(PS10-C56) The Moderating Role of Anxiety Sensitivity on the Relationship between Vaccine Hesitancy and Vaccine Side Effects

Anticipation and experience of vaccine side effects are key factors that likely contribute to both vaccine hesitancy and vaccine uptake (Arce et al., 2021; Manfredi et al., 2021). Although side effects are primarily somatic reactions to a vaccine, there is increasing focus on psychological factors that contribute to the experience of side effects. Although several psychological factors (e.g., depression, stress) have been associated with greater severity of vaccine side effects (Madison et al., 2021), no study to date has investigated potential mechanisms underlying this relationship. Given that vaccine side effects often include symptoms of physiological arousal, it stands to reason that how individuals perceive and appraise their own physiological arousal may be an important variable in understanding the link between vaccine side effects and vaccine hesitancy. Anxiety sensitivity, or the fear of benign physiological sensations (Reiss & McNally, 1985), has been shown to predict side effects to various pharmacological agents, including blood pressure medication (Alcántara et al., 2014) and nicotine replacement therapy (Zvolensky et al., 2017). The primary aim of this study is to evaluate whether vaccine side effects predict vaccine hesitancy, and whether anxiety sensitivity moderates this hypothesized relationship.  

A nationally representative sample of adults (N = 121) completed the Anxiety Sensitivity Index (ASI; Taylor et al., 2007) during the COVID-19 pandemic. Eight months later, when COVID-19 vaccines were available to all adults, vaccinated participants endorsed the severity of several symptoms experienced following vaccination (0 = “Not at all”, 6 = “Extremely”). The list of symptoms was comprised of common COVID-19 vaccine side effects (Centers for Disease Control and Prevention, 2020) and the DSM-defined symptoms of a panic attack. Participants also reported their level of vaccine hesitancy using the 5C Scale (Betsch et al., 2018), which we modified to specifically refer to the COVID-19 vaccines; we considered their scores on the Confidence subscale, which measures trust in the vaccine’s safety, efficacy, development, and administration. Results indicated that vaccine hesitancy was significantly associated with greater severity of vaccine side effects, but only for individuals with high anxiety sensitivity. These findings suggest that for vaccine hesitant individuals, there may be clinical utility to reducing anxiety sensitivity at the vaccination event (e.g., through interoceptive exposure) to reduce side effects.