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Study Finds Pre-Vaccination Expectations Linked to Adverse Events in COVID-19 Vaccination, Highlights Importance of Contextualizing Vaccine Information and Treatment with Nirmatrelvir in Acute Phase

A recent study published in JAMA Network Open explored the relationship between pre-vaccination expectations and systemic adverse events among individuals receiving their second dose of a COVID-19 vaccine.[0] The study found that expectations of low benefit, high adverse effects, and prior negative experiences were associated with COVID-19 vaccination adverse effects. Additionally, the tendency to catastrophize instead of normalize benign bodily sensations was also linked to higher reported adverse events.[1] The authors of the study suggest that these insights could be beneficial for clinician-patient interactions and public vaccine campaigns by optimizing and contextualizing information provided about COVID-19 vaccines.

One significant contributor to vaccine hesitancy has been concerns about adverse events.[2] The study concluded that the severity and frequency of systemic adverse events in the week after COVID-19 vaccination “was not only caused by vaccine-specific reactogenicity but also by psychosocial context factors that can be identified prior to vaccination.”[2] The three major contributors to nocebo effects included personal prior reactions to the first COVID-19 vaccination, individual expectations regarding potential harms and benefits of vaccination, and symptom misattribution.

The study also found that having excellent knowledge about the COVID-19 vaccine was significantly associated with a positive practice of vaccinating children between ages 12 and 18 years with the COVID-19 vaccine. The researchers noted that clinicians and public vaccine campaigns could benefit from contextualizing information about COVID-19 vaccines and being transparent about their risk-benefit profiles to improve overall vaccine acceptance.

The efficacy of COVID-19 vaccines in curbing infection, morbidity, and mortality, including against the latest COVID-19 strains, is well-established. However, their effectiveness hinges on a substantial portion of the population receiving vaccination. A recent study reported that vaccination has reduced the risk of developing long COVID-19 symptoms caused by the SARS-CoV-2 virus.

The study also explored the response to vaccination of recovered COVID-19 patients and found that their SARS-CoV-2-specific response to vaccination lagged behind that of never-infected participants’ response. The study found that uninfected vaccine recipients experienced a greater than 60-fold rise in their levels of SARS-CoV-2-targeting killer T cells.[3]

Another study published in JAMA Internal Medicine found that treatment with nirmatrelvir during the acute phase of COVID-19 may reduce the risk for post-acute adverse health outcomes. The study included 35,717 veterans who had a severe acute respiratory syndrome coronavirus 2 positive test result between Jan. 3, 2022, and Dec. 31, 2022, with at least one risk factor for severe COVID-19 who were treated with oral nirmatrelvir within five days after the positive test.[4]

In conclusion, the study highlights the importance of contextualizing information about COVID-19 vaccines and being transparent about their risk-benefit profiles to improve overall vaccine acceptance. Additionally, the study emphasizes the effectiveness of COVID-19 vaccines in reducing infection, morbidity, and mortality, even against the newest emerging COVID-19 variants. Finally, the study highlights the potential benefits of treatment with nirmatrelvir during the acute phase of COVID-19 in reducing the risk for post-acute adverse health outcomes.

0. “LinkUP intervention improves COVID-19 testing, vaccination referral rates among PWID” Healio, 27 Mar. 2023, https://www.healio.com/news/infectious-disease/20230327/linkup-intervention-improves-covid19-testing-vaccination-referral-rates-among-pwid

1. “Prior Experiences Shape Expectations of COVID-19 Vaccine Adverse Effects” Mirage News, 27 Mar. 2023, https://www.miragenews.com/prior-experiences-shape-expectations-of-covid-975149/

2. “Negative Expectations of COVID-19 Vaccines Led to More Adverse Events After Vaccination” Contagionlive.com, 28 Mar. 2023, https://www.contagionlive.com/view/negative-expectations-of-covid-19-vaccines-led-to-more-adverse-events-after-vaccination

3. “mRNA vaccine beats infection for key defense against COVID-19, Stanford Medicine scientists find” Stanford Medical Center Report, 28 Mar. 2023, https://med.stanford.edu/news/all-news/2023/03/vaccine-covid-infection.html

4. “Nirmatrelvir Cuts Risk for Post-COVID-19 Condition | Health” Islander News.com, 27 Mar. 2023, https://www.islandernews.com/lifestyle/health/nirmatrelvir-cuts-risk-for-post-covid-19-condition/article_75f0e029-a0ac-5fa7-905a-0b924ffc6cd4.html

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