Bell’s Palsy After 24 Hours of mRNA-1273 SARS-CoV-2 Vaccine

Coronavirus disease 2019 (COVID-19) has become the fastest-spreading pandemic of the 21st century. Various vaccines have been made available via emergency use authorization. Currently, two mRNA vaccines are being offered internationally, BNT162b2 and mRNA-1273. In randomized trials of these vaccines, the incidence of Bell’s palsy in the vaccinated group does not statistically exceed the placebo group. The FDA recommends increased surveillance for Bell’s palsy as a potential side effect with the administration of the vaccines among larger populations globally. There have been a few case reports of Bell’s palsy associated with mRNA vaccines. Type I interferons have been proposed as the potential mechanism linking mRNA COVID-19 vaccines to Bell’s palsy. Here, we report the case of a 36-year-old previously healthy patient who developed symptoms of Bell’s palsy along with left-arm numbness, tingling, and subjective weakness masquerading as a subacute stroke after receiving the second dose of the mRNA-1273 vaccine. CT and MRI of the brain were unremarkable. He was discharged home with a diagnosis of Bell’s palsy and improved on follow-up. mRNA COVID-19 vaccines may be considered a risk factor for Bell’s palsy.

[1]  C. Martin-Villares,et al.  Bell’s palsy following a single dose of mRNA SARS-CoV-2 vaccine: a case report , 2021, Journal of Neurology.

[2]  V. Baker,et al.  Bell’s palsy following the Ad26.COV2.S COVID-19 vaccination , 2021, QJM : monthly journal of the Association of Physicians.

[3]  H. Fennema,et al.  Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19 , 2021, The New England journal of medicine.

[4]  A. Pariente,et al.  Type I interferons as the potential mechanism linking mRNA COVID-19 vaccines to Bell's palsy , 2021, Therapies.

[5]  B. Alghamdi,et al.  Minor to Moderate Side Effects of Pfizer-BioNTech COVID-19 Vaccine Among Saudi Residents: A Retrospective Cross-Sectional Study , 2021, International journal of general medicine.

[6]  O. Levy,et al.  Bell's palsy and SARS-CoV-2 vaccines , 2021, The Lancet Infectious Diseases.

[7]  N. Cirillo,et al.  Bell’s palsy following COVID-19 vaccination , 2021, Journal of Neurology.

[8]  N. Cirillo Reported orofacial adverse effects of COVID‐19 vaccines: The knowns and the unknowns , 2021, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[9]  J. Mascola,et al.  Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine , 2020, The New England journal of medicine.

[10]  T. Hadlock,et al.  Bell's palsy: aetiology, clinical features and multidisciplinary care , 2015, Journal of Neurology, Neurosurgery & Psychiatry.