pune the union health ministrys latest analysis of adverse events following immunization aefi for covid19 showed that 48 out of 78 cases had a consistent causal association to vaccination of these 48 as many as 20 reactions were due to anxiety during vaccinationthe nationallevel causality assessment report stated that as many as 22 cases including seven deaths were coincidental it meant they were not linked to vaccination seven adverse events including two deaths were in the indeterminate category and one event was in the unclassifiable categorythe causality assessment for the 78 cases six related to covaxin administration and the rest covishield was completed on august 3 after thorough review deliberation and approval by the national aefi committee the latest report stated that of the 48 cases of consistent causal association to vaccination a total of 28 were vaccine productrelated reactions such as anaphylaxis allergic reactions and dizziness the rest 20 were of immunization anxietyrelated reactionsthe consistent causal association to vaccination is a causeandeffect relationship between the vaccine and the adverse event that follows vaccine productrelated reaction refers to an adverse event following immunization aefi caused by a vaccine because of one or more of the inherent properties of its product such as the adjuvant preservative or stabilizer immunization anxietyrelated reaction refers to an aefi arising from anxiety about the immunizationdr narendra arora advisor national aefi committee said a chunk of reactions were driven by only panic or fear of vaccination such as nausea increase in heart rate and increased sweating among others there has been a higher incidence of anxiety among women than men after which they had to be admitted to healthcare facilities to alleviate their condition he saiddr arora said coincidental events were the aefis caused by something other than the vaccine product immunization error or vaccination anxiety so far among all the aefis assessed after the vaccination drive against covid began all the deaths except one were coincidental only one death was due to anaphylaxis he saidamong the seven deaths not linked to vaccination one was a sudden cardiac death one was related to atypical pneumonia with pulmonary embolism and another was due to chronic diarrhoea and severe malnutritionaccording to the report seven aefi cases including two sudden cardiac deaths were in the indeterminate category indeterminate category includes reactions which have occurred soon after vaccination but there is no definitive evidence in current literature or clinical trial data that these events could have been caused due to the vaccine such cases are later reassessed after all the postdeath documentation is available dr arora saidthe report stated that there was another sudden unexplained death of a 70yearold man under the unclassifiable category unclassifiable events are those which were investigated but there was not enough evidence for assigning a diagnosis due to missing crucial information according to an official of the union ministry of health and family welfarethe official said in unclassifiable cases there might be unavailability of complete documentsthe incidence of aefi events is very small