青少年心理健康与药物滥用对新冠疫苗犹豫态度的关系：一项混合方法纵向队列研究

Relationship between mental health and substance abuse on COVID-19 vaccine hesitancy in youth: A mixed methods longitudinal cohort study.

作者信息

Everest Louis, Henderson Joanna, Ma Clement, Prebeg Matthew, Relihan Jacqueline, Hawke Lisa D

机构信息

Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

University of Toronto, Toronto, Ontario, Canada.

出版信息

PLoS One. 2025 Jan 8;20(1):e0313157. doi: 10.1371/journal.pone.0313157. eCollection 2025.

DOI:10.1371/journal.pone.0313157

PMID:39774518

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11709255/

Abstract

BACKGROUND

Mental health and substance use challenges are highly correlated in youth and have been speculated to be associated with COVID-19 vaccine hesitancy. Literature has also suggested that mental health challenges in youth have increased during the COVID-19 pandemic. However, the longitudinal relationship between mental health challenges in youth and COVID-19 vaccine hesitancy is not well established.

OBJECTIVE

We examined the relationship between mental health, substance use and COVID-19 vaccine hesitancy in youth during the COVID-19 pandemic.

METHODS

Youth ages 14 to 29-years participated in a longitudinal survey study. Participants provided sociodemographic, mental health, and substance use data, as well as qualitative and quantitative information on their vaccine perspectives every two months between February 2021 to August 2021, and on February 2022. Generalized estimating equation logistic regression models were used to analyze the effect of mental health and substance use on vaccine hesitancy over time. Qualitative content area analyses were used to identify trends in vaccine attitudes.

RESULTS

Mental health challenges and substance use frequency were associated with vaccine hesitancy, and significantly increased the odds of vaccine hesitancy over time. Additionally, mental health challenges were associated with decreases in vaccine hesitancy (OR: 0.80 (95% CI 0.66, 0.97)) when vaccines first began to emerge, but increases in vaccine hesitancy (OR: 1.72 (95% CI 1.32, 2.26)) one year later. Participants reported perceptions regarding vaccine safety and efficacy were the primary determinants influencing hesitant, uncertain, and acceptant vaccine attitudes. Additionally, changes in vaccine attitudes over time for some participants, were associated with changes in mental health.

CONCLUSIONS

Increases in mental health challenges and substance use were associated with increases in COVID-19 vaccine hesitancy in youth over the COVID-19 pandemic. Health policy agencies should be aware of the potential impact of mental health challenges and substance use in youth, when developing vaccine policy and programs.

摘要

背景

心理健康和物质使用问题在青少年中高度相关，并且据推测与对新冠疫苗的犹豫态度有关。文献还表明，在新冠疫情期间，青少年的心理健康问题有所增加。然而，青少年心理健康问题与新冠疫苗犹豫态度之间的纵向关系尚未明确确立。

目的

我们研究了新冠疫情期间青少年的心理健康、物质使用与新冠疫苗犹豫态度之间的关系。

方法

14至29岁的青少年参与了一项纵向调查研究。参与者提供了社会人口统计学、心理健康和物质使用数据，以及在2021年2月至2021年8月期间每两个月一次，以及在2022年2月时关于他们对疫苗看法的定性和定量信息。使用广义估计方程逻辑回归模型来分析心理健康和物质使用随时间对疫苗犹豫态度的影响。采用定性内容领域分析来确定疫苗态度的趋势。

结果

心理健康问题和物质使用频率与疫苗犹豫态度相关，并且随着时间的推移显著增加了疫苗犹豫的几率。此外，当疫苗刚开始出现时，心理健康问题与疫苗犹豫态度的降低相关（优势比：0.80（95%置信区间0.66，0.97）），但一年后与疫苗犹豫态度的增加相关（优势比：1.72（95%置信区间1.32，2.26））。参与者报告称，对疫苗安全性和有效性的看法是影响其对疫苗持犹豫、不确定和接受态度的主要决定因素。此外，一些参与者随时间的疫苗态度变化与心理健康变化有关。