7 billion doses of the COVID vaccine have been administered around the world, with nearly 400 million doses in the United States alone. Undoubtedly, the vaccine has saved, and will continue to save, countless lives. While we should appreciate these innovations of modern-day medical science, the vaccine has not been universally accepted, hampering our efforts to reduce harm. Side-effects of the COVID vaccine are widely discussed in news outlets. Countless online discussion boards teem with anecdotes of people feeling sick after getting jabbed. This is no surprise as we construct stories to describe and find meaning in our experience. Human ancestors may have shared such stories around the campfire; in modern times, we have a vast array of social media platforms which may serve the same evolutionary function. But lost in this discussion of side effects, and ignored by the CDC, vaccine experts and the media, is the inconvenient fact that a significant portion of these side effects are not actually caused by the vaccine. Instead, they are the result of our negative expectations, the so-called nocebo effect.

"The nocebo effect" stems from the Latin word nocere, which translates roughly as "to harm" and can be best summarized as the occurrence of a harmful event that stems from consciously or subconsciously anticipating or expecting it. We are just discovering the power behind this phenomenon, as explored in the groundbreaking research of a dozen top level researchers.

While there has never before been such a massive demonstration of the nocebo effect as with the COVID vaccine, there are myriad other examples throughout history, and recent studies have documented the critical role of the nocebo effect in treatment side effects--such as with statins for high cholesterol--and the psychological and social processes that produce these effects, such as the higher incidence of complaints after negative media reports of certain medicines, all the way to the illnesses associated with the Havana Syndrome, during which dozens of US government employees fell ill after reportedly being exposed to an unidentified sound wave. Most importantly, researchers have investigated strategies that can be adopted by both clinicians and patients to reduce the nocebo effect.
About the Author: Michael Bernstein, Ph.D., is an experimental psychologist and an Assistant Professor in the School of Public Health at Brown University. His work is focused on harnessing the placebo effect to reduce opioid use among pain patients. He has received funding from government and non-governmental agencies, including the National Institutes of Health, where he is currently an early career investigator.

Charlotte Blease, Ph.D., is a philosopher of medicine currently based at Harvard Medical School and a co-founder of the Society for Interdisciplinary Placebo Studies. She is a former Fulbright Scholar and a winner in 2012 of the UK-wide BBC Radio 3's New Generation Thinkers Competition. Dr. Blease has written extensively about the ethics of placebo and nocebo effects. Her research has been profiled by international news outlets including The Washington Post, The Guardian, and The Sydney Morning Herald.

Cosima Locher, Ph.D., is a psychologist who is dedicated to studying honest (e.g., "open-label") placebos. She is published in leading peer-reviewed journals, such as PAIN, the American Journal of Psychiatry, JAMA Psychiatry, and JAMA Pediatrics. Dr. Locher is a co-founder of The Pain Net, an international network of researchers interested in Chronic Primary Pain, including with a special focus on the placebo effect.

Walter Brown, M.D., is a Clinical Professor Emeritus of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University. He has studied the placebo effect for the past 40 years, is the author of three books including The Placebo Effect in Clinical Practice.