{"id":"https://openalex.org/W7224833345","doi":"https://doi.org/10.21203/rs.3.rs-10436096/v1","title":"Symptom Expectations and Subsequent Symptom Reporting Following COVID-19 Vaccination: A Prospective Naturalistic Study of Nocebo-Related Processes","display_name":"Symptom Expectations and Subsequent Symptom Reporting Following COVID-19 Vaccination: A Prospective Naturalistic Study of Nocebo-Related Processes","publication_year":2026,"publication_date":"2026-10-30","ids":{"openalex":"https://openalex.org/W7224833345","doi":"https://doi.org/10.21203/rs.3.rs-10436096/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-10436096/v1","doi":"https://doi.org/10.21203/rs.3.rs-10436096/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10436096/v1","pdf_url":"https://www.researchsquare.com/article/rs-10436096/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-10436096/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5075377943","display_name":"Anna Paluszak","orcid":"https://orcid.org/0000-0002-5473-9252","observed_orcids":["https://orcid.org/0000-0002-5473-9252"]},"institutions":[{"id":"https://openalex.org/I4210137484","display_name":"Wroclaw University of Health and Sport Sciences","ror":"https://ror.org/03gn3ta84","country_code":"PL","type":"education","lineage":["https://openalex.org/I4210137484"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Anna Paluszak","raw_affiliation_strings":["University of Vocational Education","Wroclaw University of Health and Sport Sciences"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Vocational Education","institution_ids":[]},{"raw_affiliation_string":"Wroclaw University of Health and Sport Sciences","institution_ids":["https://openalex.org/I4210137484"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160197772","display_name":"Agnieszka Matkowska Kocjan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I385303915","display_name":"Wroclaw Medical University","ror":"https://ror.org/01qpw1b93","country_code":"PL","type":"education","lineage":["https://openalex.org/I385303915"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Agnieszka Matkowska Kocjan","raw_affiliation_strings":["Wroclaw Medical University, 50-368 Wroc\u0142aw, Poland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Wroclaw Medical University, 50-368 Wroc\u0142aw, Poland","institution_ids":["https://openalex.org/I385303915"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021879936","display_name":"Adam Paluszak","orcid":"https://orcid.org/0000-0002-7730-2723","observed_orcids":["https://orcid.org/0000-0002-7730-2723"]},"institutions":[{"id":"https://openalex.org/I4210137484","display_name":"Wroclaw University of Health and Sport Sciences","ror":"https://ror.org/03gn3ta84","country_code":"PL","type":"education","lineage":["https://openalex.org/I4210137484"]}],"countries":["PL"],"is_corresponding":false,"raw_author_name":"Adam Paluszak","raw_affiliation_strings":["University of Vocational Education","Wroclaw University of Health and Sport Sciences"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Vocational Education","institution_ids":[]},{"raw_affiliation_string":"Wroclaw University of Health and Sport Sciences","institution_ids":["https://openalex.org/I4210137484"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5072840867","display_name":"Alicja Kuczy\u0144ska","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Alicja Kuczy\u0144ska","raw_affiliation_strings":["University of Vocational Education"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Vocational Education","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12035","display_name":"Pain Management and Placebo Effect","score":0.9854000210762024,"subfield":{"id":"https://openalex.org/subfields/2805","display_name":"Cognitive Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T12035","display_name":"Pain Management and Placebo Effect","score":0.9854000210762024,"subfield":{"id":"https://openalex.org/subfields/2805","display_name":"Cognitive Neuroscience"},"field":{"id":"https://openalex.org/fields/28","display_name":"Neuroscience"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10118","display_name":"SARS-CoV-2 and COVID-19 Research","score":0.004399999976158142,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10168","display_name":"COVID-19 and Mental Health","score":0.0019000000320374966,"subfield":{"id":"https://openalex.org/subfields/3203","display_name":"Clinical Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/nocebo-effect","display_name":"nocebo effect","score":0.8040000200271606},{"id":"https://openalex.org/keywords/symptom-expectations","display_name":"symptom expectations","score":0.8669999837875366},{"id":"https://openalex.org/keywords/covid-19-vaccination","display_name":"COVID-19 vaccination","score":0.9599999785423279},{"id":"https://openalex.org/keywords/vaccine-adverse-events","display_name":"vaccine adverse events","score":0.8240000009536743},{"id":"https://openalex.org/keywords/symptom-reporting","display_name":"symptom reporting","score":0.75},{"id":"https://openalex.org/keywords/response-expectancy","display_name":"response expectancy","score":0.6240000128746033},{"id":"https://openalex.org/keywords/headache","display_name":"headache","score":0.5149999856948853},{"id":"https://openalex.org/keywords/chadox1-ncov-19-vaccine","display_name":"ChAdOx1 nCoV-19 vaccine","score":0.8619999885559082},{"id":"https://openalex.org/keywords/bnt162b2","display_name":"BNT162b2","score":0.9829999804496765},{"id":"https://openalex.org/keywords/naturalistic-research","display_name":"naturalistic study","score":0.4869999885559082}],"concepts":[{"id":"https://openalex.org/C2778360308","wikidata":"https://www.wikidata.org/wiki/Q1332954","display_name":"Nocebo","level":4,"score":0.6689000129699707},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6353999972343445},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.5698000192642212},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.5533000230789185},{"id":"https://openalex.org/C2909182145","wikidata":"https://www.wikidata.org/wiki/Q1332954","display_name":"Nocebo Effect","level":4,"score":0.4348999857902527},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.4291999936103821},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.4230000078678131},{"id":"https://openalex.org/C143095724","wikidata":"https://www.wikidata.org/wiki/Q515895","display_name":"Odds","level":3,"score":0.4223000109195709},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.3619999885559082},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.35600000619888306},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.33480000495910645},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.3319999873638153},{"id":"https://openalex.org/C167699689","wikidata":"https://www.wikidata.org/wiki/Q1521337","display_name":"Naturalistic observation","level":2,"score":0.3192000091075897},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.313400000333786},{"id":"https://openalex.org/C148220186","wikidata":"https://www.wikidata.org/wiki/Q7111912","display_name":"Outcome (game theory)","level":2,"score":0.3124000132083893},{"id":"https://openalex.org/C2778834376","wikidata":"https://www.wikidata.org/wiki/Q7696504","display_name":"Telephone interview","level":2,"score":0.31150001287460327},{"id":"https://openalex.org/C167704817","wikidata":"https://www.wikidata.org/wiki/Q7295548","display_name":"Rate ratio","level":3,"score":0.29789999127388},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.2815000116825104},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.27549999952316284},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.2635999917984009},{"id":"https://openalex.org/C27081682","wikidata":"https://www.wikidata.org/wiki/Q269829","display_name":"Placebo","level":3,"score":0.2628999948501587},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.2581000030040741},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.2558000087738037},{"id":"https://openalex.org/C2779517570","wikidata":"https://www.wikidata.org/wiki/Q7144954","display_name":"Patient-reported outcome","level":3,"score":0.2533999979496002},{"id":"https://openalex.org/C3017735446","wikidata":"https://www.wikidata.org/wiki/Q7507668","display_name":"Illness behavior","level":2,"score":0.2526000142097473},{"id":"https://openalex.org/C171606756","wikidata":"https://www.wikidata.org/wiki/Q506132","display_name":"Psychometrics","level":2,"score":0.251800000667572}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-10436096/v1","doi":"https://doi.org/10.21203/rs.3.rs-10436096/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10436096/v1","pdf_url":"https://www.researchsquare.com/article/rs-10436096/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10436096/v1","doi":"https://doi.org/10.21203/rs.3.rs-10436096/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10436096/v1","pdf_url":"https://www.researchsquare.com/article/rs-10436096/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"score":0.98580002784729,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7224833345.pdf","grobid_xml":"https://content.openalex.org/works/W7224833345.grobid-xml"},"referenced_works_count":36,"referenced_works":["https://openalex.org/W1518596071","https://openalex.org/W1966754527","https://openalex.org/W1990719199","https://openalex.org/W1997688782","https://openalex.org/W2002926191","https://openalex.org/W2019039429","https://openalex.org/W2030711540","https://openalex.org/W2063836318","https://openalex.org/W2088694808","https://openalex.org/W2097892010","https://openalex.org/W2111663549","https://openalex.org/W2135951181","https://openalex.org/W2137530642","https://openalex.org/W2167418359","https://openalex.org/W2168067765","https://openalex.org/W2275737843","https://openalex.org/W2515918419","https://openalex.org/W2517898512","https://openalex.org/W2578303353","https://openalex.org/W2807782653","https://openalex.org/W2885815791","https://openalex.org/W2895308006","https://openalex.org/W2922254588","https://openalex.org/W2952465403","https://openalex.org/W2962784756","https://openalex.org/W3194827020","https://openalex.org/W3202683323","https://openalex.org/W3208782854","https://openalex.org/W4206097200","https://openalex.org/W4309184804","https://openalex.org/W4309336759","https://openalex.org/W4310787851","https://openalex.org/W4361000529","https://openalex.org/W4362692346","https://openalex.org/W4398224677","https://openalex.org/W4401538119"],"related_works":["https://openalex.org/W4361000529","https://openalex.org/W4409704914","https://openalex.org/W4403932101","https://openalex.org/W4362692346","https://openalex.org/W3164728585","https://openalex.org/W4310787851","https://openalex.org/W4309336759","https://openalex.org/W7058815058","https://openalex.org/W4285792600","https://openalex.org/W4398254666"],"abstract_inverted_index":{"Abstract":[0],"Purpose.":[1],"Response":[2],"expectancies":[3],"are":[4,231],"central":[5],"to":[6],"nocebo":[7,245],"models,":[8,173],"but":[9,236],"naturalistic":[10],"studies":[11],"cannot":[12],"readily":[13],"distinguish":[14],"expectancy-related":[15],"symptom":[16,25,108,128,159,207,211,218],"reporting":[17,219],"from":[18],"biological":[19],"reactions.":[20],"We":[21],"tested":[22],"whether":[23],"pre-intervention":[24],"expectations":[26,212],"prospectively":[27],"predicted":[28],"subsequent":[29],"reports.":[30],"Methods.":[31],"Adults":[32],"awaiting":[33],"AstraZeneca":[34],"or":[35],"Pfizer-BioNTech":[36],"vaccination":[37],"in":[38,44,220],"Poland":[39],"completed":[40,54],"a":[41,202,221],"pre-vaccination":[42],"assessment":[43],"the":[45,65,87,93,121,237],"first":[46],"half":[47],"of":[48,67,137],"2021":[49],"(N":[50],"=":[51,114,143,150,164,190,197],"244);":[52],"197":[53],"telephone":[55],"follow-up":[56],"about":[57],"two":[58],"weeks":[59],"later.":[60],"The":[61,104,225],"primary":[62],"outcome":[63],"was":[64,129,154],"number":[66,136],"reported":[68,107,138,180],"symptoms.":[69],"A":[70],"multivariable":[71],"negative-binomial":[72],"model":[73],"adjusted":[74,85,122,229],"for":[75,86,205],"vaccine":[76],"type,":[77],"sex,":[78],"and":[79,90,98,106,184,228],"age.":[80],"Symptom-specific":[81],"logistic":[82],"models":[83],"were":[84,110,213],"same":[88],"covariates":[89],"controlled":[91],"using":[92],"Benjamini-Hochberg":[94],"false-discovery":[95],"rate.":[96],"Attrition-weighted":[97,199],"alternative-model":[99],"analyses":[100,230],"assessed":[101],"robustness.":[102],"Results.":[103],"expected":[105,127,135,175,206],"counts":[109],"positively":[111],"correlated":[112],"(rho":[113],".34,":[115],"95%":[116,145,166,192],"CI":[117,146,167,193],"[.22,":[118],".46]).":[119],"In":[120],"count":[123,160],"model,":[124],"each":[125],"additional":[126],"associated":[130,157,178,215],"with":[131,158,179,216,233],"an":[132,243],"11%":[133],"higher":[134],"symptoms":[139],"(incidence":[140,161],"rate":[141,162],"ratio":[142,163,189],"1.11,":[144],"[1.02,":[147],"1.20],":[148],"p":[149],".011).":[151],"Vaccine":[152],"type":[153],"not":[155,241],"independently":[156,214],"0.91,":[165],"[0.61,":[168],"1.36]).":[169],"Of":[170],"five":[171],"symptom-specific":[172],"only":[174],"headache":[176,181],"remained":[177],"after":[182],"adjustment":[183],"false-discovery-rate":[185],"correction":[186],"(adjusted":[187],"odds":[188],"4.06,":[191],"[1.52,":[194],"10.88],":[195],"q":[196],".027).":[198],"analysis":[200],"produced":[201],"similar":[203],"estimate":[204],"count.":[208],"Conclusions.":[209],"Pre-intervention":[210],"later":[217],"real-world":[222],"medical":[223],"context.":[224],"temporal":[226],"ordering":[227],"consistent":[232],"nocebo-related":[234],"processes,":[235],"observational":[238],"design":[239],"does":[240],"establish":[242],"expectancy-induced":[244],"effect.":[246]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-31T00:00:00"}