Considerations on immunization anxiety-related reactions in clusters
Abstract
A cluster of adverse events following immunization (AEFI) represents a stress test for an immunization program. The community can suspect on vaccine-related reaction leading to mistrust on the immunization program. An immunization anxiety-related reaction is one of the hypotheses to be tested and can be reasonably accepted when the vaccine-related and immunization error-related reactions are ruled out and no coincidental events can explain the cases. Immunization program approaches widely accepted to understand and respond to adverse events are root-cause analysis and systems analysis. Psychiatric cognitive frame will support the root-cause analysis assigning a causal relationship to individual temporary disorders of the affected vaccinees. Communication will focus on vaccine safety and absence of errors in the immunization program. Systems analysis addresses the whole context considering the fear spread as a systemic threat. Socio-psychological frame offers a broader opportunity to understand and respond to a specific community. Management is based on communication to change community belief in misperceptions of vaccine risks and support the idea of immunization as a causal factor, different from the vaccine. Communities can consider use of psychiatric labels, Mass Psychogenic Illness or Mass Hysteria, as an act of inconsiderateness. Labels like immunization anxiety-related reactions in clusters or collective immunization anxiety-related reactions are recommended to bridge the causal perception of the community with the result of the scientific investigation of the cases.
Authors
Downloads
Keywords
- Mass Vaccination
- Immunization Programs
- Drug-Related Side Effects and Adverse Reactions
- Anxiety Disorders
- Somatoform Disorders
- Medical Sociology
- Vaccines
Author Biography
, Clinical Research and Development ManagerDivision of Clinical Trials and PharmacovigilanceInstituto ButantanSão Paulo, Brazil
Clinical Research and Development Manager
Division of Clinical Trials and Pharmacovigilance
Instituto Butantan, São Paulo, Brazil
https://orcid.org/0000-0002-1410-8579References
Bartholomew RE, Victor JS. A social-psychological theory of collective anxiety attacks: The "Mad Gasser" Reexamined. Sociological Quarterly. 2004; 45(2): 229-48. https://doi.org/10.1111/j.1533-8525.2004.tb00011.x
Council for International Organizations of Medical Sciences (CIOMS). Adverse events following immunization. Definition and application of terms of vaccine pharmacovigilance (report of CIOMS/WHO Working Group on Vaccine Pharmacovigilance). Geneva: CIOMS; 2012. p. 39-53.
World Health Organization. Vaccine Safey Basics e-learning course. 2013 [cited 01-Oct-2014]; Available from: http://vaccine-safety-training.org/.
Mallick S. Mass psychogenic illness: a threat to immunization program. Indian J Publ health. 2009; 53(4): 266.
Susser M. What is a cause and how do we know one? A grammar for pragmatic epidemiology. Am J Epidemiol. 1991; 133(7): 635-48. https://doi.org/10.1093/oxfordjournals.aje.a115939
Clements CJ. Mass psychogenic illness after vaccination. Drug safety : Internat J Med Toxicol Drug Exper. 2003; 26(9): 599-604. https://doi.org/10.2165/00002018-200326090-00001
Maclure M. Popperian refutation in epidemiology. Am J Epidemiol. 1985; 121(3): 343-50. https://doi.org/10.1093/oxfordjournals.aje.a114005
IOM (Institute of Medicine) - Committee to Review Adverse Effects of Vaccines. Approach. In: Stratton K, Ford A, Rusch E, Clayton EW, editors. Adverse Effects of Vaccines: Evidence and Causality. Washington (DC): The National Academies Press; 2012. p. 39-53.
D'Argenio P, Citarella A, Intorcia M, Aversano G. An outbreak of vaccination panic. Vaccine. 1996; 14(13): 1289-90. https://doi.org/10.1016/S0264-410X(96)00069-2
Huang WT, Hsu CC, Lee PI, Chuang JH. Mass psychogenic illness in nationwide in-school vaccination for pandemic influenza A(H1N1) 2009, Taiwan, November 2009-January 2010. European Communicable Disease Bulletin. 2010; 15(21): 19575. https://doi.org/10.2807/ese.15.21.19575-en
Kharabsheh S, Al-Otoum H, Clements J, Abbas A, Khuri-Bulos N, Belbesi A, et al. Mass psychogenic illness following tetanus-diphtheria toxoid vaccination in Jordan. Bull World Health Organization. 2001; 79(8): 764-70.
Khiem HB, Huan le D, Phuong NT, Dang DH, Hoang DH, Phuong le T, et al. Mass psychogenic illness following oral cholera immunization in Ca Mau City, Vietnam. Vaccine. 2003; 21(31): 4527-31. https://doi.org/10.1016/S0264-410X(03)00498-5
Yasamy MT, Bahramnezhad A, Ziaaddini H. Postvaccination mass psychogenic illness in an Iranian rural school. Eastern Mediterranean Health J. 1999; 5(4): 710-6.
Bernard DM, Cooper Robbins SC, McCaffery KJ, Scott CM, Skinner SR. The domino effect: adolescent girls' response to human papillomavirus vaccination. Medical J Australia. 2011; 194(6): 297-300. https://doi.org/10.5694/j.1326-5377.2011.tb02978.x
Nemery B, Fischler B, Boogaerts M, Lison D, Willems J. The Coca-Cola incident in Belgium, June 1999. Food Chemical Toxicology. 2002; 40(11): 1657-67. https://doi.org/10.1016/S0278-6915(02)00135-7
Page LA, Keshishian C, Leonardi G, Murray V, Rubin GJ, Wessely S. Frequency and predictors of mass psychogenic illness. Epidemiology. 2010; 21(5): 744-7. https://doi.org/10.1097/EDE.0b013e3181e9edc4
Bartholomew RE, Wessely S, Rubin GJ. Mass psychogenic illness and the social network: is it changing the pattern of outbreaks? J Roy Soc Med. 2012; 105(12): 509-12. https://doi.org/10.1258/jrsm.2012.120053
Ditto B, Byrne N, Holly C, Balegh S. Social contagion of vasovagal reactions in the blood collection clinic: a possible example of mass psychogenic illness. Health Psychology. 2014; 33(7): 639-45. https://doi.org/10.1037/hea0000053
Vincent C. Understanding and responding to adverse events. New Engl J Med. 2003; 348(11): 1051-6. https://doi.org/10.1056/NEJMhpr020760
Wessely S. Responding to mass psychogenic illness. New Engl J Med. 2000; 342(2): 129-30. https://doi.org/10.1056/NEJM200001133420212
Cardoso de Oliveira LR. Honor, Dignidad y Reciprocidad. Cuadernos Antropología Social. 2004: 25-39.
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use
