Perspectives regarding COVID-19 vaccination among unvaccinated persons with mental illness

The risk of COVID-19 infection and related health consequences is higher among persons with mental illnesses (PMI). Vaccines have had an impact in reducing the morbidity and mortality in patients with COVID-19 infection. Understanding the reasons for vaccine hesitancy in PMI is crucial for promoting vaccine acceptance in this population, but it remains an under-researched topic.

This cross-sectional study assessed perspectives among unvaccinated PMI regarding COVID-19 vaccination in a tertiary care teaching hospital. Factors associated with vaccine hesitancy in this population were explored.

One-hundred consecutive PMI attending the psychiatric outpatient clinic who had not taken the COVID-19 vaccination were recruited after obtaining informed consent. A semi-structured questionnaire was used to elicit knowledge, attitudes, and practices regarding COVID-19 vaccination. The Oxford vaccine hesitancy scale was used to assess vaccine hesitancy; the Brief Psychiatric Rating Scale and Depression Anxiety Stress Scale-21 were administered to assess current psychopathology.

A majority of the participants (62%) were unwilling for the vaccination, the most common reasons being the perception that they were not at risk of infection, and worry about the possible side effects of the vaccination. Factors associated with low vaccine hesitancy were higher levels of education, greater perception of the risk of contracting the disease, belief that vaccination was effective, and easy accessibility to the vaccine.

Improving awareness, providing accurate information, and ensuring better accessibility to vaccines are necessary to improve vaccine coverage among PMI. Mental health professionals need to assume an active role in providing education and clarifying misconceptions among our vulnerable patient population to help mitigate vaccine hesitancy.