Lip Swelling After the COVID-19 Vaccine—Here's What To Know

About three weeks after receiving her second dose of the Pfizer-BioNTech COVID-19 vaccine, Desiree Battaglia woke up with a strange situation: Her lips were puffy.

"My initial reaction was a bit of alarm and just, 'What the heck is going on?'" Battaglia, 34, told Health. Battaglia initially thought she had had a reaction to cauliflower wings with cayenne pepper she had the day before. "I'm not big on spicy foods, so I figured it was a sensitivity to the spice."

So, Battaglia took an antihistamine and assumed the puffiness would disappear—but it didn't. The next day, Battaglia went to see a doctor. "We talked through all the possible causes, and she took a look at my lips and the inside of my mouth. Since I had not used any new skincare products or detergents, we both agreed it was probably the cayenne pepper," Battaglia said. "There were even little bumps along the outline of my lip that seemed to present as a reaction to the heat of the pepper." Her doctor also told her it would probably clear up in a day or two. It didn't.

While Battaglia said that her lips seemed to be getting better on Wednesday, they got worse the next day. "By Thursday evening, I was starting to feel a tingling sensation on my lips, and I noticed they were starting to swell again," Battaglia said and added that she was getting nervous at that point. "It definitely didn't make sense that this would carry on for so many days and would actually get worse," Battaglia said.

Battaglia said it was her mom who first suggested that maybe she was reacting to the COVID-19 vaccine. "I was skeptical since it had been about three weeks since the second dose," Battaglia said. But, after reading about the vaccine, she learned that lip swelling could happen—even a few weeks after the vaccine.

Lip swelling has been linked to the Moderna vaccine, especially in people who have had facial fillers. But Battaglia didn't have lip fillers; she had the Pfizer vaccine, not Moderna.

Battaglia said that her lips "definitely hurt a little…they felt very raw and itchy, mostly around the outer edge." They even started to feel numb. "I recall trying to drink out of my coffee mug that morning, and coffee kept dribbling down the side as my lips weren't able to form a full seal. It was very uncomfortable; it felt as if they were being blown up like a balloon."

On Friday—five days after she first had lip swelling—Battaglia went back to the doctor, who put her on a prescription steroid medication and a topical steroid. She was asked to follow up with a dermatologist.

"I started to see improvement that same day, but it did take a few days for my lips to return to their normal size," Battaglia said. She also noticed that she had "constant dryness" on her mouth and that her lips even looked grayish. "It looked like they had deflated and were wrinkled and dry," explained Battaglia.

Battaglia saw a dermatologist a few days later. "She was the first to say she was pretty confident it was a delayed reaction to the vaccine, as it's something she's seen a number of times before with other vaccines," Battaglia said. Her doctor recommended that she apply Vaseline or Aquaphor to keep her lips hydrated and keep up with the steroid medications. "Basically, since the skin on my lips stretched out so quickly and then returned to normal size, they were dried out and just needed some time to fully return to normal," said Battaglia.

It's only natural to have questions after hearing about Battaglia's experience. Here's what you need to know.

Can Lip Swelling Happen With the COVID-19 Vaccine?

A report issued by the Food and Drug Administration in December 2020 detailed how two people out of 30,000 enrolled in the Moderna COVID-19 vaccine trial had swelling within two days of receiving the second dose of their vaccine. While the report noted that "both subjects had prior dermal filler" (aka lip fillers), there were no more details. As of August 2022, the CDC did not warn about the risk of swollen lips with the Moderna or Pfizer-BioNTech vaccine.

But, experts said that lip swelling could happen with the COVID-19 vaccine—and really, any vaccine in general. "Lip swelling, or angioedema, can occur with almost any vaccine," Amiinah Kung, MD, an allergist at Northwestern Medicine Central DuPage Hospital, told Health. The side effect can be "scary," Dr. Kung said, because "it can be associated with anaphylaxis, a serious allergic reaction that can lead to shock or even death." Lip swelling on its own, though, is relatively harmless, Dr. Kung said. It's just uncomfortable.

As for why this kind of reaction can happen, that's less clear. "It could be a minor allergic reaction," infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, told Health. And even though the vaccine is injected in your arm, it enters your body's bloodstream and prompts an immune system response, Purvi Parikh, MD, an allergist/immunologist with Allergy & Asthma Network, told Health. Because of this, "swelling can occur anywhere," Dr. Parikh said.

Richard Watkins, MD, an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University, agreed. "Any person can have an idiosyncratic reaction to the vaccine," Dr. Watkins said.

Still, while lip swelling from vaccines can happen, it's hard to be entirely sure that Battaglia's swollen lips directly resulted from the COVID-19 vaccine. "This lip swelling may have been from something else altogether," Dr. Parikh said.

If you develop lip swelling after getting vaccinated, Dr. Kung recommended calling your healthcare provider. And, if it happens within four hours of getting the vaccine, you may need emergency treatment—that means you should take a trip to the ER.

"If the reaction occurs 24 hours later, this is considered a delayed reaction, which may or may not be allergic in nature," said Dr. Kung. If this happens after your first dose of the vaccine, Dr. Kung said it's a good idea to talk to an allergist to see if you should still receive the second dose as planned, along with any precautions you should take.

Battaglia said her lips were "completely back to normal" after a few weeks. Despite her intense experience, Battaglia said she doesn't want other people to be nervous about getting the vaccine.

"Once I learned this reaction can happen with any vaccine, it was even less concerning to me," explained Battaglia. "I think it's important that we do all we can to reach herd immunity and return to some type of normalcy."

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.