Tag Archives: nocebo effect

Covid-19 Vaccines a ‘nocebo effect’ …?

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Meta research (an aggregation and analysis of related research efforts) has revealed a curious ‘nocebo effect’ related to reaction to Covid-19 vaccinations.

” … Researchers at Harvard Medical School and Beth Israel Deaconess Medical Center compared the rates of adverse events reported by participants who received the vaccines to the rates of adverse events reported by those who received a placebo injection containing no vaccine.

Although the scientists found significantly more trial participants who received the vaccine reported adverse events, nearly a third of participants who received the placebo also reported at least one adverse event, with headache and fatigue being the most common.”

The Ritual of Treatment

A good updated report on the placebo effect in clinical settings – Placebos Demonstrate Power of the Human Mind

Professor Ted Kaptchuk, who studies the effect, explains:

“The placebo effect is more than positive thinking — believing a treatment or procedure will work. It’s about creating a stronger connection between the brain and body and how they work together” …

Placebos won’t, for example, cure cancer. But when a disease affects the brain-body relationship, as Angelman does, the placebo response can confound research, as we saw above. We learn from the National Library of Medicine that “Migraines, joint pain, arthritis, asthma, high blood pressure, and depression are some disease conditions that are more sensitive to the placebo effect.”

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.”

Did you know these three facts about the placebo effect?

You may be surprised to read of three ‘effects’ of placebos proposed recently by Eve M. Krakow in Psychology Today.

Dr Krakow takes pains to emphaise that the placebo effect is a physical phenomenon. There’s nothing magical about it. It will seem magical (as Isaac Asimov once wryly observed) until there’s sufficient science.

First, the placebo has a negative ‘flipside’. This is the nocebo effect, and it’s noted and discussed elsewhere on this site (check the tags column). A placebo effect can have either positive or negative outcomes.

Second, and very weirdly (if not ‘magically’) the placebo effect seems to become stronger and more proncounced over time. Placebos seem to get stronger!

Thirdly, the placebo effect does not necessarily require deception – that is, the practitioner lying to a patient that the (inert placebo) treatment is actually the ‘real’ treatment. We cover this too, on this site – look for ‘white label placebos’ in the tags.

Vaccine side effects are nocebos?

One of the anti-vax memes in circulation is the risk of side effects from Covid vaccines.

meta-analysis of 12 randomized, placebo-controlled clinical trials, a team of researchers at Beth Israel Deaconess Medical Center (BIDMC) in Boston found that up to 64 percent of adverse effects may be attributable to this kind of worry. See this article in Science Alert.

Interestingly, the meta-analysis engaged with the ‘placebo effect’ as a nocebo effect, with (across the 12 trials) about half of participants taking the vaccine, the other half a placebo. The nocebo effect accounted for up to 76 percent of systemic adverse events and 24 percent of local adverse events after the first vaccine dose.

We’re unsurprised to read that non-specific symptoms (think pain, mood disorder, IBS) are particularly ‘nocebo sensitive’.

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.