Risks of COVID-19-related hospitalisation and mortality among individuals with mental disorders following BNT162b2 and CoronaVac vaccinations: A case-control study

• Published in: Psychiatry research Vol. 329; p. 115515
• Main Authors: Yiu, Hei Hang Edmund, Yan, Vincent K.C., Wei, Yue, Ye, Xuxiao, Huang, Caige, Castle, David J., Chui, Celine S.L., Lai, Francisco T.T., Li, Xue, Wong, Carlos K.H., Wan, Eric Y.F., Wong, Ian C.K., Chan, Esther W.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-11-2023
• Subjects: COVID-19; Hospitalisation; Mental disorders; Mortality; Vaccination; Vaccine effectiveness; COVID-19; Mental disorders; Vaccination; Mortality; Vaccine effectiveness; Hospitalisation
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2023.115515

•This is the first study to explore BNT162b2/CoronaVac's effectiveness in individuals with mental disorders against Omicron.•The booster dose significantly reduced COVID-19-related hospitalisation and mortality in individuals with mental disorders.•The risk reduction magnitude with BNT162b2 was generally higher than CoronaVac, but the gap narrowed after the third dose.•Individuals with mental disorders should be prioritised in future vaccination programmes of bivalent COVID-19 vaccines.
Concerns have been raised regarding potential weaker vaccine immunogenicity with higher immune suppression for individuals with pre-existing mental disorders. Yet, data on the effectiveness of COVID-19 vaccinations among this vulnerable population are limited. A case-control study was conducted to investigate the risks of COVID-19-related hospitalisation and mortality among individuals with mental disorders following one to three doses of BNT162b2 and CoronaVac vaccinations in Hong Kong. Data were extracted from electronic health records, vaccination and COVID-19 confirmed case records. Conditional logistic regression was applied with adjustment for comorbidities and medication history. Subgroup analyses were performed with stratification: by age (< 65 and ≥ 65) and mental disorders diagnosis (depression, schizophrenia, anxiety disorder, and bipolar disorder). Two doses of BNT162b2 and CoronaVac significantly reduced COVID-19-related hospitalisation and mortality. Further protection for both outcomes was provided after three doses of BNT162b2 and CoronaVac. The vaccine effectiveness magnitude of BNT162b2 was generally higher than CoronaVac, but the difference diminished after the third dose. Individuals with mental disorders should be prioritised in future mass vaccination programmes of booster doses or bivalent COVID-19 vaccines. Targeted strategies should be developed to resolve the reasons behind vaccine hesitancy among this population and increase their awareness on the benefits of vaccination.