Tag Archives: COVID-19

More on Nocebos and Vaccine Side Effects

Further to our most recent post about the likelihood that the frequency of adverse side effects may be attributable to the placebo effect (or more appropriately, the nocebo effect), here’s some more detail provided by reknowned placebo research Ted Kaptchuk, in an article from the Harvard Medical School, ‘Power of Placebo: Some COVID-19 vaccine reactions may result from placebo response’.

“Nonspecific symptoms like headache and fatigue—which we have shown to be particularly nocebo sensitive—are listed among the most common adverse reactions following COVID-19 vaccination in many information leaflets,” said senior author Ted Kaptchuk, HMS professor of medicine and director of the Program in Placebo Studies at Beth Israel Deaconess.

“Evidence suggests that this sort of information may cause people to misattribute common daily background sensations as arising from the vaccine or cause anxiety and worry that make people hyperalert to bodily feelings about adverse events,” he said.

Kaptchuk and colleagues are known for a large and growing body of evidence showing that full disclosure of placebo treatment, what he calls “open-label placebo,” can actually improve common chronic conditions without any nocebo effects. Kaptchuk believes it is ethically necessary to fully inform participants about the vaccines’ potential adverse reactions.

“Medicine is based on trust,” said Kaptchuk. “Our findings lead us to suggest that informing the public about the potential for nocebo responses could help reduce worries about COVID-19 vaccination, which might decrease vaccination hesitancy.”

Using placebos in a Covid 19 vaccine?

In this article the author argues strongly against using the ‘double blind placebo controlled’ methodology in testing the effectiveness of the numerous vaccines now in the works.

” … the use of a placebo in a challenge trial for a Covid-19 vaccine is both pointless and ethically questionable.

We’ll use a deliberately simplistic analogy to help explain why. Suppose we need to test a new type of parachute during wartime, when a better parachute happens to be urgently needed. Sooner or later it will have to be tried in a real jump. But we won’t let that happen until we are already quite sure it is going to work. And we are certainly not going to give dummy parachutes to a control group, randomly selected from a group of volunteers. We already know what will happen to them.”

While this logic may hold, as far as testing vaccines go, but we wonder if there’s space to think that, at least for symptoms if not the condition itself, placebos might have a place? After all, nobody yet understands how an intangible input like a placebo actually seems to cause real effects in the material world …

The ‘Pancebo’ Effect

“The pancebo effect is when a person begins to worry that the worst is about to happen without valid evidence. It’s panic over logic.”

This article at Huffpost was written by a Canadian in the early days of the virus (where were you on the 2nd of March?). Of course it reads as naive and uninformed right now, in August, but we include it because it’s the first time we’ve come across the term ‘pancebo’, which remains topical. This was not, perhaps, the author’s intent, since he was referring to a kind of fear-panic (a ‘nocebo’) inspired by the emergence of Covid-19. Instead, these days, it might better refer to the rash of crazy conspiracy theories that crowd our newsfeeds. It’s still about fear, but the ‘pancebo effect’ of fear of the virus seems to have been translated into a generalised fear of authority figures, health officials, government and anyone who can be vaguely associated with the panglobal lizard people who are ‘really’ in control.