Journal Article

Risk of COVID‐19 Hospitalization and Protection Associated With mRNA Vaccination Among US Adults With Psychiatric Disorders

Rao, Suchitra, Grisel, Nancy, Yang, Duck‐Hye, Griggs, Eric P., Miley, Kathleen, DeSilva, Malini B., Barron, Michelle A., Liao, I‐Chia, Najdowski, Morgan, Natarajan, Karthik, Murthy, Kempapura, Grannis, Shaun J., Levy, Matthew E., Arndorfer, Julie, Weber, Zachary A., Bassett, Elizabeth, Tenforde, Mark W., Han, Jungmi, Irving, Stephanie A., Dickerson, Monica, Mamawala, Mufaddal, Ball, Sarah W., Klein, Nicola P., Dixon, Brian E., Dascomb, Kristin, Valvi, Nimish R., Embi, Peter J., Ong, Toan C., Gaglani, Manjusha, Stenehjem, Edward, Spark, Talia L., Link‐Gelles, Ruth, Patel, Palak, Naleway, Allison L., Kharbanda, Anupam B., Beaton, Maura A., Fadel, William F., Ray, Caitlin, Dunne, Margaret M., Raiyani, Chandni

2024

Overview

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.

• Publisher: John Wiley & Sons, Inc,John Wiley and Sons Inc
• Subject: Adult / Adults / Age groups / anxiety disorders / Clinical outcomes / Codes / Cohort analysis / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / COVID-19 Vaccines / Disorders / Drug dosages / Electronic health records / epidemiology / FDA approval / Health behavior / Health disparities / Health risks / Hospitalization / Humans / Immune response / Infections / Inpatient care / Intervention / Mental disorders / Mental Disorders - epidemiology / mood disorders / mRNA / mRNA vaccines / Original / Psychosis / psychotic disorders / Public health / Retrospective Studies / Risk / RNA, Messenger / Severe acute respiratory syndrome coronavirus 2 / Vaccination / Vaccine efficacy / Vaccines