The most commonly reported side effects to the Covid vaccination are headaches and fatigue.
22,578 of these people stood out for reporting these adverse effects.
These people had never actually received the Covid vaccine but still reported side effects.
The placebo effect describes positive effects from receiving a treatment with no active ingredients.
The strength of a placebo often scales to how theatrically it is presented.
Over the counter medications have milder placebo effects than prescription pills, which are in turn surpassed by injections placebos and then mock surgical.
The evil twin of this is the nocebo effect, where people receive negative effects from receiving an inactive treatment.
Much like its better known sibling, the nocebo effect is stronger when people have a strong expectation that something will go wrong.
The widespread and vocal concerns that the COVID-19 vaccines cause side effects may be responsible for those side effects.
The nocebo effect is more effective in causing subjective symptoms such as headaches, muscle pains and fatigue, which are also the most commonly reported side effects of the vaccine.
Lead author Julia W said: “Collecting systematic evidence regarding these nocebo responses in vaccine trials is important for COVID-19 vaccination worldwide, especially because concern about side effects is reported to be a reason for vaccine hesitancy.”
Senior author T Kaptchuk said: “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.
“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 hyper alert to bodily feelings about adverse events.”
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There are multiple historic cases of people’s lives being threatened by the belief that their life is under threat.
In 2007 a man rushed into an emergency department, shouted “help me, I took all my pills” and fell unconscious.
The man was administered for urgent care but physicians were unsure about the empty bottle of experimental antidepressants he had brought with him.
At the end of four hours of intravenous treatment for dangerously low blood pressure a researcher from his clinical trial arrived and explained to him that he was in the placebo group.
15 minutes later he had recovered fully from his overdose.
Nocebo and placebo effects are a common occurrence in medicine.
A 2013 analysis in the BMJ questioned whether statins were suitable for people in low risk categories.
Media coverage has been attributed to 200,000 patients dropping the medication in the following six months, citing side effects.
The analysis received a correction the following year noting that the rate of side effects was not accurate and that many of them were due to the nocebo effect.
Muscle pain as a result of statin use, when not caused by the nocebo effect, are found in only a few cases per million.
The exact mechanism of the nocebo effect is not known, but there is some understanding of how to control it.
One of the main factors may be the authority that is placed in doctors, explaining why placebos given by doctors have stronger effects than those that are self-administered.
Kaptchuk and his colleagues call for the introduction of “open label placebos” where patients are given the full information on a treatment and told they are in the placebo group.
They believe this could improve the treatment of common conditions and remove the associated nocebo effects.
Kaptchuk explains: “Medicine is based on trust.
“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.”
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