Previous reports suggested peripheral facial nerve (Bell) palsy was an adverse effect of the mRNA BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine, but a recent case-control study from Israel found no significant association between this vaccine and risk of facial nerve palsy. Study findings were published in JAMA Otolaryngology–Head & Neck Surgery.

The findings from this study appear “noteworthy,” according to the researchers, given the first vaccination in Israel occurred in mid-December 2020; more than 92% of the country’s population greater than 50 years of age had received their first dose by March 1, 2021. “Given even a small association of the vaccine with facial nerve palsy, a dramatic increase in cases should have been evident,” the study researchers explained.

The study included 37 patients (mean age, 50.9 years; men, 59.5%) who were admitted to an emergency department of a tertiary referral center in Israel with new-onset peripheral facial nerve palsy from January 1 to February 28, 2021. A total of 21 (56.7%) patients had received the BNT162b2 COVID-19 vaccine. All patients were matched by age, sex, and admission date to 74 control patients who were admitted for reasons other than facial nerve palsy.

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In the group of vaccinated patients, the mean interval between vaccination to the onset of palsy was 9.3 days from the first dose and 14.0 days from the second one. In the control group, 59.5% (n=44) of patients were vaccinated with BNT162b2. The adjusted odds ratio for exposure to the vaccine in patients with palsy was 0.84 (95% CI, 0.37-1.90; P =.67).

In a separate analysis, the study investigators found a similar admission volume in 2021 for facial nerve palsy compared with the years between 2015 and 2020 (mean, 26.8; median, 27.5).

Limitations of this study included the assessment of only recent vaccination effects, and the lack of long-term outcomes to for analysis. Additionally, findings may not be generalizable across other authorized COVID-19 vaccines.

Ultimately, the study researchers concluded that “no association was found between recent vaccination with the BNT162b2 vaccine and risk of facial nerve palsy.”


Shemer A, Pras E, Einan-Lifshitz A, Dubinsky-Pertzov B, Hecht I. Association of COVID-19 vaccination and facial nerve palsy: A case-control study. JAMA Otolaryngol Head Neck Surg. 2021;147(8):739-743. doi:10.1001/jamaoto.2021.1259

This article originally appeared on Neurology Advisor