Prevalence and correlates of vaccine attitudes and behaviors in a cohort of low-income mothers

Gilbert, Ross M.; Mersky, Joshua P.; Lee, Chien-Ti Plummer

doi:10.1016/j.pmedr.2020.101292

Cited by 6 publications

(8 citation statements)

References 44 publications

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“…For instance, in a cross-sectional study of patients with schizophrenia which took place during the 2009 H1N1 influenza pandemic in Australia, three-quarters indicated that they were willing to be vaccinated [ 41 ]; however, in keeping with similar studies [ 42 ], the absence of a general population comparison group renders interpretation problematic. In a small cohort of socioeconomically disadvantaged mothers, those with mental health problems were seemingly less likely to have children with up-to-date vaccine coverage, although the association was weak and the study underpowered [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

Batty

Deary

2022

Annals of Medicine

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Background Although several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health and, particularly, mental health, is poorly understood. Methods We used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (Oxford University/AstraZeneca, November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16–95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, including the completion of the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression). Peri-pandemic, individuals indicated whether they or someone in their household was shielding; that is, people judged by the UK National Health Service as being particularly clinically vulnerable who were therefore requested to remain at home. Intention to take up vaccination for COVID-19 was also self-reported. Results In an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine-hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to vaccine-hesitancy. Conclusions People with a physical condition were more likely to take up the potential offer of a COVID-19 vaccination. These effects were not apparent for indices of mental health. Key messages In understanding predictors of COVID-19 vaccine hesitancy, the role of physical and mental health has not been well-examined despite both groups seemingly experiencing an elevated risk of the disease. In a large UK cohort study, people with a pre-pandemic physical condition were more likely to take up the theoretical offer of vaccination. There were no apparent effects for indices of pre-pandemic mental health.

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Section: Discussionmentioning

confidence: 99%

Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

Batty

Deary

2022

Annals of Medicine

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show abstract

“…In a small cohort of socioeconomically disadvantaged mothers, those with mental health problems were seemingly less likely to have children with up-to-date vaccine coverage, although the association was weak and the study underpowered. 44…”

Section: Discussionmentioning

confidence: 99%

Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

Batty

Deary

2021

Preprint

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ImportanceAlthough several predictors of COVID-19 vaccine hesitancy have been identified, the role of physical health has not been well-examined, and the association with mental health is unknown.ObjectiveTo examine the association of pre-pandemic mental health, physical health, and shielding with vaccine hesitancy after the announcement of the successful testing of the Oxford University/AstraZeneca vaccine.Design, Setting, and ParticipantsWe used individual-level data from a pandemic-focused investigation (COVID Survey), a prospective cohort study nested within the UK Understanding Society (Main Survey) project. In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 12,035 individuals aged 16-95 years. Pre-pandemic, study members had responded to enquiries about diagnoses of mental and physical health, completed the 12-item General Health Questionnaire for symptoms of psychological distress (anxiety and depression), and indicated whether they or someone in their household was shielding.Main outcome measuresSelf-reported intention to take up a vaccination for COVID-19. To summarise our results, we computed odds ratios with accompanying 95% confidence intervals for indices of health and shielding adjusted for selected covariates.ResultsIn an analytical sample of 11,955 people (6741 women), 15.4% indicated that they were vaccine hesitant. Relative to their disease-free counterparts, shielding was associated with a 24% lower risk of being hesitant (odds ratio; 95% confidence interval: 0.76; 0.59, 0.96), after adjustment for a range of covariates which included age, education, and ethnicity. Corresponding results for cardiometabolic disease were 22% (0.78; 0.64, 0.95), and for respiratory disease were 26% (0.74; 0.59, 0.93). Having a pre-pandemic diagnosis of anxiety or depression, or a high score on the distress symptom scale, were all unrelated to the willingness to take up a vaccine.Conclusions and relevancePeople who have been prioritised for COVID-19 vaccination owing to a physical condition are more likely to take it up. These effects were not apparent for indices of mental health.

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“…Six studies covered the impact of maternal mental health on the vaccine uptake in their children [ 29 – 32 , 41 , 42 ]. For children at the age of five, there were consistent results for a lower odds of receiving a vaccine if they had a mother affected by a mental health issue or with a lower score of mental well-being [ 29 , 31 ]. This was both in a U.S. and a U.K. setting.…”

Section: Resultsmentioning

confidence: 99%

“…This was both in a U.S. and a U.K. setting. However, Gilbert et al [ 29 ] did not find conclusive results for the impact of mental well-being among low-income mothers in delaying their children’s vaccination.…”

Section: Resultsmentioning

confidence: 99%

Exploring the impact of mental health conditions on vaccine uptake in high-income countries: a systematic review

et al. 2023

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Background Vaccination is an essential public health intervention to reduce morbidity and mortality from infectious diseases. Despite being at higher at risk of infectious diseases, health inequalities towards vaccine uptake in people with mental health issues have not been systematically appraised. Methods We searched 7 databases from 1994 to 26/03/2021. We included all studies with a relative measure of effect comparing a group with a mental health issue to a control group. All studies covering any mental health issue were eligible with no constraints to study population, vaccine type or region, provided in a high-income country for comparability of health care systems. The study outcomes were synthesised by study population, mental health issue and type of vaccine. Results From 4,069 titles, 23 eligible studies from 12 different countries were identified, focusing on adults (n = 13) or children (n = 4) with mental health issues, siblings of children with mental health issues (n = 2), and mothers with mental health issue and vaccine uptake in their children (n = 6). Most studies focused on depression (n = 12), autism, anxiety, or alcoholism (n = 4 respectively). Many studies were at high risk of selection bias. Discussion Mental health issues were associated with considerably lower vaccine uptake in some contexts such as substance use disorder, but findings were heterogeneous overall and by age, mental health issue or types of vaccine. Only individuals with mental health issues and physical comorbidities had consistently higher uptake in comparison to other adults. Mental health should be considered as a health inequality for vaccine uptake but more context specific research is needed focusing more on specific mental health issues and subgroups of the population to understand who misses vaccination and why.

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Prevalence and correlates of vaccine attitudes and behaviors in a cohort of low-income mothers

Cited by 6 publications

References 44 publications

Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

Pre-pandemic mental and physical health as predictors of COVID-19 vaccine hesitancy: evidence from a UK-wide cohort study

Exploring the impact of mental health conditions on vaccine uptake in high-income countries: a systematic review

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