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. 2025 Apr 15;25(1):1410.
doi: 10.1186/s12889-025-22615-5.

Surveillance of psychogenic adverse events following immunization in Zhejiang, China, 2020-2023

Xuejiao Pan  1 , Xiaohua Qi  1 , Yaping Chen  1 , Hui Liang  2
Affiliations

Surveillance of psychogenic adverse events following immunization in Zhejiang, China, 2020-2023

Xuejiao Pan et al. BMC Public Health. .

Abstract

Background: Adverse events following immunization (AEFIs) refer to any untoward medical occurrence that follows immunization. Despite the large number of studies reporting various types of AEFIs worldwide, information on the psychogenic AEFIs remains scarce.

Objective: To describe the frequency and characteristics of psychogenic AEFIs among vaccine recipients in Zhejiang Province, China, from 2020 to 2023.

Methods: Psychogenic AEFIs in Zhejiang Province from January 1, 2020, to December 31, 2023, were collected through the Chinese National AEFI Information System (CNAEFIS) for a descriptive epidemiological analysis.

Results: From 2020 to 2023, a total of 421 cases of psychogenic AEFIs were reported in Zhejiang Province, accounting for 0.47% of all AEFI cases and corresponding to an incidence rate of 1.48/1 million doses. 74.82% of the psychogenic AEFIs were related to the coronavirus disease 2019 (COVID-19) vaccine, and 93.82% occurred on the day of vaccination. The common symptoms of psychogenic AEFIs included headache/dizziness, chest tightness/chest pain, fatigue/drowsiness, paleness, cold/chill, and nausea/vomiting. In addition, the distribution of psychogenic AEFIs varied significantly by gender, age, occupation, season, and location.

Conclusions: The overall incidence of psychogenic reactions after vaccination in Zhejiang Province is low, which is relatively higher in females and students. Monitoring, identification, evaluation, and response are required after new vaccines are launched and vaccine strategies are adjusted.

Keywords: AEFI; Adverse events; China; Psychogenic; Surveillance; Vaccine.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the Ethics and Research Committees of Zhejiang CDC (approval number: 2021-002-07, approval date: 2021-11-08). Due to the study’s observational nature and the use of a de-identified dataset, informed consent was waived by the Ethics and Research Committees of Zhejiang CDC. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent for publication: NA. Competing interests: The authors declare no competing interests.

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