Department of Sociology, University of New Hampshire, Durham, New Hampshire.
Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts.
Am J Prev Med. 2022 May;62(5):679-687. doi: 10.1016/j.amepre.2021.11.006. Epub 2021 Dec 16.
Mental health problems increased during the COVID-19 pandemic. The 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.
A nationally representative cohort of U.S. adults (N=8,090) in the Understanding America Study were interviewed regularly 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.
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 that vaccinated and never vaccinated respondents followed similar Patient Health Questionnaire 4 trends before vaccination, diverging significantly after vaccination. Analyses were robust to individual and wave fixed effects and 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).
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.
在 COVID-19 大流行期间，心理健康问题有所增加。人们知道接种疫苗后风险降低，可能会减轻焦虑，但这一假设仍未得到验证。本研究旨在检验美国 COVID-19 疫苗接种者的心理困扰是否有所减轻，以及预期恐惧的变化是否介导了任何关联。
一项在美国理解研究中进行的具有全国代表性的美国成年人队列（N=8090）定期接受访谈，时间从 2020 年 3 月至 2021 年 6 月（28 波）。差异-差异回归检验了接种疫苗是否会降低焦虑（患者健康问卷 4 评分），并使用中介分析来确定潜在机制，包括感染、住院和死亡的感知风险。
接种疫苗与焦虑程度降低 0.04 标准差（95%置信区间=-0.07，-0.02）相关。接种疫苗与感染风险感知降低 7.77 个百分点（95%置信区间=-8.62，-6.92）、住院风险感知降低 6.91 个点（95%置信区间=-7.72，-6.10）和死亡风险感知降低 4.68 个点（95%置信区间=-5.32，-4.04）相关。纳入风险感知可使疫苗接种与焦虑的关联降低 25%。事件研究模型表明，接种疫苗和从未接种疫苗的受访者在接种疫苗前遵循相似的患者健康问卷 4 趋势，接种疫苗后明显分化。分析结果对个体和波固定效应和时变控制具有稳健性。疫苗接种对焦虑的影响因种族/族裔而异，在美国印第安人和阿拉斯加原住民中观察到的降幅最大（β=-0.20，p<0.05，95%置信区间=-0.36，-0.03）。
COVID-19 疫苗接种与焦虑和感染、住院和死亡的感知风险降低有关。疫苗接种活动可以促进接受 COVID-19 疫苗的这些额外好处。
