Early last month, several reports emerged that people experienced symptoms like syncope (fainting), dizziness, lightheadedness, and rapid breathing immediately after receiving the Johnson & Johnson one-dose COVID-19 vaccine in at least five different vaccination sites in the U.S. The incidents led to the temporary shutdown of four of the sites while an investigation took place. The symptoms were initially linked to the Janssen COVID-19 vaccine, which was being administered to the people under the Food and Drug Administration (FDA) Emergency Use Authorization (EUA). After reviewing the reports of clusters of adverse events after administration of Janssen COVID-19 vaccine from these five mass vaccination sites, the Centers for Disease Control and Prevention (CDC) has concluded that such symptoms might actually be caused by anxiety about receiving an injection, which can occur immediately after vaccination with any vaccine.
Syncope and other anxiety-related events can occur after Covid-19 vaccination, said the CDC, and urged vaccine providers to be aware of such events after vaccination and observe all COVID-19 vaccine recipients for any adverse reactions for at least 15 minutes after vaccine administration. The CDC published the results of its investigation on Friday in its Morbidity and Mortality Weekly Report (MMWR).
Anxiety-related events seen during influenza vaccination too
Overall, the five mass vaccination sites reported 64 anxiety-related events, including 17 cases of syncope (fainting) after receipt of Janssen COVID-19 vaccine during April 7–9. The most commonly reported signs and symptoms were light-headedness or dizziness (56%), pallor or diaphoresis (excessive sweating) (31%), syncope (27%), nausea or vomiting (25%), and hypotension (16%). The occurrence of these events was reported to the Vaccine Adverse Events Reporting System (VAERS), the vaccine safety monitoring program managed by CDC and FDA. No event met the VAERS classification of serious. While analysing these reports, the CDC also compared the occurrence of such events after receipt of other vaccines in the past, for example reports of syncopal events after influenza vaccination during the 2019–20 influenza season. The reporting rate of syncope to VAERS after Janssen COVID-19 vaccine was 8.2 episodes per 100,000 doses compared to 0.05 per 100,000 doses after influenza vaccination.
“Anxiety-related events can occur after any vaccination. It is important that vaccination providers are aware that anxiety-related adverse events might be reported more frequently after receipt of the Janssen COVID-19 vaccine than after influenza vaccination and observe all COVID-19 vaccine recipients for any adverse reactions for at least 15 minutes after vaccine administration,” the CDC said.
Possible reasons for anxiety-related events after vaccination
According to the CDC, approximately one quarter of the anxiety-related events after receipt of Janssen COVID-19 vaccine occurred in persons who reported a history of similar events after vaccination. Among the 64 cases of anxiety-related events reported during April 7–9 2021 in five mass vaccination sites in the US, 13 (20%) patients informed staff members of a history of fainting associated with receiving injections or needle aversion. Anxiety-related events were more common in women. Below are some possible reasons suggested by the CDC for anxiety-related events after receipt of Janssen COVID-19 vaccine.
- Because the Janssen COVID-19 vaccine requires only a single dose, it’s possible that people who have needle aversion would opt for it more often, which could then account for the higher incidence of anxiety-related events after being vaccinated.
- The stress of an ongoing pandemic might also increase anxiety surrounding COVID-19 vaccination.
- An anxiety-related event witnessed by others on-site or reported through media coverage might increase people’s anxiety further.
The CDC investigators suggested that increasing awareness about anxiety-related events after vaccination will enable vaccination providers to make an informed decision about continuing vaccination.
Published : May 2, 2021 5:58 pm | Updated:May 2, 2021 6:45 pm