To the Editor Recent attention has centered on whether COVID-19 vaccines are associated with Bell Palsy or sudden sensorineural hearing loss (SSNHL). Formeister and colleagues address the latter, using Centers for Disease Control and Prevention (CDC) Vaccine Adverse Event Reporting System (VAERS) data to compare the incidence of SSNHL in individuals receiving a COVID-19 vaccine to historical baseline rates. Their study reports a lower estimated incidence of SSNHL in vaccinated individuals compared with historical norms. As the authors acknow ledge, the finding should be interpreted with care. The VAERS is an early warning system for detecting adverse events, and reports may be incomplete, inaccurate, coincidental, or unverifiable. Extrapolated epidemiological analyses are susceptible to bias, underreporting, or spurious associations. Many cases go unreported (particularly if mild and self-limited), and duplicate reporting may occur. As an example of potential distortions, long before the pandemic, VAERS reporting increased during pending litigation for vaccine injury.
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