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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Did Fear of Needles Cause Clusters of Post-Vaccine Anxiety and Fainting?

By Gary Evans, Medical Writer

Mass vaccination sites in five different states reported clusters of people stricken with anxiety and fainting after receiving the Janssen COVID-19 vaccine April 7-9, 2021, the Centers for Disease Control and Prevention (CDC) reports.

The reactions appear to be psychological, since nothing was wrong with the lots of vaccine, and all of the people examined had no clinical medical problems. The incidents occurred before the national pause on the Janssen immunization as a result of rare blood clot reactions. Immunization with the vaccine has resumed, and the pause is over. However, women younger than age 50 years should be aware that they are at risk of the rare but real side effect of blood clots.

The lead CDC investigator of the anxiety reaction clusters hypothesizes that those with an acute fear of needles sought out the Janssen vaccine, since it is a one-dose shot that requires no second vaccination. It is possible that a chain reaction of hysteria occurred in some people, after seeing other vaccine recipients faint. Overall, among 8,624 Janssen COVID-19 vaccine recipients, 64 people had the anxiety reactions. The most commonly reported signs and symptoms were light-headedness or dizziness (56%), pallor or excessive sweating (31%), fainting (27%), nausea or vomiting (25%), and hypotension (16%).

“The events described in this report are consistent with the definition of anxiety-related events following vaccination,” says Allison Hause, PhD, an epidemiologist in the CDC immunization branch. “It’s possible that individuals with a fear of needles have sought out the Janssen COVID-19 vaccine because it is a single dose. We do not consider these events to be a safety concern associated with Janssen COVID-19 vaccine. We performed a vaccine lot analysis for the vaccine used at each site to determine if a particular vaccine lot was associated with these events. No safety issues or clustering of adverse events indicated a product quality problem."

The CDC interviewed vaccination site staff members to gather additional information about the reported events and vaccination site practices. Four of the five sites closed temporarily while an investigation took place.

“Thirteen (20%) of the affected patients informed staff members of a history of fainting associated with receiving injections or needle aversion,” the CDC reported. “Among the 64 total cases, 39 (61%) occurred in women. Median patient age was 36 years (range 18-77 years). Most events resolved within 15 minutes with supportive care. Thirteen (20%) patients were transported to an emergency department for further medical evaluation. Among these, five for whom follow-up information was available were released from medical care on the same day.”

For more on this story, see the June 2021 issue of Hospital Infection Control and Prevention.