Some Johnson & Johnson vaccine reactions are caused by anxiety, says CDC

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Of the three main COVID-19 vaccines being distributed in the U.S., Johnson & Johnson's has been perhaps the most embattled. Mass vaccination sites in five states shut down in early April after a rash of adverse reactions, including nausea and dizziness. But those symptoms were likely due to anxiety, not the vaccine, according to a new report from the Centers for Disease Control and Prevention.

It's been a rough few weeks for the Johnson & Johnson one-shot COVID-19 vaccine, which was paused and then restarted by the Food and Drug Administration due to issues involving rare blood clots that have not been definitively linked to the vaccine. The blood clots are a separate issue, unrelated to the anxiety-induced reactions, the CDC said.

To further investigate the anxiety-related cases, the CDC interviewed vaccination site staff members to gather additional information about the reported events and vaccination site practices. Four of the five sites temporarily closed while an investigation took place.

Overall, 64 anxiety-related events among 8,624 recipients, including 17 incidences of fainting, were reported from those sites for vaccines administered from April 7-9.

The CDC's finding was that anxiety-related events, including fainting, can occur immediately after vaccination with any vaccine, and might be caused by anxiety about receiving an injection. Although four of the five mass vaccination sites that reported anxiety-related events temporarily suspended COVID-19 vaccination, none of the reports were considered serious.

WHAT'S THE IMPACT?

About one quarter of the anxiety-related events occurred in people who had reported a history of similar events after vaccination. What's more, the CDC speculates that the J&J vaccine, being a single-dose offering, may naturally attract more people with an aversion to needles. That means those seeking out the J&J vaccine are likely more predisposed to anxiety-related events.

The stress of the ongoing pandemic may be another factor, the CDC found, as well as the vaccine push itself, which likely causes anxiety among many Americans.

Perhaps oddly, adolescents have higher rates of fainting after vaccination, and about half of the fainting reports were among people in the youngest age group (18-29) recommended for vaccination. For that reason, providers and those administering shots should be aware that younger people may be more highly predisposed to anxiety-related events after receiving their doses.

THE LARGER TREND

The findings come at an important time, with vaccine hesitancy among many Americans on the rise and threatening the goal of herd immunity, in which a critical mass of the population becomes inoculated and slows the spread of pathogens.

The vaccine push received a jolt this week as Walgreens announced it will activate multiple mobile clinics in Chicago. The traveling mobile clinics will focus on bringing COVID-19 vaccines directly to underserved communities and those with barriers to accessing the vaccine. Over the next two months, additional mobile clinics will make stops in a number of locations across the country.

A report released Thursday from RBC Capital Markets unearthed a suggestion for policymakers: Using morbidity and mortality as a proxy for reopening decisions could result in further suppression of the virus, and there could be a return to quasi-normalcy by June or July, even if true herd immunity isn't achieved until the fall. 

But the spread of variants, skyrocketing cases in other countries and uneven vaccine uptake could lead to a winter resurgence, though it would likely pale next to the surge seen this past winter due to the millions of vaccinations that have been distributed.

RBC found that daily vaccination rates are beginning to slow, although 29.1% of the population has now been fully vaccinated and 42.7% have received at least one dose.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com