Investigation of the incidence of immunisation stress-related response following COVID-19 vaccination in healthcare workers

Abstract

Introduction Safe vaccination worldwide is critical to end the coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate adverse reactions to vaccination using a web-based questionnaire and examine the risk factors for the occurrence of immunisation stress-related response (ISRR). Methods We conducted a questionnaire survey using Google Form® among the employees of St. Marianna University Hospital who had received the COVID-19 vaccine between April 2021 and May 2021, 1 week after the first and second vaccinations. We developed and used a questionnaire to identify individuals with ISRR according to the World Health Organization diagnostic criteria. A generalised linear mixed model was constructed with ISRR onset as the dependent variable, subjects as the random factor, and each parameter as a fixed factor. A multivariate model was constructed using the forced imputation method with factors that were significant in the univariate analysis. Results We enrolled 2,073 and 1,856 respondents in the first and second questionnaire surveys, respectively. Fifty-five and 33 ISRR cases were identified in the first and second vaccinations, respectively. In the univariate analysis, strong pre-vaccination anxiety (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.30–4.12, p = 0·004) and history of allergy (OR, 1.6; 95% CI, 1.14–2.24, p = 0·007) were significant risk factors. Multivariate analysis also showed that strong pre-vaccination anxiety (OR, 2.1; 95% CI, 1.15–3.80, p = 0.016) and history of allergy (OR, 1.5; 95% CI, 1.09–2.15, p = 0.014) were significant risk factors. Conclusions Confirmation of allergy prior to vaccination and subsequent action are essential for addressing ISRR.

Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels

“…Contrary to our results, high anxiety is associated with decreased intention to receive the vaccine in some groups. Among healthcare workers, the occurrence of an immunization-stress-related response was significantly higher among those with strong prevaccination anxiety and history of allergy [ 25 ]. Anxiety symptoms among Chinese psoriatic patients were associated with high vaccine hesitancy.…”

“…In fact, high anxiety among adults attending COVID-19 vaccination centers is associated with fear that terrible consequences may happen [ 6 , 23 , 24 ]. An immunization-stress-related response may develop in people receiving the first as well as the second dose of the vaccine [ 25 ]. For some, vaccine fear and anxiety may be justifiable given that vaccine adverse effects can be severe in a trivial number of people (e.g., anaphylactic shock requiring resuscitation) [ 26 , 27 ].…”

Emotional Reaction to the First Dose of COVID-19 Vaccine: Post Vaccination Decline in Anxiety and Stress Among Anxious Individuals and Increase Among Individuals with Normal Anxiety Levels Pre Vaccination

“…Contrary to our results, high anxiety is associated with decreased intention to receive the vaccine in some groups. Among health care workers, the occurrence of immunization stress-related response was significantly higher among those with strong pre-vaccination anxiety and history of allergy [25]. Anxiety symptoms among Chinese psoriatic patients were associated with high vaccine hesitancy.…”

“…In fact, high anxiety among adults attending COVID-19 vaccination centers is associated with fear that terrible consequences may happen [6,23,24]. Immunization stress-related response develops in people receiving the first as well as the second dose of the vaccine [25]. For some, vaccine fear and anxiety may be justifiable given that vaccine adverse effects can be severe in a trivial number of people (e.g., anaphylactic shock requiring resuscitation) [26,27].…”

Sex Differences in Serious Adverse Events Reported Following Booster Doses of COVID-19 Vaccination in Thailand: A Countrywide Nested Unmatched Case-Control Study

“…However, the events among young females could be misclassified, and the risk could be overestimated. For instance, immunization stress-related responses (ISRRs), commonly seen in stroke-mimic symptoms in young females [ 42 ], could be overdiagnosed, and the vaccine campaign primarily faced this difficulty in vaccine acceptance [ 43 ].…”