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Four cases of audio-vestibular disorders related to immunisation with SARS-CoV-2 mRNA vaccines
Pierre Ekobena1, Laura E Rothuizen1, Francesca Bedussi2
1Department of Laboratory Medicine and Pathology, Service of Clinical Pharmacology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Objective:
To gain medical insight into the clinical course and safety of otolaryngologic disorders following immunisation with severe acute respiratory coronavirus (SARS-CoV-2) mRNA-based vaccines.
Design:
Case description.
Study Sample:
We report four cases of transient audio-vestibular symptoms, which occurred shortly after inoculation of two BNT162b2 (Pfizer-BioNTech®) and mRNA-1273 (Moderna®) vaccines.
Results:
Hearing loss was unilateral in all cases and recovered at least partially: it was associated with persistent gait instability in two cases, after 1 and 7 months. Trigger mechanisms underpinning audio-vestibular impairment remain uncertain. Immune tolerance mechanisms with off-target innate activation of T-lymphocytes may be involved in vestibulocochlear nerve disorders, as for other cranial nerves involvement.
Conclusions:
The occurrence of audio-vestibular manifestations following mRNA-based vaccines needs ENT monitoring to support their causality in such rare vaccine-related adverse events. Audio-vestibular disorders appeared of transitory nature, including hearing loss, and should not deter further efforts in large-scale vaccination campaigns against SARS-CoV-2.
Insights
Four patients experienced temporary audio-vestibular issues, including hearing loss, after receiving severe acute respiratory coronavirus (SARS-CoV-2) mRNA vaccines. These rare events were transient and should not impede vaccination efforts.
Area of Science:
- Otolaryngology
- Immunology
- Vaccinology
Background:
- Severe acute respiratory coronavirus (SARS-CoV-2) mRNA vaccines (BNT162b2 and mRNA-1273) have been widely adopted.
- Understanding potential adverse events, particularly otolaryngologic manifestations, is crucial for vaccine safety monitoring.
Observation:
- This study describes four cases of transient audio-vestibular symptoms following SARS-CoV-2 mRNA vaccination.
- Symptoms included unilateral hearing loss, which partially or fully resolved.
- Two cases also presented with persistent gait instability lasting up to seven months.
Findings:
- The exact mechanisms triggering these audio-vestibular symptoms remain unclear.
- Potential involvement of immune tolerance mechanisms and off-target T-lymphocyte activation is hypothesized.
- These rare adverse events appear to be temporary.
Implications:
- Otolaryngology (ENT) monitoring is recommended for patients experiencing audio-vestibular symptoms post-vaccination.
- The transient nature of these symptoms should not discourage widespread SARS-CoV-2 vaccination.
- Further research is needed to elucidate the precise causal links and underlying pathophysiology.
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