PMID- 34696287 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20211029 IS - 2076-393X (Print) IS - 2076-393X (Electronic) IS - 2076-393X (Linking) VI - 9 IP - 10 DP - 2021 Oct 14 TI - Nocebo-Prone Behavior Associated with SARS-CoV-2 Vaccine Hesitancy in Healthcare Workers. LID - 10.3390/vaccines9101179 [doi] LID - 1179 AB - Among healthcare workers (HCWs), SARS-CoV-2 vaccine hesitancy may be linked to a higher susceptibility to nocebo effects, i.e., adverse events (AEs) experienced after medical treatments due to negative expectations. To investigate this hypothesis a cross-sectional survey was performed with a self-completed questionnaire that included a tool (Q-No) for the identification of nocebo-prone individuals. A total of 1309 HCWs (67.2% women; 43.4% physicians; 28.4% nurses; 11.5% administrative staff; 16.6% other personnel) completed the questionnaires, among whom 237 (18.1%) had declined vaccination. Q-No scores were >/=15 in 325 participants (24.8%) suggesting nocebo-prone behavior. In a multivariate logistic regression model with Q-No score, age, gender, and occupation as independent variables, estimated odds ratios (ORs) of vaccination were 0.43 (i.e., less likely, p < 0.001) in participants with Q-No score >/= 15 vs. Q-No score < 15, 0.58 in females vs. males (p = 0.013), and 4.7 (i.e., more likely) in physicians vs. other HCWs (p < 0.001), independent of age, which was not significantly associated with OR of vaccination. At least one adverse effect (AE) was reported by 67.5% of vaccinees, mostly local pain and flu-like symptoms. In a multivariate logistic regression model, with Q-No score, age, gender, and occupation as independent variables, estimated ORs of AE reporting were 2.0 in females vs. males (p < 0.001) and 1.47 in physicians vs. other HCWs (p = 0.017) independently of age and Q-No score, which were not significantly associated with OR of AE. These findings suggest that nocebo-prone behavior in HCWs is associated with SARS-CoV-2 vaccination hesitancy indicating a potential benefit of a campaign focused on nocebo-prone people. FAU - Mitsikostas, Dimos D AU - Mitsikostas DD AUID- ORCID: 0000-0002-4691-3388 AD - 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece. FAU - Aravantinou-Fatorou, Konstantina AU - Aravantinou-Fatorou K AUID- ORCID: 0000-0002-0687-0563 AD - 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece. FAU - Deligianni, Christina AU - Deligianni C AD - Danish Headache Center, Rigshospitalet Glostrup, University of Copenhagen, 2600 Copenhagen, Denmark. FAU - Kravvariti, Evrydiki AU - Kravvariti E AD - 1st Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Korompoki, Eleni AU - Korompoki E AUID- ORCID: 0000-0003-0403-8316 AD - Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece. FAU - Mylona, Maria AU - Mylona M AD - 1st Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. FAU - Vryttia, Pinelopi AU - Vryttia P AD - Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece. FAU - Papagiannopoulou, Georgia AU - Papagiannopoulou G AD - 2nd Neurology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece. FAU - Delicha, Eumorphia-Maria AU - Delicha EM AD - ASTAT, Statistics in Clinical Research, 16675 Glyfada, Greece. FAU - Dellis, Athanasios AU - Dellis A AD - 2nd Surgery Department, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece. FAU - Tsivgoulis, Georgios AU - Tsivgoulis G AD - 2nd Neurology Department, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece. FAU - Dimopoulos, Meletios A AU - Dimopoulos MA AUID- ORCID: 0000-0001-8990-3254 AD - Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece. FAU - Amanzio, Martina AU - Amanzio M AD - Department of Psychology, University of Turin, Via Verdi 10, 10124 Turin, Italy. FAU - Sfikakis, Petros P AU - Sfikakis PP AD - 1st Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, Laikon General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. LA - eng PT - Journal Article DEP - 20211014 PL - Switzerland TA - Vaccines (Basel) JT - Vaccines JID - 101629355 PMC - PMC8541064 OTO - NOTNLM OT - SARS-CoV-2 OT - adverse event OT - healthcare workers OT - nocebo OT - tolerability OT - vaccine hesitancy COIS- All individuals included have no conflict of interest to declare, related to this article. Christina Deligianni has received research grants from the International Headache Society and the Hellenic Neurology Society. Evrydiki Kravvariti has received speaker's fees by Viatris Switzerland for participation in online educational events. Evie-Maria Delicha received fees for the statistical analysis of data presented in this article. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties. EDAT- 2021/10/27 06:00 MHDA- 2021/10/27 06:01 PMCR- 2021/10/14 CRDT- 2021/10/26 01:02 PHST- 2021/09/21 00:00 [received] PHST- 2021/10/11 00:00 [revised] PHST- 2021/10/11 00:00 [accepted] PHST- 2021/10/26 01:02 [entrez] PHST- 2021/10/27 06:00 [pubmed] PHST- 2021/10/27 06:01 [medline] PHST- 2021/10/14 00:00 [pmc-release] AID - vaccines9101179 [pii] AID - vaccines-09-01179 [pii] AID - 10.3390/vaccines9101179 [doi] PST - epublish SO - Vaccines (Basel). 2021 Oct 14;9(10):1179. doi: 10.3390/vaccines9101179.