Huang Hui, Zhu Xiao-Min, Liang Peng-Wei, Fang Zhong-Ming, Luo Wei, Ma Yi-Ming, Zhong Bao-Liang, Chiu Helen Fung-Kum
Affliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.
Front Med (Lausanne). 2021 Nov 11;8:761601. doi: 10.3389/fmed.2021.761601. eCollection 2021.
Persons with mental disorders (PwMDs) are a priority group for COVID-19 vaccination, but empirical data on PwMDs' vaccine uptake and attitudes toward COVID-19 vaccines are lacking. This study examined the uptake, acceptance, and hesitancy associated with COVID-19 vaccines among Chinese PwMDs during China's nationwide vaccine rollout. In total, 906 adult PwMDs were consecutively recruited from a large psychiatric hospital in Wuhan, China, and administered a self-report questionnaire, which comprised standardized questions regarding sociodemographics, COVID-19 vaccination status, attitudes toward COVID-19 vaccines, and psychopathology. Vaccine-recipients were additionally asked to report adverse events that occurred following vaccination. PwMDs had a much lower rate of vaccination than Wuhan residents (10.8 vs. 40.0%). The rates of vaccine acceptance and hesitancy were 58.1 and 31.1%, respectively. Factors associated with vaccine uptake included having other mental disorders [odds ratio (OR) = 3.63], believing that ≥50% of vaccine-recipients would be immune to COVID-19 (OR = 3.27), being not worried about the side effects (OR = 2.59), and being an outpatient (OR = 2.24). Factors associated with vaccine acceptance included perceiving a good preventive effect of vaccines (OR = 12.92), believing that vaccines are safe (OR = 4.08), believing that ≥50% of vaccine-recipients would be immune to COVID-19 (OR = 2.20), and good insight into the mental illness (OR = 1.71). Adverse events occurred in 21.4% of vaccine-recipients and exacerbated pre-existing psychiatric symptoms in 2.0% of vaccine-recipients. Nevertheless, 95.2% of vaccine-recipients rated adverse events as acceptable. Compared to the 58.1% vaccine acceptance rate and the 40.0% vaccination rate in the general population, the 10.8% vaccine coverage rate suggested a large unmet need for COVID-19 vaccination in Chinese PwMDs. Strategies to increase vaccination coverage among PwMDs may include provision of reliable sources of information on vaccines, health education to foster positive attitudes toward vaccines, a practical guideline to facilitate clinical decision-making for vaccination, and the involvement of psychiatrists in vaccine consultation and post-vaccination follow-up services.
精神障碍患者是新冠病毒疫苗接种的优先群体，但缺乏关于精神障碍患者疫苗接种率及对新冠疫苗态度的实证数据。本研究调查了在中国全国范围内推行疫苗接种期间，中国精神障碍患者对新冠疫苗的接种情况、接受度及犹豫程度。总共从中国武汉一家大型精神病医院连续招募了906名成年精神障碍患者，并让他们填写一份自我报告问卷，问卷包含有关社会人口统计学、新冠疫苗接种状况、对新冠疫苗的态度以及精神病理学的标准化问题。此外，还要求接种疫苗者报告接种后发生的不良事件。精神障碍患者的接种率远低于武汉居民（10.8%对40.0%）。疫苗接受率和犹豫率分别为58.1%和31.1%。与疫苗接种相关的因素包括患有其他精神障碍[比值比（OR）=3.63]、认为≥50%的接种者对新冠病毒免疫（OR = 3.27）、不担心副作用（OR = 2.59）以及是门诊患者（OR = 2.24）。与疫苗接受相关的因素包括认为疫苗预防效果好（OR = 12.92）、认为疫苗安全（OR = 4.08）、认为≥50%的接种者对新冠病毒免疫（OR = 2.20）以及对精神疾病有良好洞察力（OR = 1.71）。21.4%的接种者发生了不良事件，2.0%的接种者原有精神症状加重。然而，95.2%的接种者认为不良事件可以接受。与普通人群58.1%的疫苗接受率和40.0%的接种率相比，10.8%的疫苗接种覆盖率表明中国精神障碍患者对新冠疫苗接种的需求远未得到满足。提高精神障碍患者接种覆盖率的策略可能包括提供可靠的疫苗信息来源、开展健康教育以培养对疫苗的积极态度、提供实用指南以促进疫苗接种的临床决策，以及让精神科医生参与疫苗咨询和接种后随访服务。
