Abstract

This article presents a study of stroke occurrence among COVID-19 vaccine recipients in Mexico.1 It should be noted that a passive epidemiologic surveillance system cannot detect the incidence rate; therefore, a conclusion that “stroke remains an exceedingly rare event” is not justified.1 Multiple studies have demonstrated extreme underreporting in passive systems. In addition, by looking only at adverse events following immunization occurring within 30 days, one will miss many reports of strokes. Even vaccine-induced thrombotic thrombocytopenia is defined as occurring up to 42 days postvaccination.

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