BRIEF RESEARCH REPORT article
Front. Neurol.
Sec. Neuro-Otology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1637870
This article is part of the Research TopicExploring Neurotological Health Concerns Post-COVID-19 InfectionView all 4 articles
Comparison of the Rates of Emergent Otologic Adverse Events Following mRNA COVID-19 versus Influenza Vaccination: A Matched Cohort Analysis
Provisionally accepted
- 1Stanford University School of Medicine, Stanford, United States
- 2Massachusetts Eye and Ear Infirmary, Boston, United States
- 3Atropos Health, New York, New York, United States
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Background: Otologic adverse events (AEs) have been reported following COVID-19 vaccination, but their incidence compared to established vaccines is unclear. This study compared the rates of new-onset otologic AEs among matched adults receiving mRNA COVID-19 vaccines versus influenza vaccines. Methods: This retrospective cohort study utilized electronic health records, identifying adults aged 50-89 years without prior otologic disorders who received either first-dose Pfizer/Moderna COVID-19 vaccines (12/2020–01/2022) or influenza vaccines (01/2016–12/2019). Patients required ≥90 days of pre-vaccination data and ≥6 months of follow-up. High-dimensional propensity score (hdPS) matching balanced cohorts. Rates of new-onset hearing loss (HL), sudden HL, tinnitus, vertigo, aural fullness, and otalgia were compared within 6 months post-vaccination using logistic regression. A sensitivity analysis excluded patients ever diagnosed with COVID-19. Results: After hdPS matching, 20,325 patients per cohort were included (mean age ~65 years; ~53% female). Rates of otologic AEs were similarly low in FluVax vs COVIDVax cohorts: any HL (1.16% vs 1.16%), sudden HL (0.01% vs 0.02%), tinnitus (0.41% vs 0.47%), vertigo (1.96% vs 1.59%), otalgia (0.27% vs 0.25%), and aural fullness (0.09% vs 0.20%). COVIDVax patients had lower odds of vertigo (OR 0.81; 95% CI: 0.70–0.94) but higher odds of aural fullness (OR 2.16; 95% CI: 1.25–3.72). Sensitivity analysis confirmed higher odds only for aural fullness. Conclusions: New-onset otologic AEs were rare among a large cohort of hdPS-matched patients with mRNA COVID-19 or pre-pandemic flu vaccination. These results indicate a similar otologic safety profile of the vaccines, although future research is recommended to corroborate the findings.
Keywords: COVID-19, Vaccination, influenza, Hearing Loss, Tinnitus, Vertigo, Aural fullness, Otalgia
Received: 29 May 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Munjal, Batts, Gombar and Stankovic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Konstantina M Stankovic, Stanford University School of Medicine, Stanford, United States
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