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Side-effect expectations from COVID-19 vaccination: findings from a nationally representative cross-sectional survey (CoVAccS – wave 2)

Smith, LE; Sim, J; Amlôt, R; Cutts, M; Dasch, H; Sevdalis, N; Rubin, GJ; Sherman, S


LE Smith

R Amlôt

M Cutts

H Dasch

N Sevdalis

GJ Rubin


Objectives: Concern about side effects is one of the most common reasons for refusing vaccination. Side-effect expectations are also known to predict perception of side effects. We aimed to investigate the percentage of people who thought side effects from COVID-19 vaccination were likely and investigate factors associated with side-effect expectation. Methods: Online cross-sectional survey of 1470 UK adults who had not been vaccinated for COVID-19 (conducted 13 to 15 January 2021). We asked participants how likely they thought side effects from COVID-19 vaccination were. Linear regression analyses were used to investigate associations with side-effect expectations. Results: Most participants were uncertain whether they would experience side effects from a COVID-19 vaccine; only a minority reported that side effects were very likely (9.4%, 95% CI 7.9% to 10.9%, n=138/1470). Personal and clinical characteristics, general, and COVID-19 vaccination beliefs and attitudes explained 29.7% of the variance in side-effect expectation, with COVID-19 vaccination beliefs alone accounting for 17.2%. Side-effect expectations were associated with: older age, being clinically extremely vulnerable to COVID-19, being afraid of needles, lower perceived social norms for COVID-19 vaccination, lower perceived necessity and safety of COVID-19 vaccination, and perceived lack of information about COVID-19 and vaccination. Conclusions: Side-effect expectation was associated with believing that COVID-19 vaccination was unsafe, ineffective and that others would be less likely to approve of you having a COVID-19 vaccination. Communications should emphasise the safety, effectiveness, and widespread uptake of vaccination, while promoting accurate perceptions of the incidence of vaccination side effects.


Smith, L., Sim, J., Amlôt, R., Cutts, M., Dasch, H., Sevdalis, N., …Sherman, S. (2022). Side-effect expectations from COVID-19 vaccination: findings from a nationally representative cross-sectional survey (CoVAccS – wave 2). Journal of Psychosomatic Research,

Acceptance Date Nov 13, 2021
Publication Date Jan 1, 2022
Journal Journal of Psychosomatic Research
Print ISSN 0022-3999
Publisher Elsevier
Keywords Adverse effects; COVID-19; Expectation; Nocebo effect; Vaccination
Publisher URL