To the Editor Widespread vaccination against SARS-CoV-2 is critical in turning the tide on the COVID-19 pandemic, but achieving widespread acceptance has proven elusive. Fear of adverse effects has been a recurring theme in surveys of the public vaccination hesitancy. Therefore, studies investigating the incidence of sudden sensorineural hearing loss (SSNHL) after COVID-19 vaccination garner intense interest. Whereas Formeister and colleagues find no association between COVID-19 vaccination and incidence of hearing loss in their cross-sectional analysis, Yanir et al identify a possible association but with very small effect size and without consistent demographic groups. Ulrich and colleagues conclude that the benefits of COVID-19 vaccination exceed the possible cost of rare instances of SSNHL. Analyses involving large data sets often un cover statistically significant differences that are not necessarily clinically meaningful, and spurious associations can arise owing to chance or bias.
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