The COVID-19 pandemic has produced many calls for a vaccine. There is growing concern that vaccine hesitancy and anti-vaccination presence will dampen the uptake of a coronavirus vaccine. There are many cited reasons for vaccine hesitancy. Mercury content, autism association, and vaccine danger have been commonly found in anti-vaccination messages. It is also mused that the reduced disease burden from infectious diseases has paradoxically reduced the perceived requirement for vaccine uptake. Our analysis using Google Trends has shown that throughout the pandemic the search interest in a coronavirus vaccine has increased and remained high throughout. Peaks are found when public declarations are made, the case number increases significantly, or when vaccine breakthroughs are announced. Anti-vaccine searches, in the context of COVID-19, have had a continued and growing presence during the pandemic. Contrary to what some may believe, the burden of coronavirus has not been enough to dissuade anti-vaccine searches entirely.

NICE has accredited the process used by BSR to create its clinical guidelines. The term began on 27 February 2012 and the current renewed accreditation is valid until 31 December 2023. More information on accreditation can be viewed at www.nice.org.uk/accreditation.

Objective In this systematic review and meta-analysis of psoriatic arthritis (PsA) studies, we pooled data from existing literature to (1) estimate the prevalence of mental health disorders in PsA patients and (2) compare disease activity in PsA patients with and without these comorbidities. Method We searched PubMED, Web of Science, Scopus, PsycINFO and the Cochrane Library using a predefined protocol in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Where possible, meta-analysis was performed using random effects model. Prevalence estimates were pooled according to the severity of mental health disorders. Results A total of 24 studies, amounting to 31,227 PsA patients, were included for review. Anxiety and depression were the only consistently reported mental health disorders, defined using a range of screening criteria/thresholds. Anxiety prevalence ranged from 4 to 61% with a pooled estimate of 33% (95%CI 17 to 53%) having at least mild anxiety and 21% (95%CI 14 to 29%) at least moderate. Depression prevalence ranged from 5 to 51%, with 20% (95%CI 8 to 35%) having at least mild and 14% (95%CI 8 to 21%) at least moderate. Only two studies compared disease activity according to the presence of mental health comorbidities; both reported higher disease activity and pain among those with comorbid anxiety and depression. Conclusions Anxiety and depression are highly prevalent among PsA patients. Studies of other mental health disorders were scarce. More studies are needed on the impact of these comorbidities on disease activity and long-term outcomes.