COVID-19 Vaccination as Effective for Adults with Common Mental Disorders as for Those Without

Unvaccinated individuals with mental illness have higher rate of hospitalization

INDIANAPOLIS – A large multi-state electronic health record-based study from the Centers for Disease Control and Prevention’s (CDC’s) VISION Network has found that COVID-19 vaccines are as effective for adults with anxiety or depression or mood disorders as for individuals without these common diagnoses. This is one of the first studies to evaluate COVID-19 mRNA vaccine effectiveness for those living with mental illness.

While vaccination provided similar protection regardless of psychiatric diagnosis (none, one or multiple conditions), in contrast, unvaccinated adults with any of these conditions had a higher rate of hospitalization for COVID-19 – a marker for severe disease – than did those without a psychiatric diagnosis.

Both these findings held true whether two, three or four vaccinations were received and for ages 18-49, 50-64 and 65 and older.

“Although mental health conditions can tax the immune system, putting stress on the body, we saw similar COVID-19 vaccine effectiveness in people with psychiatric diagnoses compared with those without. That’s encouraging,” said study co-author Shaun Grannis, M.D., M.S., Regenstrief Institute vice president for data and analytics.

“But we also found that the risk of COVID-19 associated hospitalization is higher among unvaccinated patients with a psychiatric diagnosis,” added Dr. Grannis. “For patients with a diagnosis of depression, anxiety, or mood disorders who are wondering if the COVID vaccine would be valuable, this paper gives us evidence that the vaccine maintains its effectiveness even in the face of mental illness. So, I would encourage vaccination because it reduces the risk of hospitalization significantly.”

Psychiatric disorders have been associated with lower antibody positivity and reduced immune response to other vaccines. Prior to this study, it was not known whether anxiety, depression, or mood disorders influence COVID-19 vaccine effectiveness.

“While the evidence on vaccine effectiveness for the overall population is well-established, many people still have questions about whether someone like them should get the vaccine or whether people like them benefit from the vaccine,” said study co-author Brian Dixon, PhD, MPA, interim director of Regenstrief Institute’s Clem McDonald Center for Bioinformatics. “Studies like this one help answer those questions for large segments of society. Our network will continue to pursue rigorous studies on important, vulnerable populations. That is, after all, the work we do in public health.”

“Risk of COVID-19 hospitalization and protection associated with mRNA vaccination among US adults with psychiatric disorders” is published in the peer-reviewed journal Influenza and Other Respiratory Viruses. The study was funded by the CDC.

All authors and affiliations:

Matthew E. Levy^1,2 | Duck-Hye Yang¹ | Margaret M. Dunne¹ | Kathleen Miley³ | Stephanie A. Irving⁴ | Shaun J. Grannis^5,6 | Zachary A. Weber¹ | Eric P. Griggs⁷ | Talia L. Spark¹ | Elizabeth Bassett¹ | Peter J. Embi^5,8 | Manjusha Gaglani^9,10 | Karthik Natarajan^11,12 | Nimish R. Valvi⁵  |  Toan C. Ong¹³  |  Allison L. Naleway⁴  |  Edward Stenehjem¹⁴   |  Nicola P. Klein¹⁵  |  Ruth Link-Gelles⁷  |  Malini B. DeSilva³  |  Anupam B. Kharbanda¹⁶  |  Chandni Raiyani⁹  |  Maura A. Beaton¹¹   |  Brian E. Dixon^5,17  |  Suchitra Rao¹³  |  Kristin Dascomb¹⁴  |  Palak Patel¹⁸  |  Mufaddal Mamawala⁹  |  Jungmi Han¹¹  |  William F. Fadel^5,17  |  Michelle A. Barron¹³  |  Nancy Grisel¹⁴  |  Monica Dickerson¹⁸  |  I-Chia Liao⁹  |  Julie Arndorfer¹⁴  |  Morgan Najdowski⁷  |  Kempapura Murthy⁹  |  Caitlin Ray¹⁸  |  Mark W. Tenforde¹⁸  |  Sarah W. Ball¹

¹Westat, Rockville, Maryland, USA | ²Helix, San Mateo, California, USA | ³HealthPartners Institute, Minneapolis, Minnesota, USA | ⁴Kaiser Permanente Center for Health Research, Portland, Oregon, USA | ⁵Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, USA | ⁶School of Medicine, Indiana University, Indianapolis, Indiana, USA | ⁷Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA | ⁸Vanderbilt University Medical Center, Nashville, Tennessee, USA  |  ⁹Baylor Scott & White Health, Temple, Texas, USA | ¹⁰Texas A&M University College of Medicine, Temple, Texas, USA | ¹¹Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA | ¹²New York Presbyterian Hospital, New York, New York, USA  |  ¹³School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA | ¹⁴Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA | ¹⁵Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California, USA | ¹⁶Children’s Minnesota, Minneapolis, Minnesota, USA | ¹⁷Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA | ¹⁸Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Shaun Grannis, M.D., M.S.
In addition to his role as vice president for data and analytics and research scientist with the Clem McDonald Center for Biomedical Informatics, at Regenstrief Institute, Shaun Grannis, M.D., M.S., is the Regenstrief Professor of Medical Informatics and a professor of family medicine at Indiana University School of Medicine. He is also an adjunct professor with Indiana University Richard M. Fairbanks School of Public Health and at Indiana University School of Informatics and Computing, both at Indiana University-Indianapolis.

Brian E. Dixon, PhD, MPA
In addition to his role as the director of public health informatics at the Regenstrief Institute and Indiana University Richard M. Fairbanks School of Public Health at Indiana University-Indianapolis, Brian E. Dixon, PhD, MPA, is the interim director and a research scientist with the Clem McDonald Center for Biomedical Informatics at Regenstrief Institute and a professor of epidemiology at the Fairbanks School of Public Health. He is also an affiliate scientist at the U.S. Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center.