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Objectives: This study aims to analyze the association between the SARS-CoV-2 vaccine and the immediate botulinum toxin response.

Introduction: Recently, several queries have been sent to IMCAS ALERT regarding possible changes in the duration of the botulinum toxin effect in esthetic indications.
There is no consensus and many do not have the same vision.
Differences between different products are always questioned, but do not represent the majority opinion. The idea of possible differences prevails in certain batches (due to concentration variations? due to conservation and storage?).
Little is known about any change in treatment responses associated with the COVID 19 epidemic, either with the disease or with vaccination.

Materials / method: This was an observational, retrospective, and multicenter study. Data were collected between April and June 2021, and a medical record review of 71 patients from 27 to 76 years old who were treated with botulinum toxin (Botox®, Allergan; Dysport®, Galderma; Xeomin®, Merz) injection.

Results: There was no change in the immediate outcome of patients vaccinated for Covid-19 and botulinum toxin as just one of our patients demanded a higher dose of botulinum toxin to obtain the satisfactory previous result, which has represented only 2,3% of studied patients, our sample is small and further studies will be necessary to elucidate if it is relevant.
limitations of this study are the number of patients and their follow-up; however, this is an initial phase that could set the basis for future complete studies also to analyze if we have some different response in the duration of effect.

Conclusion: To the best of our knowledge, this is the first study analyzing the botulinum toxin immediate response in patients undergoing Sars-Cov-2 vaccination. This study is unprecedented and relevant because it aims to bring information about patients vaccinated for Sars-Cov-2 and treated with botulinum toxin, in a moment that little is known about this disease..

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