Researchers show a correlation between low COVID-19 Vaccine uptake and unmedicated mental health.
I've often thought, with such a high risk of catching COVID-19 and such a high risk of serious illness, both short and long term from 'long COVID', that people must be mad not to take up the offer of the initial vaccine and the regular boosters.
Now a Swedish team at the Karolinska Institutet have analysed data from seven studies in Sweden, Norway, Iceland, Estonia and Scotland and found a significant correlation between unmedicated mental illness and low vaccine take-up.
Do you have any information on COVID-19 Vaccination rates in Europe and North America? As of September 2024, COVID-19 vaccination rates in Europe and North America continue to show variations across regions, but significant progress has been made overall.
In Europe, many Western European countries such as Portugal, Spain, and Denmark have some of the highest vaccination rates, with over 80% of their populations having received at least one dose. Meanwhile, Central and Eastern European countries like Bulgaria and Romania continue to lag behind, with coverage rates below 60%, largely due to vaccine hesitancy and logistical challenges. Vaccination efforts are ongoing, with boosters and updated vaccine formulations being administered in line with new variants of concern 1.1,3.1.
In North America, Canada boasts one of the highest vaccination rates, with around 85% of the population fully vaccinated, while the United States has a more mixed rate of about 70%, reflecting regional disparities. Certain states and demographic groups, especially in rural areas, still show lower vaccination uptake 2.1.
Both Europe and North America have implemented booster campaigns, with many countries now administering updated boosters that target newer variants to ensure long-term immunity and protection against severe outcomes from COVID-19. These campaigns continue, especially ahead of seasonal waves during colder months1.1,3.1.
Unmedicated mental illness linked to lower COVID-19 vaccination levels
Vaccination coverage for COVID-19 is high in both people with and without mental illness, according to a large multinational study led by researchers at Karolinska Institutet and published in Nature Communications. However, Swedish registry data revealed that individuals with unmedicated mental illness have lower vaccination levels.
The researchers analysed data from seven studies in five countries (Sweden, Norway, Iceland, Estonia, and Scotland) as part of the COVIDMENT consortium, totalling just over 325,000 individuals, and registry data from Sweden including over 8 million individuals.
Successful vaccination campaign
The pooled analysis from the COVIDMENT cohort showed that 85 per cent of individuals were vaccinated with the first dose of the COVID-19 vaccine (until September 30, 2021). There was no statistically significant difference in vaccination levels in people with or without a mental illness diagnosis, or with or without anxiety or depressive symptoms.
The high vaccination coverage among most individuals with mental illness shows that the COVID-19 vaccination campaign has been successful.
Dr. Mary Barker, lead author
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
However, Swedish registry data revealed that individuals diagnosed with a mental illness who did not have any dispensed prescription of medication for their mental illness were 9 per cent less likely to receive the first dose of the vaccine. Moreover, individuals with substance use disorder were 16 per cent less likely to be vaccinated.Higher risk of severe COVID-19
The research was financed by NordForsk, EU’s Horizon 2020 program, the Swedish Research Council for Health, Working Life and Welfare, the Swedish Research Council, the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, the Estonian Research Council, and the Research Council of Norway. Some of the authors have listed potential conflicts of interest, including honoraria from and shareholdings in pharmaceutical companies. See the scientific article for more information.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. As individuals with mental illness are at higher risk of severe COVID-19 outcomes, high vaccination coverage is especially important in this group.
Dr. Mary Barker.
PublicationMary M. Barker, Kadri Kõiv, Ingibjörg Magnúsdóttir, Hannah Milbourn, Bin Wang, Xinkai Du, Gillian Murphy, Eva Herweijer, Elísabet U. Gísladóttir, Huiqi Li, Anikó Lovik, Anna K. Kähler, Archie Campbell, Maria Feychting, Arna Hauksdóttir, Emily E. Joyce, Edda Bjork Thordardottir, Emma M. Frans, Asle Hoffart, Reedik Mägi, Gunnar Tómasson, Kristjana Ásbjörnsdóttir, Jóhanna Jakobsdóttir, Ole A. Andreassen, Patrick F. Sullivan, Sverre Urnes Johnson, Thor Aspelund, Ragnhild Eek Brandlistuen, Helga Ask, Daniel L. McCartney, Omid V. Ebrahimi, Kelli Lehto, Unnur A. Valdimarsdóttir, Fredrik Nyberg & Fang Fang.
Mental illness and COVID-19 vaccination: a multinational investigation of observational & register-based data.
Nature Communications, online 26 September 2024, doi: 10.1038/s41467-024-52342-1.
AbstractOne significant statistic revealed by AI (see the AI panel) was in regard to the USA: "Certain states and demographic groups, especially in rural areas, still show lower vaccination uptake". Generally-speaking these areas in America tend to be Republican-leaning, White evangelical Christian, creationist and Trumpanzee cult strongholds. This doesn't necessarily mean those groups tend to have unmedicated mental health problems, though trying to debate them in the social media sometime feels like you've strayed into an asylum.
Individuals with mental illness are at higher risk of severe COVID-19 outcomes. However, previous studies on the uptake of COVID-19 vaccination in this population have reported conflicting results. Using data from seven cohort studies (N = 325,298) included in the multinational COVIDMENT consortium, and the Swedish registers (N = 8,080,234), this study investigates the association between mental illness (defined using self-report measures, clinical diagnosis and prescription data) and COVID-19 vaccination uptake. Results from the COVIDMENT cohort studies were pooled using meta-analyses, the majority of which showed no significant association between mental illness and vaccination uptake. In the Swedish register study population, we observed a very small reduction in the uptake of both the first and second dose of a COVID-19 vaccine among individuals with vs. without mental illness; the reduction was however greater among those not using psychiatric medication. Here we show that uptake of the COVID-19 vaccine is generally high among individuals both with and without mental illness, however the lower levels of vaccination uptake observed among subgroups of individuals with unmedicated mental illness warrants further attention.
Introduction
The coronavirus disease 2019 (COVID-19) pandemic was an unprecedented global health crisis, which, as of August 2023, had caused 6.9 million deaths globally1. Although multiple effective vaccines against COVID-19 were developed and distributed globally, vaccine hesitancy and refusal were observed worldwide2,3,4,5. Crucially, the success of vaccination programmes in controlling the COVID-19 pandemic relies on high vaccination coverage6. Furthermore, the risk of severe COVID-19 infection and COVID-19-related mortality has been shown to be significantly higher among certain vulnerable population groups, such as individuals with mental illness (e.g. substance use disorder and psychiatric disorders requiring psychiatric hospital admissions)7,8. Therefore, high coverage of COVID-19 vaccination is especially important among these high-risk groups.
Previous systematic reviews exploring the association between mental illness and uptake of various vaccinations have reported heterogenous results9,10. Similarly, findings from previous nationwide studies of COVID-19 vaccination uptake in people with mental illness have been inconsistent. As such, while the majority of previous studies have demonstrated lower COVID-19 vaccine uptake among individuals with certain types of mental illness such as schizophrenia and substance use disorder, uptake has been shown to be higher among individuals with anxiety or depression, compared to those with no mental illness11,12,13,14. Furthermore, one study which explored associations between the use of various types of prescribed psychiatric medications and COVID-19 vaccine uptake found that while individuals using antipsychotics, anxiolytics or hypnotics had lower vaccine uptake, no significant difference in uptake was observed for individuals using antidepressants15. However, previous studies have not investigated the associations between mental illness severity or medication status (i.e. medicated vs. unmedicated mental illness) and COVID-19 vaccination. In order to explore this, we used data on mental health diagnoses and symptoms from cohort studies included in the multinational COVIDMENT consortium16, in addition to diagnostic and prescription data from the nationwide Swedish registers. Our hypothesis was that individuals with mental illness would have lower uptake of COVID-19 vaccination in general, and that this association would differ by mental illness type, severity, and medication status.
Barker, M.M., Kõiv, K., Magnúsdóttir, I. et al.
Mental illness and COVID-19 vaccination: a multinational investigation of observational & register-based data. Nat Commun 15, 8124 (2024). https://doi.org/10.1038/s41467-024-52342-1
Copyright: © 2024 The authors.
Published by springer Nature Ltd. Open access.
Reprinted under a Creative Commons Attribution 4.0 International license (CC BY 4.0)
But this study does nothing to dispel the idea that:
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