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The Impact of Pessimistic Expectations on the Effects of COVID-19-Induced Uncertainty in the Euro Area.

ABSTRACT: We estimate a monthly interacted-VAR model for euro area macroeconomic aggregates allowing for the impact of uncertainty shocks to depend on the state of the average outlook for the economy measured by survey data. We find that, in response to an uncertainty shock, the peak decrease in industrial production and inflation is around three and a half times larger during pessimistic times. We build an assessment of the role of uncertainty for a path of innovations consistent with the increase in the observed VSTOXX measure of uncertainty since the outset of the COVID-19 epidemics in February and March 2020. Industrial production is predicted to experience a year-over-year peak loss of around 9.2% in the fourth quarter of 2020, and subsequently to recover with a rebound to pre-crisis levels roughly in June 2021. The large impact is the result of an extreme shock to uncertainty occurring at a time of very negative expectations for the economic outlook. We conduct simulations that quantify the potential benefit of recovered confidence in reducing the uncertainty-induced losses associated with a possible third wave of the pandemic.

SUBMITTER: Pellegrino G

PROVIDER: S-EPMC8250985 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ImportanceUptake of vaccination against COVID-19 is strongly affected by concerns about adverse effects. Research on nocebo effects suggests that these concerns can amplify symptom burden.ObjectiveTo investigate whether positive and negative expectations prior to COVID-19 vaccination are associated with systemic adverse effects.Design, setting, and participantsThis prospective cohort study analyzed the association of expected benefits and risks of vaccination, adverse effects at first vaccination, and observed adverse effects in close contacts with severity of systemic adverse effects among adults receiving a second dose of messenger RNA (mRNA)-based vaccines between August 16 and 28, 2021. A total of 7771 individuals receiving the second dose at a state vaccination center in Hamburg, Germany, were invited to participate; of these, 5370 did not respond, 535 provided incomplete information, and 188 were excluded retrospectively. The mobile application m-Path was used for data collection.Main outcomes and measuresPrimary outcome was a composite severity index of systemic adverse effects in 12 symptom areas measured once daily with an electronic symptom diary over 7 consecutive days. Data were analyzed by mixed-effects multivariable ordered logistic regression adjusted for prevaccine symptom levels and observation times.ResultsA total of 10 447 observations from 1678 individuals receiving vaccinations (BNT162b2 [Pfizer BioNTech] in 1297 [77.3%] and mRNA-1273 [Moderna] in 381 [22.7%]) were collected. The participants' median age was 34 (IQR, 27-44) years, and 862 (51.4%) were women. The risk for more severe adverse effects was higher for persons expecting a lower benefit of vaccination (odds ratio [OR] for higher expectations, 0.72 [95% CI, 0.63-0.83]; P < .001), expecting higher adverse effects of vaccination (OR, 1.39 [95% CI, 1.23-1.58]; P < .001), having experienced higher symptom burden at the first vaccination (OR, 1.60 [95% CI, 1.42-1.82]; P < .001), scoring higher on the Somatosensory Amplification Scale (OR, 1.21 [95% CI, 1.06-1.38]; P = .004), and if the vaccine mRNA-1273 was given rather than BNT162b2 (OR, 2.45 [95% CI, 2.01-2.99]; P < .001). No associations were seen for observed experiences.Conclusions and relevanceIn this cohort study, several nocebo effects occurred in the first week after COVID-19 vaccination. The severity of systemic adverse effects was associated not only with vaccine-specific reactogenicity but also more negative prior experiences with adverse effects from the first COVID-19 vaccination, more negative expectations regarding vaccination, and tendency to catastrophize instead of normalize benign bodily sensations. Clinician-patient interactions and public vaccine campaigns may both benefit from these insights by optimizing and contextualizing information provided about COVID-19 vaccines.

Dataset Information

The Impact of Pessimistic Expectations on the Effects of COVID-19-Induced Uncertainty in the Euro Area.

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