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

Hei Hang Edmund Yiu; Vincent K. C. Yan; Yue Wei; Xuxiao Ye; Caige Huang; David J. Castle; Celine S. L. Chui; Francisco T. T. Lai; Xue Li; Carlos K. H. Wong; Eric Y. F. Wan; Ian C. K. Wong; Esther W. Chan

doi:10.1016/j.psychres.2023.115515

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

Hei Hang Edmund Yiu
, Vincent K. C. Yan
, Yue Wei
, Xuxiao Ye
, Caige Huang
, David J. Castle
, Celine S. L. Chui
, Francisco T. T. Lai
, Xue Li
, Carlos K. H. Wong
, Eric Y. F. Wan
, Ian C. K. Wong
, Esther W. Chan

Aston Pharmacy School

University of Hong Kong
The University of Tasmania
Education University of Hong Kong

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

19 Downloads (Pure)

Abstract

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.

Original language	English
Article number	115515
Number of pages	9
Journal	Psychiatry Research
Volume	329
Early online date	4 Oct 2023
DOIs	https://doi.org/10.1016/j.psychres.2023.115515
Publication status	Published - Nov 2023

Bibliographical note

Funding

This work was supported by a research grant from the Health Bureau; HMRF Research on COVID-19, The Government of the Hong Kong Special Administrative Region (principal investigator [work package 2], EWC; reference no. COVID1903011). The authors gratefully acknowledge the Centre for Health Protection, Department of Health and Hospital Authority for facilitating data access. ICKW is partially supported by the Laboratory of Data Discovery for Health (D24H) funded by AIR@-InnoHK administered by Innovation and Technology Commission. The authors also thank Ms Lisa Y Lam for proofreading.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Humans
COVID-19 Vaccines
BNT162 Vaccine
COVID-19/prevention & control
Case-Control Studies
Mental Disorders
Vaccination
Hospitalization

Access to Document

10.1016/j.psychres.2023.115515Licence: CC BY 4.0

HHE Yiu et al_.Risks of COVID-19-related hospitalisation and mortality among individuals w mental disorders_BNT162b2 and CoronaVac vaccinations
Copyright © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Final published version, 1.15 MBLicence: CC BY 4.0

Cite this

Yiu, H. H. E., Yan, V. K. C., Wei, Y., Ye, X., Huang, C., Castle, D. J., Chui, C. S. L., Lai, F. T. T., Li, X., Wong, C. K. H., Wan, E. Y. F., Wong, I. C. K., & Chan, E. W. (2023). Risks of COVID-19-related hospitalisation and mortality among individuals with mental disorders following BNT162b2 and CoronaVac vaccinations: A case-control study. Psychiatry Research, 329, Article 115515. https://doi.org/10.1016/j.psychres.2023.115515

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

abstract = "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.",

keywords = "Humans, COVID-19 Vaccines, BNT162 Vaccine, COVID-19/prevention \& control, Case-Control Studies, Mental Disorders, Vaccination, Hospitalization",

author = "Yiu, \{Hei Hang Edmund\} and Yan, \{Vincent K. C.\} and Yue Wei and Xuxiao Ye and Caige Huang and Castle, \{David J.\} and Chui, \{Celine S. L.\} and Lai, \{Francisco T. T.\} and Xue Li and Wong, \{Carlos K. H.\} and Wan, \{Eric Y. F.\} and Wong, \{Ian C. K.\} and Chan, \{Esther W.\}",

note = "Copyright {\textcopyright} 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).",

year = "2023",

month = nov,

doi = "10.1016/j.psychres.2023.115515",

language = "English",

volume = "329",

journal = "Psychiatry Research",

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Yiu, HHE, Yan, VKC, Wei, Y, Ye, X, Huang, C, Castle, DJ, Chui, CSL, Lai, FTT, Li, X, Wong, CKH, Wan, EYF, Wong, ICK & Chan, EW 2023, 'Risks of COVID-19-related hospitalisation and mortality among individuals with mental disorders following BNT162b2 and CoronaVac vaccinations: A case-control study', Psychiatry Research, vol. 329, 115515. https://doi.org/10.1016/j.psychres.2023.115515

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AU - Yiu, Hei Hang Edmund

AU - Yan, Vincent K. C.

AU - Wei, Yue

AU - Ye, Xuxiao

AU - Huang, Caige

AU - Castle, David J.

AU - Chui, Celine S. L.

AU - Lai, Francisco T. T.

AU - Li, Xue

AU - Wong, Carlos K. H.

AU - Wan, Eric Y. F.

AU - Wong, Ian C. K.

AU - Chan, Esther W.

PY - 2023/11

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N2 - 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.

AB - 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.

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KW - COVID-19/prevention & control

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KW - Mental Disorders

KW - Vaccination

KW - Hospitalization

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ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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