To those of us on the front lines of health care, COVID vaccine hesitancy is unfathomable. Despite overwhelming evidence of safety and efficacy, a significant percentage of people have an irrational distrust of vaccination. This has begged the question, is vaccine hesitancy a mental disorder? There is very little research on this question. I found three interesting studies.
Murphy et al published an interesting study in Nature Communications on the psychological characteristics of vaccine hesitant individuals and found these disturbing results.
Psychological characteristics associated with COVID-19 vaccine hesitancy and resistance in Ireland and the United Kingdom | Nature Communications
“In the UK sample, the combined vaccine hesitant and resistant group differed most clearly from the vaccine acceptance group on the following psychological variables: lower levels of trust in health care professionals (d = 0.39), scientists (d = 0.38), and the state (d = 0.16); higher levels of paranoia (d = 0.27) and religious beliefs (d = 0.21); lower levels of altruism (d’s ranged from 0.17 to 0.22); higher levels of social dominance (d = 0.21); lower levels of the personality traits agreeableness (d = 0.22) and conscientiousness (d = 0.17), and higher levels of neuroticism (d = 0.11); higher levels of internal locus of control (d = 0.16) and belief in chance (d = 0.17), and lower levels of beliefs about the role of powerful others (d = 0.19); lower cognitive reflection (d = 0.14); and more negative attitudes towards migrants (d = 0.11).”
Whereas Murphy et al found evidence of personality aberrations among vaccine hesitant individuals, Uvais assessed those with confirmed psychiatric disorders to see if they display vaccine hesitancy.
COVID-19 Vaccine Hesitancy Among Patients With Psychiatric Disorders | Psychiatrist.com
“Promotion of COVID-19 vaccine uptake among vulnerable populations such as patients with psychiatric illnesses is an important public health priority at the moment, as emerging evidence clearly indicates that patients with psychiatric conditions are prone to higher rates of COVID-19 infection as well as its complications. This study explored COVID-19 vaccination hesitancy among Indian patients with psychiatric disorders. Findings of this study showed that only 54.5% of the respondents reported a definitive or probable intention to receive COVID-19 vaccination, and 37.8% reported a definitive intention not to receive vaccination. The COVID-19 vaccination hesitancy in this study is significantly higher when compared to studies conducted among the general population across the world. A recent global survey exploring acceptance of COVID-19 vaccine among the population of 19 countries found an overall 71.5% acceptance for COVID-19 vaccination uptake.12 A systematic review of studies on COVID-19 vaccination acceptance conducted in 33 countries across the globe also found3 a 70% acceptance rate in the majority of the studies.13 In summary, there is a significantly higher vaccine hesitancy among patients with psychiatric illnesses compared to the general population. Public health experts and policymakers should reach out to this vulnerable population with specific public health interventions to target COVID-19 vaccine hesitancy among this group.”
Severe mental illness is itself associated with a higher risk of mortality from COVID.
Association of Psychiatric Disorders With Mortality Among Patients With COVID-19 - PubMed (nih.gov)
“In this cohort study of adults with SARS-CoV-2-positive test results in a large New York medical system, adults with a schizophrenia spectrum disorder diagnosis were associated with an increased risk for mortality, but those with mood and anxiety disorders were not associated with a risk of mortality. These results suggest that schizophrenia spectrum disorders may be a risk factor for mortality in patients with COVID-19.”
When these three studies are taken together, the following conclusions emerge.
Vaccine hesitant individuals display significantly higher levels of paranoid thinking
Patient with severe mental illness display higher levels of vaccine hesitancy
Patients with schizophrenia have higher COVID mortality suggesting that it is a separate risk factor
Much more research needs to be done on this subject. But as many physicians have observed, COVID vaccine hesitancy is so irrational it suggests a delusional system. This has prompted the question, is COVID vaccine hesitancy a form of mental illness. These three studies suggest that may be the case.