Disproportionality analysis of oral adverse events following COVID-19 vaccination: Investigating demographic disparities and notoriety bias using a hybrid frequentist-Bayesian approach
| Authors | |
|---|---|
| Year of publication | 2026 |
| Type | Article in Periodical |
| Magazine / Source | Dental and Medical Problems |
| MU Faculty or unit | |
| Citation | |
| web | https://dmp.umw.edu.pl/en/article/2026/63/1/87/ |
| Doi | https://doi.org/10.17219/dmp/210050 |
| Keywords | COVID-19 vaccines; oral manifestations; pharmacovigilance; adverse drug reaction reporting systems; Bayesian analysis |
| Attached files | |
| Description | Background. Ensuring vaccine safety is crucial for maintaining public confidence, particularly in relation to non-life-threatening adverse events (AEs) that may impact quality of life and contribute to vaccine hesitancy. While systemic reactions to coronavirus disease 2019 (COVID-19) vaccines are well documented, oral AEs remain underexplored, despite emerging reports linking vaccination to taste disturbances and other oral manifestations. Objectives. The aim of the study was to explore oral AEs following COVID-19 vaccination and to assess their potential to constitute signals of disproportionate reporting (SDRs) that warrant further investigation and validation. Material and methods. A hybrid frequentist–Bayesian signal detection approach was applied to analyze oral AEs following COVID-19 vaccination using data from the US Vaccine Adverse Event Reporting System (VAERS). A two-stage analysis was conducted. The primary analysis identified SDRs, and the secondary analysis assessed reporting biases, including selective reporting bias and notoriety bias. Results. Oral AEs were reported 2.4 times more frequently following COVID-19 vaccination compared with other vaccines, with taste-related SDRs showing the highest disproportionality. The most prominent SDRs included taste disorder (proportional reporting ratio (PRR) = 23.96), ageusia (PRR = 17.79), hypogeusia (PRR = 6.25), dysgeusia (PRR = 3.22), and oral lichen planus (PRR = 3.12). Females and middle-aged adults exhibited the highest reporting rates, whereas severe, hospitalized and fatal cases were less frequent. Co-occurrence analysis of gustatory and olfactory AEs suggests notoriety bias, likely influenced by increased public awareness. Regression analyses indicated that female sex and older age were associated with increased odds of oral SDRs, while state-level political inclination had no significant effect. Conclusions. The findings highlight demographic disparities in the reporting of oral AEs. However, they should not be interpreted as undermining vaccine safety. Future research should focus on clinically significant oral SDRs, such as oral lichen planus, to distinguish true safety signals from potential reporting biases. Improved awareness and communication are essential for contextualizing these findings within dental practice. |
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