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Influenza Other Respir Viruses . Risk of COVID-19 Hospitalization and Protection Associated With mRNA Vaccination Among US Adults With Psychiatric

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses


. 2024 Mar;18(3):e13269.
doi: 10.1111/irv.13269. Risk of COVID-19 Hospitalization and Protection Associated With mRNA Vaccination Among US Adults With Psychiatric Disorders

Matthew E Levy[SUP] 1 2 [/SUP], Duck-Hye Yang[SUP] 1 [/SUP], Margaret M Dunne[SUP] 1 [/SUP], Kathleen Miley[SUP] 3 [/SUP], Stephanie A Irving[SUP] 4 [/SUP], Shaun J Grannis[SUP] 5 6 [/SUP], Zachary A Weber[SUP] 1 [/SUP], Eric P Griggs[SUP] 7 [/SUP], Talia L Spark[SUP] 1 [/SUP], Elizabeth Bassett[SUP] 1 [/SUP], Peter J Embi[SUP] 5 8 [/SUP], Manjusha Gaglani[SUP] 9 10 [/SUP], Karthik Natarajan[SUP] 11 12 [/SUP], Nimish R Valvi[SUP] 5 [/SUP], Toan C Ong[SUP] 13 [/SUP], Allison L Naleway[SUP] 4 [/SUP], Edward Stenehjem[SUP] 14 [/SUP], Nicola P Klein[SUP] 15 [/SUP], Ruth Link-Gelles[SUP] 7 [/SUP], Malini B DeSilva[SUP] 3 [/SUP], Anupam B Kharbanda[SUP] 16 [/SUP], Chandni Raiyani[SUP] 9 [/SUP], Maura A Beaton[SUP] 11 [/SUP], Brian E Dixon[SUP] 5 17 [/SUP], Suchitra Rao[SUP] 13 [/SUP], Kristin Dascomb[SUP] 14 [/SUP], Palak Patel[SUP] 18 [/SUP], Mufaddal Mamawala[SUP] 9 [/SUP], Jungmi Han[SUP] 11 [/SUP], William F Fadel[SUP] 5 17 [/SUP], Michelle A Barron[SUP] 13 [/SUP], Nancy Grisel[SUP] 14 [/SUP], Monica Dickerson[SUP] 18 [/SUP], I-Chia Liao[SUP] 9 [/SUP], Julie Arndorfer[SUP] 14 [/SUP], Morgan Najdowski[SUP] 7 [/SUP], Kempapura Murthy[SUP] 9 [/SUP], Caitlin Ray[SUP] 18 [/SUP], Mark W Tenforde[SUP] 18 [/SUP], Sarah W Ball[SUP] 1 [/SUP]



Affiliations
Abstract

Background: Although psychiatric disorders have been associated with reduced immune responses to other vaccines, it remains unknown whether they influence COVID-19 vaccine effectiveness (VE). This study evaluated risk of COVID-19 hospitalization and estimated mRNA VE stratified by psychiatric disorder status.
Methods: In a retrospective cohort analysis of the VISION Network in four US states, the rate of laboratory-confirmed COVID-19-associated hospitalization between December 2021 and August 2022 was compared across psychiatric diagnoses and by monovalent mRNA COVID-19 vaccination status using Cox proportional hazards regression.
Results: Among 2,436,999 adults, 22.1% had ≥1 psychiatric disorder. The incidence of COVID-19-associated hospitalization was higher among patients with any versus no psychiatric disorder (394 vs. 156 per 100,000 person-years, p < 0.001). Any psychiatric disorder (adjusted hazard ratio [aHR], 1.27; 95% CI, 1.18-1.37) and mood (aHR, 1.25; 95% CI, 1.15-1.36), anxiety (aHR, 1.33, 95% CI, 1.22-1.45), and psychotic (aHR, 1.41; 95% CI, 1.14-1.74) disorders were each significant independent predictors of hospitalization. Among patients with any psychiatric disorder, aHRs for the association between vaccination and hospitalization were 0.35 (95% CI, 0.25-0.49) after a recent second dose, 0.08 (95% CI, 0.06-0.11) after a recent third dose, and 0.33 (95% CI, 0.17-0.66) after a recent fourth dose, compared to unvaccinated patients. Corresponding VE estimates were 65%, 92%, and 67%, respectively, and were similar among patients with no psychiatric disorder (68%, 92%, and 79%).
Conclusion: Psychiatric disorders were associated with increased risk of COVID-19-associated hospitalization. However, mRNA vaccination provided similar protection regardless of psychiatric disorder status, highlighting its benefit for individuals with psychiatric disorders.

Keywords: COVID-19; anxiety disorders; electronic health records; epidemiology; mental disorders; mood disorders; psychotic disorders; vaccination.

 
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