Letter to the Editor: Facial paralysis following messenger RNA COVID-19 Vaccines: The report of two Cases

Abstract

The Covid-19 pandemic is a big challenge for all of us and has brought us suffering, death, and fear. This issue is an unprecedented situation and requires an unprecedented response. Fortunately, COVID-19 vaccines have been developed rapidly and in a short period, they were demonstrated to be safe and effective. Also, World Health Organization is working to promote fair access to safe and effective COVID-19 vaccines and coordinates key steps in this process. Nowadays, thankfully more than ten different vaccines have been administered. The vaccination programs started in early December 2020 and more than 20% of the world population has received at least one dose of a COVID-19 vaccine by the end of June 2021 (1,2). Some of the COVID-19 vaccines have been the first to be produced using the messenger RNA (mRNA) platform. While high effectivity is an expectation of these vaccines also, they are “reactogenic,” meaning that they’re likely to cause a noticeable immune response. So, according to reports, about side effects following vaccination with the Pfizer and Moderna mRNA vaccines the side effects of the COVID-19 vaccine vary with the type of the vaccine (3,4). While the soreness of the site of injection is the most common side effect, other side effects such as headache, fatigue, muscle aches, joint pain, chills, and fever usually last 24 to 48 hours (3,4). Maybe not as a side effect but, an imbalance was reported in the incidence of facial paralysis following the vaccination. Facial paralysis (FP) was reported during the phase 3 clinical trials of mRNA COVID-19 vaccines (3,4). Seven cases were observed in vaccine groups among the 35611 participants (3,4). Also, facial nerve-related disorders such as facial paresis, facial spasms, and nerve disorders were reported as a drug reaction with mRNA COVID-19 vaccines (5). According to reports, we see symptoms of nerve pathology can vary from one to another and range in severity from mild weakness to total paralysis (5). According to World Health Organization Pharmacovigilance Database, almost half of the patients with FP were reported from the United States of America (USA) and the United Kingdom (UK) (5). According to our current knowledge, there is no case reported from Turkey. In June 2021, we had the opportunity to treat two patients with FP who developed nerve damage following the Pfizer COVID-19 vaccine. The purpose of this letter is to describe the individual situation of two FP patients in detail and to help health professionals make a decision about how to do things in similar features.