Conclusion
Natural infections with viruses such as measles and mumps have been associated with both transient and permanent hearing loss. Thus, measles and mumps vaccines prevent such hearing loss by protecting against natural infection. Vaccines currently routinely recommended to the general population in the U.S.* have not been shown to cause hearing loss.
Epidemiological Evidence
The 2012 report by the Institute of Medicine (IOM), now called the National Academy of Medicine (NAM), found no relevant studies of quality in the literature assessing hearing loss and MMR vaccine, since the only applicable study available used a passive surveillance system and therefore lacked an unvaccinated comparison group 1. A large case-centered analysis published in 2016 found no association between hearing loss and vaccination 2. A 2018 US cohort study found a small increased risk of otitis media in infants receiving their second dose of rotavirus vaccine (hazard ratio: 1.11; 95% confidence interval: 1.08-1.15) 3. A 2019 Canadian cohort study found no association between influenza vaccination during pregnancy and childhood sensory disorders 4.
Proposed Biological Mechanism
Natural infection with wild-type mumps virus has been associated with transient high-frequency deafness in 4.4% of cases among members of the military, as well as with permanent unilateral deafness approximately once every 20,000 cases 1. Prior to the use of mumps vaccine, mumps was the most common cause of acquired hearing loss in children in the United States and other countries 5-7. Direct viral infection has been implicated as the mechanism in such cases of hearing loss. Measles infection can also cause hearing loss, most likely as a result of encephalitis 1,8.
The 2012 IOM report described several cases 9-11 and some experimental evidence 12,13 of hearing loss after measles or mumps vaccines. The IOM concluded that there was no mechanistic evidence for an association between hearing loss and rubella vaccine 1. Although spontaneous hearing loss can rarely occur after these vaccinations, the causes are unknown, and the data available has not demonstrated an increased risk.
* These conclusions do not necessarily consider vaccines recommended only for special populations in the United States such as Yellow Fever vaccine (international travelers) or Smallpox vaccine (military personnel), or vaccines no longer recommended to the public such as the Janssen (J&J) COVID-19 vaccine.
References
1. Institute of Medicine. In: Stratton K, Ford A, Rusch E, Clayton EW, eds. Adverse Effects of Vaccines: Evidence and Causality. Washington (DC): National Academies Press (US); 2012.
2. Baxter R, Lewis N, Bohrer P, Harrington T, Aukes L, Klein NP. Sudden-Onset Sensorineural Hearing Loss after Immunization: A Case-Centered Analysis. Otolaryngology–head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2016; 155(1): 81-6.
3. Layton JB, Butler AM, Panozzo CA, Brookhart MA. Rotavirus vaccination and short-term risk of adverse events in US infants. Paediatric and perinatal epidemiology 2018; 32(5): 448-57.
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5. Brookhouser PE, Worthington DW, Kelly WJ. Unilateral hearing loss in children. The Laryngoscope 1991; 101(12 Pt 1): 1264-72.
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8. Cohen BE, Durstenfeld A, Roehm PC. Viral Causes of Hearing Loss: A Review for Hearing Health Professionals. Trends in Hearing 2014; 18: 2331216514541361.
9. Asatryan A, Pool V, Chen RT, Kohl KS, Davis RL, Iskander JK. Live attenuated measles and mumps viral strain-containing vaccines and hearing loss. Vaccine 2008; 26(9):1166-72.
10. Brodsky L, Stanievich J. Sensorineural hearing loss following live measles virus vaccination. Int J Pediatr Otorhinolaryngol 1985; 10(2): 159-63.
11. Hulbert TV, Larsen RA, Davis CL, Holtom PD. Bilateral hearing loss after measles and rubella vaccination in an adult. The New England journal of medicine 1991; 325(2): 134.
12. Fukuda S, Chida E, Kuroda T, Kashiwamura M, Inuyama Y. An anti-mumps IgM antibody level in the serum of idiopathic sudden sensorineural hearing loss. Auris Nasus Larynx 2001; 28 Suppl: S3-5. 13. Fukuda S, Ishikawa K, Inuyama Y. Acute measles infection in the hamster cochlea. Acta Otolaryngol Suppl 1994; 514: 111-6.
