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Let’s Unpack That

‘Thanks Pfizer’: The weird world of shakes, health anxiety and illness online

Eloise Hendy asks psychologists and doctors if the viral wave of vaccine-induced symptoms is real or faked or something else entirely

Saturday 04 February 2023 07:17 GMT

A woman’s bare feet poke out from a blue blanket. The TV is on and her toenails are neatly painted pink. “Alright guys,” she says in a Southern drawl, “so this is where we’re at.” Her feet are twitching. She throws the blanket off and raises her legs, and they shake like a fish out of water. The caption simply reads: “Thanks Pfizer”.

This is one of many videos that have recently surfaced on the internet that, according to those posting them, show “severe all body convulsions” supposedly caused by Covid-19 vaccines. A number have received incredibly high engagement, despite being shared by the same handful of accounts that seem to share little else. The same woman who posted the feet video, for example, has also shared others where she describes her “vaccine injury” as “my personal earthquake,” and one where she staggers out of a hospital bathroom, lock-kneed and juddering. At the time of writing, that video has over 13 million views on Twitter, and has been widely shared across Facebook and, more concerningly, to far-right and QAnon-adjacent groups on Telegram.

Away from these extremist circles however, the consensus seems to be that the Pfizer “shakes” are obvious fakes – intentional, attention-seeking hoaxes with conservative, anti-vax political aims. Not symptoms of “vaccine injury” but conspiracy theory. Indeed, context has been added under the “Thanks Pfizer” feet post that, as Twitter puts it, readers “thought people might want to know”. This states that “spasms have not been demonstrated to be a proven side effect of the Covid-19 vaccines. Over 11 billion vaccine doses have been administered across 184 countries and this has never been found.” The context box also adds that although the woman’s shaking appears very hard, even uncontrollable, “the camera remains still and level…”

Predictably perhaps, the internet took this woman’s videos and ran with them. Dua Lipa shaking her hips on stage with the caption “Thanks Pfizer”. Mark from Peep Show dancing at Rainbow Rhythms. Within days even the official Duolingo account was in on it, posting a GIF of the green avian linguist twerking on a conference table. Yet, while the general reaction has been to make a big joke out of this “vaccine injury” content, there is also something deeply unsettling about it. What is really going on in those videos? Are the people making them “fakers”, or are they genuinely convinced they have been injured, perhaps irreparably? Are the shakes they are experiencing real and involuntary, whatever their cause? Where does the line lie between misinformation, conspiracy and hypochondria? Perhaps most importantly, how can anyone tell if someone is really ill, believes they are, or are just saying it for attention?

A major reason why it can be so tricky to definitively judge the veracity of “symptoms” shared online is simply because, from a medical perspective, casting any such judgement would be dubious at best, and at worst unethical. Clinical psychologist Dr Lauren Kerwin, for example, stresses that she “cannot speak to the motivation” of those making the “Pfizer shakes” videos, because she has “never spoken to them nor personally met or assessed them”. “I also cannot speak to whether the vaccines are causing these tremors or not,” Kerwin states. “It would be unethical for me to diagnose these individuals.” Similarly, Dr David Veale, a consultant psychiatrist at the Maudsley Hospital in south London and co-author of Overcoming Health Anxiety, indicates that the people seeking online validation with these videos “need proper evaluation by both neurologists and psychiatrists”. Yet, he also says that while these shakes “could be extremely rare, unrecognised side effects of the vaccine”, this is “unlikely”. “Some could be an unrelated problem,” he suggests, “some may be staged, or others may be a somatic manifestation of distress.”

The medical community “calls this somatisation – your body manifesting what the mind holds to be irrefutably true,” Dr Asif Munaf tells me. In other words, the mind can have powerful effects on the body, and a person may be experiencing symptoms even if they do not stem from a diagnosed medical condition. As Dr Munaf puts it, “the mind is the most powerful instrument known to us”. Are there genuine shakes? “Well,” Dr Munaf says, “if you strongly believe the vaccine causes shakes, then you could theoretically develop them as you have convinced yourself of this causation.”

Racing heart, sweating, shakes and tremors, breathing difficulties, tight chest, are all signs of increased anxiety, and can easily be mistaken for something else

Counselling Directory member Lauren Calladine

Of course, the fact that somatisation is possible doesn’t mean that some people may not be intentionally feigning symptoms. Indeed, there is a well-recognised and widely studied disorder that spins around this: factitious disorder, previously known as Munchausen syndrome. As Dr Kerwin explains, this is “a condition in which a person intentionally produces or feigns symptoms of an illness in order to assume the sick role and gain attention and sympathy from others”. Yet, while this may sound like plain old manipulation, Dr Kerwin cautions that factitious disorder should be regarded as a legitimate, if misunderstood condition, often stemming from “underlying psychological issues such as a history of abuse or neglect, low self-esteem, and a need for control”. Far from being a case of “lying” or “making stuff up”, factitious disorder is “a very complex condition that requires extremely careful clinical assessment”, according to consultant clinical psychologist Dr Kirren Schnack. The problem is that in cases of factitious disorder, as Dr Schnack notes, “the patient’s prognosis is poor, as they’re mostly unwilling to accept the diagnosis”.

In this situation, where clinical assessment is either not available or its findings outright rejected, it seems many people turn to the internet for validation. Indeed, Counselling Directory member Lauren Calladine suggests that, in recent years, “due to the ease of social media giving such vulnerable people a new platform for attention, a new trend has developed called ‘Munchhausen’s by internet’.” The syndrome is also known as fictitious disorder, but it is of course intrinsically hard to prove or disprove. Yet, many therapists and psychiatrists now believe, like Calladine, that “the instant gratification someone experiencing this disorder can get from likes, comments and shares” may drive them “to create a whole image or personality based on chronic illnesses”. The question remains, however: how can anyone possibly know whether someone is “creating a personality based on chronic illnesses”, or desperately seeking support and connection online while genuinely suffering?

In a society that routinely dismisses and mischaracterises both chronic and mental illnesses, the spectres of both factitious and fictitious disorder loom large. After all, many people with chronic illnesses are often accused of “making up” or exaggerating their symptoms, while those with anxiety disorders are told their condition is “all in their head”. This accusation is particularly damaging, and part of what makes the whole issue of “faking symptoms” a minefield, as the supposed line between mental and physical disorders has always been so blurry that it’s basically non-existent. As Calladine stresses, “many symptoms of anxiety are the same as many health conditions. Racing heart, sweating, shakes and tremors, breathing difficulties, tight chest, are all signs of increased anxiety, and can easily be mistaken for something else.” This brings us back to somatisation, as the more anxious you become, the more these symptoms will grip you, and the more convinced you will become that you are experiencing the illness you fear. Indeed, Calladine describes health anxiety as “one of the most vicious, debilitating forms of anxiety”.

Compulsively checking the internet for health advice and information should, in this case, be seen as a symptom in itself. As Dr Schnack emphasises, people stricken with health anxiety “may body check, research the internet, read extensively about serious health conditions [and] have repeated medical investigations”. In extreme cases, patients may become “so convinced that they’ll die soon of the disease they’re concerned about, that they make plans for their death, and discuss these with loved ones.” Like Calladine, Dr Schnack stresses health anxiety is “a truly terrifying condition for the sufferer”, but she also stresses that, with medical and psychological support, it is one “that can be treated and overcome”.

The problem, once again, is that the overwhelming mixture of information and misinformation being shared online can create vicious cycles – those with health anxiety turning to the internet for reassurance and instead finding new sources of terror. Dr Babak Ashrafi from Superdrug Online Doctor, certainly suggests the internet is contributing to a health anxiety boom. “There’s no doubt that we are seeing ever-rising levels of self-diagnosis and health anxiety in recent years,” he says. “While it’s useful for patients to have some idea of what they think is causing concern,” he argues it can be very challenging when professional medical diagnosis differs from a patient’s own internet-sourced self-diagnosis, as it causes mistrust and delays in treatment. This puts added pressure on an already stretched NHS, and creates another vicious cycle. “These same pressures,” Dr Ashrafi says, “can in turn mean that the only place patients have to turn to is online.” Indeed, Superdrug Online Doctor’s research showed that for one in five people in the UK, social media and internet posts are the first port of call when looking for health information, with people more likely to view health content on social media than book a doctor’s appointment. “The person is trying to get more information,” Dr Veale also notes, “but where there is uncertainty it just takes you down a rabbit hole of more doubts and distress.” Armed with internet information, he suggests, patients who do eventually seek medical examinations “may be more likely to dismiss any psychological understanding of the problem. Sometimes the belief is so strongly held it is regarded as ‘delusional’.”

This certainly seems to be the case with a number of the people currently sharing “Pfizer shakes” videos. Wired recently reported that one woman who posted a video on Facebook of herself shuddering on what looks like a hospital bed, has since declared that doctors have indicated her shaking stems from conversion disorder – a mental condition triggered by extreme stress. In a Facebook post on January 12 however, she said she remained unconvinced that stress was the cause of her condition, and has since made multiple posts about using CBD oil and “detoxing” to manage her symptoms. When medical expertise isn’t believed, wellness industry pseudoscience can easily rush in to fill the gap. Keeping people anxious and delusional can, after all, be profitable.

Navigating illness and the internet is, clearly, a knotty subject. Yet one thing it is important not to lose sight of in discussions about medical misinformation, pseudoscience and conspiracy is the real suffering of people whose experiences and symptoms don’t fit into easy categorisations. Bryan Blears is an NHS worker and a vaccine supporter. Following his second Pfizer vaccine in July 2021, he reports suffering from “intense chest pains which have resulted in about a dozen A&E attendances, numerous cardiology follow-ups and no diagnosis”. After contracting Covid in December 2022, this got worse. “I have crushing chest pain on the left side almost every day,” he says. Despite undergoing “a chest x-ray, numerous ECGs, blood tests for [raised levels of] troponin [which might indicate heart injury] and D-dimer [proteins formed after a blood clot dissolves], an echocardiogram and a treadmill stress test,” so far, there have been no answers. Blears describes each day as “a rollercoaster of emotions”, as he constantly flips between “the rational, medical-led approach and the anxiety-filled, internet-fuelled irrationalism of there being many vaccine-related deaths, which I fear becoming a part of”. “To give you an indication as to how seriously this has disrupted my life, I have said my goodbyes and written a will, despite being 32 years old.”

“What are my real symptoms,” Blears asks, “which I do believe are extremely rare but genuine?” His greatest concern is “being lumped in as part of a group of conspiracy theorists”. Ultimately, of course, this is a fear of being dismissed and disbelieved. “I think that these groups have caused real damage to the small number of people who may genuinely be adversely affected by their vaccines,” Blears stresses, “because we will not be taken seriously while they continue to push their content.”

The line between truth, belief, and lies may always remain blurry. “Sometimes we struggle to accept that our bodies can produce sensations without there always being a clear medical explanation, or disease pathology present,” Dr Schnack concludes. “People want certainty, and sometimes there isn’t any.”

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