AstraZeneca vaccine: real side effects or nocebo effects?

As rare as it may be, blood clots caused by the AstraZeneca vaccine create feelings of mistrust that can exacerbate the negative effects.

There is a term to explain this phenomenon: the nocebo effect, explains Mahyar Etminan of the Department of Ophthalmology, Medicine and Pharmacology at the University of British Columbia (UBC).

The concept, unlike a placebo, describes a negative outcome that arises from the belief that the intervention will cause harm, he says.

“Expected” effects

Elisabeth Lefrancois enthusiastically took her first dose of AstraZeneca vaccine a week ago. By evening, symptoms appeared: chills, flu-like effects, fatigue and pain in the heart. Like a mixture of flu and the day after tomorrow, describes a Vancouver woman in her forties.

Ms. Lefrancois was not too worried even after being warned that vaccinations could cause side effects. However, she acknowledges that she has some concerns about the reported thrombosis cases.

Of course, we think about it. I just saw a woman die in Quebec. Maybe it makes us notice our side effects more., she said.

This needs to be put in perspective, but it’s scary to see someone dead.

Quote from:Elizabeth Lefrancois

Number of thrombosis vs the number of vaccinations is minimal, but it remains that we are human, and when we see someone who gets sick, it worries– adds Ms. Lefrancois.

A causal relationship between the death of a woman in Monterey, Quebec and the AstraZeneca vaccination has not been established. An investigation is underway.

Vaccine bottle.

The patient died of a blood clot in the brain at a Montreal hospital after receiving a dose of the COVID-19 vaccine. An investigation is underway.

Photo: Associated Press / Valentina Petrova.

AstraZeneca open air

If you do not study the side effects in a well-controlled study, it is difficult to tell if there is a causal relationship between the vaccine and the patient’s feelings, or if it is a nocebo effect, ”admits Mahyar Etminan.

However, he believes, the concept plays an important role here. Thus, under the microscope of the media, the AstraZeneca vaccine has a greater place in the public consciousness. The fact that it’s on the news every day adds fuel to the fire., he said.

However, the AstraZeneca vaccine is not the only vaccine that can have serious side effects. Research in Israel explores the link between Pfizer-BioNTech and inflammation of the heart muscle.

All vaccines and medications have side effects.– recalls Horatio Bach, professor of medicine at the University of British Columbia.

One of the problems with the negative reputation of the AstraZeneca vaccine is that information is passed on before conclusions are drawn, he said.

An investigation must be carried out before the victims are announced, because if a claim is to be withdrawn, the damage has been done and public confidence has already been eroded.he explains.

The nurse prepares the vaccine.

Dr. Brian Conway is saddened to learn that a woman has died of thrombosis in Montreal and hopes that frank discussions about the impact of vaccines can better inform the public.

Photo: CBC / Evan Mitsui

Standardize patient choice to refuse vaccine

Transparent discussion is the main remedy for the nocebo effect, says Brian Conway, director of the Vancouver Center for Infectious Diseases.

We must continue to recommend that people get vaccinated. But we will have to offer them all the information available to help them make an informed choice.

According to him, this discussion needs to be normalized, and not come to the conclusion that a person who does not want to be vaccinated must necessarily take an anti-vaccine position and stigmatize them.

If, after receiving all the information, a person decides not to be vaccinated with a particular product, this choice must be respected.he pleads.

Elisabeth Lefrancois, fully aware of the causes and risks, is delighted to receive her first dose of vaccine. The pharmacist explained well the possible minor side effects and warned her about certain symptoms considered more dangerous, such as loss of vision or difficulty with limb movement.

We will need to see how it develops, we are experiencing a lot of uncertainties. But it would be better if I got vaccinated than not at all. It is 100% safe.

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