COVID-19 vaccine uptake higher in people with mental illness but drops for those not on medication

Study: Mental illness and COVID-19 vaccination: a multinational investigation of observational & register-based data

In a recent study published in the journal Nature Communications, researchers determined the relationship between mental disorders and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination uptake. They also explored differences in the relationship by mental disorder type, severity, and medication status.

About the study

The researchers analyzed data from the international COVIDMENT consortium (n=325,298) and Swedish registers (n=8,080,234). The COVIDMENT cohorts included the Icelandic COVID-19 National Resilience Cohort (C-19 Resilience), the Estonian Biobank (EstBB) with COVID-19 (EstBB-C19) and linked electronic health records (EstBB-EHR), the Norwegian COVID-19 Mental Health and Adherence (MAP-19) study, the Scottish CovidLife study, the Swedish Omtanke2020 study, and the Norwegian Mother, Father, and Child Cohort (MoBa) study.

Results

Overall vaccination rates were high, with only minimal disparities in uptake due to mental illness. COVIDMENT participants demonstrated no significant differences in vaccine uptake or the occurrence of identified mental illnesses. However, Swedish register data revealed that vaccination rates were marginally lower among participants with specialist-diagnosed mental conditions, with a 9% lower uptake among those with mental illness who were not on psychiatric medications. Individuals with drug use problems had a 16% lower vaccination uptake. The findings were similar for both sexes.

The COVIDMENT results showed no link between depression or anxiety and vaccination uptake. However, the Swedish register data showed a nuanced picture, revealing that individuals with specialist-diagnosed depression had higher uptake of the first dose of the vaccine, but those with depression who were not taking medication had reduced uptake for the initial COVID-19 vaccination. The findings suggest that the relationship between depression or anxiety and vaccination uptake might vary depending on disease severity and drug use. Sensitivity analysis revealed comparable findings for Nordic and non-Nordic populations.

No link between anxiety or depression and second-dose uptake: The study found no significant association between anxiety or depressive symptoms and second-dose vaccine uptake, suggesting that other factors may influence continued vaccination adherence in these groups.

Among COVIDMENT participants, the team noted an overall uptake of 85% for the first SARS-CoV-2 vaccine, 82% among individuals with a mental disorder, and 87% among those without such disorders. Likewise, the second dose uptake rates were lower among those with a mental disorder (95%) versus those without (96%). Among Swedish registered participants, the overall prevalence of severe COVID-19 was low (0.4%); however, the prevalence was higher among individuals with mental disorders (0.8%) than those without (0.3%). The uptake of the first dose was 79% among those with mental disorders and 85% among those without such diagnosis. Second-dose uptake rates were 96% and 98%, respectively. Substance use disorders (PR, 0.84) were the most strongly associated with lower vaccine uptake. In contrast, depression (PR, 1.02) and bipolar disorder (PR, 1.04) were linked to higher vaccine uptake.

The study found that COVID-19 vaccine uptake is high across those with and without mental illnesses, demonstrating the SARS-CoV-2 vaccination campaign’s comprehensiveness and success in reaching most of the population. However, the researchers discovered a significantly lower vaccination rate among unmedicated adults with diagnosed mental illness in the Swedish registry. These findings could inform the planning of current and future vaccination efforts for infectious diseases and pandemics.

Journal reference:

• Barker, M.M., Kõiv, K., Magnúsdóttir, I. et al. Mental illness and COVID-19 vaccination: a multinational investigation of observational and register-based data. Nat Commun 15, 8124 (2024), DOI: 10.1038/s41467-024-52342-1, https://www.nature.com/articles/s41467-024-52342-1

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 10: Reduced Inequalities

The article discusses the relationship between mental illness and COVID-19 vaccine uptake, highlighting the disparities in vaccination rates among individuals with mental illnesses. This connects to SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. It also relates to SDG 10, which focuses on reducing inequalities within and among countries.

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.8: Achieve universal health coverage, including access to quality essential healthcare services and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
• SDG 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion, or economic or other status.

The article highlights the need to ensure equitable access to COVID-19 vaccines for individuals with mental illnesses, indicating a target under SDG 3.8. It also emphasizes the importance of addressing the disparities in vaccine uptake among different population groups, aligning with the target under SDG 10.2.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Vaccine uptake rates among individuals with mental illnesses compared to those without mental illnesses.
• Vaccine uptake rates among individuals with different types and severity of mental disorders.
• Vaccine uptake rates among individuals with mental illnesses who are on medication compared to those who are not.

The article mentions and provides data on vaccine uptake rates among individuals with mental illnesses, allowing for the measurement of progress towards the identified targets. The rates are compared based on mental illness status, medication status, and specific mental disorder types.

Table: SDGs, Targets, and Indicators

Source: news-medical.net