Department of Laboratory Medicine and Pathology, Service of Clinical Pharmacology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.
Int J Audiol. 2023 Jun;62(6):587-591. doi: 10.1080/14992027.2022.2056721. Epub 2022 May 5.
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.
Case description.
We report four cases of transient audio-vestibular symptoms, which occurred shortly after inoculation of two BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna®) vaccines.
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.
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.
了解 SARS-CoV-2 mRNA 疫苗接种后耳鼻喉科疾病的临床过程和安全性。
病例描述。
我们报告了 4 例短暂的听觉-前庭症状，这些症状发生在接种两剂 BNT162b2（辉瑞-生物科技）和 mRNA-1273（Moderna®）疫苗后不久。
所有病例的听力损失均为单侧，至少部分恢复：2 例在 1 个月和 7 个月后出现持续性步态不稳。导致听觉-前庭损伤的触发机制尚不确定。免疫耐受机制可能涉及到前庭耳蜗神经障碍，就像其他颅神经受累一样，T 淋巴细胞的非靶向固有激活。
mRNA 疫苗接种后出现听觉-前庭表现需要耳鼻喉科监测，以支持其在这种罕见的疫苗相关不良事件中的因果关系。听觉-前庭障碍表现为短暂性，包括听力损失，不应阻止在大规模 SARS-CoV-2 疫苗接种活动中进一步努力。
