COVID-19 Vaccination and Mental Health: A Difference-In-Difference Analysis of the Understanding America Study

Abstract

Introduction: Mental health problems increased during the coronavirus disease 2019 (COVID-19) pandemic. Knowledge that one is less at risk after being vaccinated may alleviate distress but this hypothesis remains unexplored. This study tests whether psychological distress declined in those vaccinated against COVID-19 in the U.S. and whether changes in anticipatory fears mediated any association. Methods: A nationally representative cohort of U.S. adults ( n =8,090) in the Understanding America Study were interviewed every 2 weeks from March 2020 to June 2021 (28 waves). Difference-in-differences regression tested whether vaccination reduced distress (Patient Health Questionnaire 4 scores), with mediation analysis used to identify potential mechanisms, including perceived risks of infection, hospitalization, and death. Results: Vaccination was associated with a 0.04-SD decline in distress (95% CI= –0.07, –0.02). Vaccination was associated with a 7.77–percentage point reduction in perceived risk of infection (95% CI= –8.62, –6.92), a 6.91-point reduction in perceived risk of hospitalization (95% CI= –7.72, –6.10), and a 4.68-point reduction in perceived risk of death (95% CI= –5.32, –4.04). Including risk perceptions decreased the vaccination–distress association by 25%. Event study models suggest vaccinated and never vaccinated respondents followed similar Patient Health Questionnaire 4 trends pre-vaccination, diverging significantly post-vaccination. Analyses were robust to individual and wave fixed effects, time-varying controls. The effect of vaccination on distress varied by race/ethnicity, with the largest declines observed among American Indian and Alaska Native individuals (β= –0.20, p <0.05, 95% CI= –0.36, –0.03). Conclusions: COVID-19 vaccination was associated with declines in distress and perceived risks of infection, hospitalization, and death. Vaccination campaigns could promote these additional benefits of receiving the COVID-19 vaccine.

Post-traumatic stress in healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

“…Given our up-to-date search, we anticipated sufficient literature to compare the prevalence between WHO regions to identify potential similarities or differences. We compared prevalence from studies with different months of study completion to contribute to our time-series analysis, which allowed us to draw correlations between changes in prevalence of PTSD symptoms and key events in the pandemic such as the availability of vaccines ( Hidaka et al., 2021 ; Koltai et al., 2022 ). We compared survey tools because previous studies on the topic found differences between the results from IES-R and PCL-5 ( Chen et al., 2022 ; Qi et al., 2022 ).…”

COVID‐19 vaccination did not improve employee mental health: A prospective study in an early phase of vaccination in Japan

“…10,11 The Research Ethics Committee of The University of Tokyo approved this study (No. 10856- [2][3][4] [5]). We measured psychological distress using an 18-item scale of the Brief Job Stress Questionnaire (BJSQ) [possible range: 18-72] 12 at T1 (4-10 February 2021) and T2 (22-29 June 2021).…”

“…3 A previous study showed using a COVID‐19 contact tracking app as an individual‐based measure was associated with better mental health. 4 The effect of the COVID‐19 vaccination as an individual‐based preventive measure on mental health is still controversial: some studies suggested the associations of vaccination on better mental health in public residence, 5 , 6 , 7 but another cross‐sectional study in HCWs showed vaccinated nurses significantly presented higher anxiety than those nonvaccinated, 8 and one Japanese study in HCWs suggested that those with high distress at baseline were likely to receive vaccines and better changes in mental health can be observed as a result. 9 The effect of the COVID‐19 vaccination on mental health among employees, who may have more distress than community‐dwelling people, needs to be examined.…”

COVID-19 vaccination coverage among patients with psychiatric disorders in China during the pandemic: a cross-sectional study

“…A cross-sectional survey in China also implied that COVID-19 vaccination could relieve anxiety and depression in vaccinated individuals [ 48 ]. A cohort study in American revealed that COVID-19 vaccination could ameliorate distress and decline perceived risk of infection, hospitalization and death [ 49 ]. Since the COVID-19 pandemic was associated with a higher prevalence of psychiatric disorder symptoms both in psychiatric patients and the general population, vaccine uptaking might alleviate their psychological burden and improve their mental health conditions temporarily.…”