No Difference Observed for Any Mental Illness and Uptake of First COVID-19 Vaccine Dose For Patients With, Without Mental Illness

In a new study from the Karolinska Institutet, investigators found that vaccination against COVID-19 was high for patients with and without mental illness. However, the results also showed that vaccination rates were lower among those who are unmedicated for their mental illness.¹

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“The high vaccination coverage among most individuals with mental illness shows that the COVID-19 vaccination campaign has been successful,” Mary Barker, postdoctoral researcher at the Institute of Environmental Medicine in the Karolinska Institutet, said in a news release.¹

In previous studies, data showed there was an association between mental illness and the uptake of vaccination, according to the current study authors. Similar findings showed that COVID-19 vaccinations have been inconsistent with individuals who have mental illness. However, previous studies have not shown associations between severity or medication status and COVID-19 vaccination.²

In the current study, investigators included 325,298 individuals who were in the COVIDMENT study and met the eligibility criteria. Approximately 65.1% were female and the mean age was 48 years old. Overall, vaccination uptake was high, with 85.1% of 314,827 individuals receiving the vaccination. Approximately 82.4% individuals with mental illness and 86.8% without mental illness received the vaccination. The investigators saw that there were no significant differences when adjusting for covariates for any mental illness and uptake of the first dose by September 30, 2021.²

Further, there were no association between anxiety or depressive symptoms for the update of the first dose of a COVID-19 vaccine. However, investigators found a small association before anxiety and depressive symptoms and a lower uptake of vaccination for males, but not females.²

For the uptake of the first dose of a COVID-19 vaccine by February 18, 2022, 88.9% of 315,584 individuals got vaccinated, with a small difference between those with mental illness (86.7%) and those without (90.3%). There was a small association between diagnosis of any mental illness and the first dose uptake by February 18, 2022, and for female patients, according to the study authors. Furthermore, for those who received a second dose by February 18, 2022, the uptake was 95.5% for 264,404 individuals, with 94.7% with mental illness and 95.9% for those without.²

In the Swedish registry data, individuals who were unmedicated for their mental illness were approximately 9% less likely to receive the first dose of the vaccine and individuals with substance use disorder were approximately 16% less likely to be vaccinated. Additionally, those with depression or bipolar disorder had a higher association with vaccine uptake, but there was no significant association for tobacco use disorder or anxiety.^1,2

Seven studies were included in the analysis between 5 countries, including Sweden, Norway, Iceland, Estonia, and Scotland. Data from the COVIDMENT study was used as well as data from the Swedish registry study analysis, according to the study authors.²

“More research is needed to explore the reasons behind these associations in order to improve current and future vaccination strategies and ultimately ensure equitable protection against infectious diseases,” said Barker in the news release. “As individuals with mental illness are at higher risk of severe COVID-19 outcomes, high vaccination coverage is especially important in this group.”¹

REFERENCES

1. People with unmedicated mental illness are less likely to be vaccinated against COVID-19. News release. EurekAlert. September 26, 2o24. Accessed October 7, 2024. https://www.eurekalert.org/news-releases/1058949

2. Barker MM, Kõiv K, Magnúsdóttir I, et al. Mental illness and COVID-19 vaccination: a multinational investigation of observational & register-based data. Nat Commun. 2024;15(1):8124. doi:10.1038/s41467-024-52342-1