be made in consultation with a healthcare provider who understands your medical history and current health status. They can help you navigate the options available and ensure that you make an informed choice that prioritizes your health and well-being. Vaccination remains a critical tool in preventing serious illness, and understanding your unique situation will empower you to take the best steps forward.

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