Dear Editors,

We would like to share ideas on the publication ‘Vocal fold paralysis following first dose of Oxford-AstraZeneca coronavirus disease 2019 vaccine’.^{Reference Jama, Amin, Hassaan and Kaddour1} We agree that the adverse effect of coronavirus disease 2019 (Covid-19) vaccination exists and the effect on the vocal fold might be possible. This clinical entity is rare and acute voice change is the common clinical presentation.^{Reference Perez, Sims and Mularczyk2} Inflammation of the vocal fold is a basic finding from examination.^{Reference Perez, Sims and Mularczyk2}

In the present case, the vaccine recipient had vocal fold paralysis; however, it is still difficult to conclude as to the clinical association. There are no data on pre-vaccination immune status or laryngological status in the present case. The vocal fold problem might be due to a background personal illness or concurrent medical problem. For example, a Covid-19 vaccine recipient might have concurrent dengue^{Reference Kebayoon and Wiwanitkit3} and dengue is a possible rare cause of vocal fold paralysis.^{Reference Tamilarasan, Chandra, Mohan and Kadambi4}