BACKGROUND: High school (HS) students have a high incidence of vasovagal reactions and are a good population for the study of vasovagal reactions. STUDY DESIGN AND METHODS: Data from 1,076 Caucasian students, 226 African-American students, and 157 nonstudents from HS blood drives in 2001 were entered into a database. Race, high-risk-factor synergism, the phenomenon of "survivorship," and female sex were evaluated. In addition, non-HS student participants were described. RESULTS: Vasovagal reactions were 84 percent lower in African-American HS students than in Caucasian HS students (3 of 226 vs. 88 of 1,076; 1.3 vs. 8.2 percent; p = 0.0001; relative risk, 6.2). In Caucasian HS students, first-time donor status increased the vasovagal reaction rate to 9.4 percent (vs. 3.6% in repeat donors, p < 0.004). Low weight (</= 130 lb) increased the reaction rate to 13.6 percent (vs. 3.3% in weight > 81.2 kg, p < 0.001). Together they increased the reaction rate to 16.0 percent (vs. 3.2%, p < 0.0001). Females had more reactions than males (11.3 vs. 4.8%, p < 0.001), but the reaction rates equalized when donors under 150 lb were excluded (5.7 vs. 4.6%, p = 0.66). CONCLUSION: African-American HS students had a significantly lower vasovagal reaction rate than Caucasian HS students. There was synergy among high-risk factors in Caucasian HS students. Female and male vasovagal reaction rates were similar when low-weight donors were excluded.
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