Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
School of Psychiatry, Faculty of Medicine and Health, University of NSW, Randwick, Australia.
Psychol Med. 2023 Nov;53(15):7232-7241. doi: 10.1017/S0033291723000776. Epub 2023 Apr 5.
Vaccine-preventable conditions cause preventable illness and may increase mortality in people living with mental illness. We examined how risks of hospitalisation for a wide range of vaccine-preventable conditions varied by age and sex among mental health (MH) service users.
Linked population data from New South Wales (NSW), Australia were used to identify vaccine-preventable hospitalisations (VPH) for 19 conditions from 2015 to 2020. Adult MH service users ( = 418 915) were compared to other NSW residents using incidence rates standardised for age, sex and socioeconomic status. Secondary analyses examined admissions for COVID-19 to September 2021.
We identified 94 180 VPH of which 41% were influenza, 33% hepatitis B and 10% herpes zoster. MH service users had more VPH admissions [adjusted incidence rate ratio (aIRR) 3.2, 95% CI 3.1-3.3]. Relative risks were highest for hepatitis (aIRR 4.4, 95% CI 4.3-4.6), but elevated for all conditions including COVID-19 (aIRR 2.0, 95% CI 1.9-2.2). MH service users had a mean age of 9 years younger than other NSW residents at first VPH admission, with the largest age gap for vaccine-preventable pneumonias (11-13 years younger). The highest relative risk of VPH was among MH service users aged 45-65.
MH service users have increased risk of hospitalisation for many vaccine-preventable conditions. This may be due to reduced vaccination rates, more severe illness requiring hospitalisation, greater exposure to infectious conditions or other factors. People living with mental illness should be prioritised in vaccination strategies.
可通过疫苗预防的疾病会导致可预防的发病，并可能增加精神疾病患者的死亡率。我们研究了在精神卫生服务使用者中，各种可通过疫苗预防的疾病的住院风险随年龄和性别变化的情况。
我们使用来自澳大利亚新南威尔士州（NSW）的链接人群数据，确定了 2015 年至 2020 年期间 19 种可通过疫苗预防的疾病的住院情况（VPH）。将成年精神卫生服务使用者（=418915 人）与其他 NSW 居民的发病率进行比较，以年龄、性别和社会经济地位为标准进行了标准化。二次分析检查了截至 2021 年 9 月的 COVID-19 入院情况。
我们发现了 94180 例 VPH，其中 41%为流感，33%为乙型肝炎，10%为带状疱疹。精神卫生服务使用者的 VPH 入院人数更多[校正发病率比（aIRR）为 3.2，95%CI 3.1-3.3]。乙型肝炎的相对风险最高（aIRR 为 4.4，95%CI 4.3-4.6），但包括 COVID-19 在内的所有疾病的风险均升高（aIRR 为 2.0，95%CI 1.9-2.2）。精神卫生服务使用者首次 VPH 入院的平均年龄比其他 NSW 居民年轻 9 岁，疫苗预防肺炎的年龄差距最大（年轻 11-13 岁）。45-65 岁的精神卫生服务使用者的 VPH 相对风险最高。
精神卫生服务使用者患多种可通过疫苗预防的疾病的住院风险增加。这可能是由于疫苗接种率降低、需要住院的病情更严重、接触传染性疾病的机会更多或其他因素所致。应优先考虑为患有精神疾病的人制定疫苗接种策略。
