Tag Archives: vaccines

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.”

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’.