Tinnitus is the medical term for the perception of sound, such as a ringing, buzzing, hissing, or roaring, that does not have an external source. This sound is typically only heard by the affected person and can range from a mild annoyance to a highly disruptive condition. As the COVID-19 vaccines rolled out, reports emerged suggesting a connection between the shot and the onset or worsening of this auditory symptom. This article examines the evidence to provide context on the nature and magnitude of this potential adverse event.
Current Understanding of the Reported Link
The link between COVID-19 vaccination and tinnitus was first flagged through passive surveillance systems, such as the Vaccine Adverse Event Reporting System (VAERS) in the United States. These systems collect reports of any health issue that occurs following vaccination, regardless of whether the vaccine is the cause. By late 2021, over 12,000 cases of post-vaccination tinnitus had been reported to VAERS, establishing a signal that warranted closer scientific examination.
Researchers have explored potential biological explanations for why the vaccine might trigger this symptom. One theory involves an immune-mediated inflammation or transient inflammatory response. The immune system’s reaction to vaccine components, such as the spike protein, might in rare cases affect the delicate structures of the inner ear. However, the precise mechanism remains unclear, and the event is thought to be an unusual immune reaction rather than a direct toxic effect.
Statistical Reality and Frequency of Occurrence
While passive reporting systems collect a wide range of data, they cannot determine the true rate of an event since they rely on voluntary submissions. To quantify the risk accurately, scientists turn to large-scale, active monitoring studies. Data from the Vaccine Safety Datalink (VSD), which uses electronic health records from millions of patients, showed the rate of new-onset tinnitus after a first dose of an mRNA COVID-19 vaccine was approximately 0.038%.
This translates to about 38 cases for every 100,000 vaccine doses administered. Further analysis of passive surveillance data showed up to 84.82 tinnitus reports per million COVID-19 vaccine doses. VSD studies comparing COVID-19 vaccine recipients to those who received the influenza vaccine found that the rates of new-onset tinnitus were similar between the two groups, suggesting the occurrence is not disproportionately linked to the COVID-19 vaccines alone.
Comparing Tinnitus from Vaccination Versus Infection
To fully understand the risk, it is important to compare the rate of tinnitus after vaccination with the rate following a COVID-19 infection. The risk of developing tinnitus is substantially higher after contracting the SARS-CoV-2 virus than after receiving the vaccine. Tinnitus is a recognized symptom that can emerge during the acute phase of the illness or persist as a symptom of long-COVID.
Initial studies reported that between 8% and 15% of people ill with COVID-19 developed tinnitus. A comprehensive review found that approximately 4% of individuals experienced tinnitus after their infection. This higher risk from the disease itself contrasts sharply with the incidence of around 0.038% following vaccination. The data consistently indicate that the infection carries a much greater risk for this specific adverse event than the vaccine.
Reporting and Medical Management
If a person experiences new-onset tinnitus or a worsening of existing symptoms shortly following vaccination, the first step is to consult a healthcare provider immediately. A medical professional can assess the symptoms, rule out other common causes of tinnitus, and determine the most appropriate course of action.
Patients should also report the event to their national surveillance system, such as VAERS. These systems rely on public reporting to help monitor vaccine safety and detect potential patterns that require further investigation. In cases where the tinnitus is suspected to be vaccine-associated, immune-targeted treatments like corticosteroids are considered a first-line option. Management focuses on addressing the symptom to reduce its impact on daily life.