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Vaccine . Associations between common mental disorders and vaccination readiness against seasonal influenza and Covid-19 of chronically ill adult pa

tetano

Editor, Senior Moderator
Vaccine


. 2025 Sep 9:64:127682.
doi: 10.1016/j.vaccine.2025.127682. Online ahead of print. Associations between common mental disorders and vaccination readiness against seasonal influenza and Covid-19 of chronically ill adult patients in primary care - a systematic review

Linda Sanftenberg[SUP] 1 [/SUP], Laura Kraeker[SUP] 2 [/SUP], Fabian Walter[SUP] 3 [/SUP], Ioanna Tsiligianni[SUP] 4 [/SUP], Izolde Bouloukaki[SUP] 5 [/SUP], Marco Roos[SUP] 3 [/SUP], Jochen Gensichen[SUP] 6 [/SUP]



Affiliations
Abstract

Background: Chronically ill are advised to receive annual vaccinations against Covid-19 and seasonal influenza. Furthermore, chronically ill show an increased prevalence of comorbid common mental disorders (CMDs), like depression, anxiety, and somatoform disorders. With vaccination rates remaining insufficient among these vulnerable patients, prior research assumes an association between CMDs and vaccination readiness. As diagnoses, treatment and vaccination of those patients are performed mainly in general practice, the aim of this review is to describe associations between CMDs and vaccination readiness against seasonal Influenza and Covid-19 in chronically ill adult patients in primary care.
Methods: A systematic literature search was conducted in Medline, Embase, PsycINFO, the Cochrane Library and ERIC. Randomized controlled trials (RCTs), clustered RCTs and observational studies were considered. Two authors screened the studies and assessed the risk of bias independently (Cochrane Risk of Bias 2-Tool). We followed the PRISMA guideline. The study protocol was published in PROSPERO (CRD42024621413). The results were synthesized narratively.
Results: Of 9820 identified studies, seven observational studies met the inclusion criteria. Regarding Covid-19, three studies could show, that CMDs might lead to decreased vaccination readiness in adults. Regarding seasonal influenza, no significant association between vaccination readiness and CMDs occurred. In terms of vaccination rates, no significant association between vaccinations against Covid-19 and CMDs could be identified. Two studies identified a significant association between decreasing vaccination rates against seasonal influenza and CMDs.
Conclusion: CMDs tend to be associated with decreased vaccination readiness, however vaccination rates were not automatically affected as well. This could indicate a potential intention-behavior gap.

Keywords: Chronic diseases; Common mental disorder; Covid-19; Influenza; Primary care; Vaccination readiness.

 
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