Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis
Prior to the introduction of COVID-19 vaccines, patients with severe mental illness (SMI) were at greater risk of COVID-19-related outcomes than the general population. It is not yet clear whether COVID-19 vaccines have reduced the risk gap. We systematically searched nine international databases an...
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MDPI AG
2024-09-01
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| author | Wen Dang Iman Long Yiwei Zhao Yu-Tao Xiang Robert David Smith |
| author_facet | Wen Dang Iman Long Yiwei Zhao Yu-Tao Xiang Robert David Smith |
| author_sort | Wen Dang |
| collection | DOAJ |
| description | Prior to the introduction of COVID-19 vaccines, patients with severe mental illness (SMI) were at greater risk of COVID-19-related outcomes than the general population. It is not yet clear whether COVID-19 vaccines have reduced the risk gap. We systematically searched nine international databases and three Chinese databases to identify relevant studies from December 2020 to December 2023 to compare the risk of COVID-19-related outcomes for SMI patients to those without SMI after vaccination. Random effects meta-analysis was performed to estimate the pooled odds ratio (OR) with 95% confidence intervals (CI). Subgroup analysis, sensitivity analysis, and publication bias analysis were conducted with R software 4.3.0. A total of 11 observational studies were included. Compared with controls, SMI patients were associated with a slightly increased risk of infection (pooled OR = 1.10, 95% CI, 1.03–1.17, <i>I</i><sup>2</sup> = 43.4%), while showing a 2-fold higher risk of hospitalization (pooled OR = 2.66, 95% CI, 1.13–6.22, <i>I</i><sup>2</sup> = 99.6%), even after both groups have received COVID-19 vaccines. Limited evidence suggests a higher mortality risk among SMI patients compared to controls post vaccination, but the findings did not reach statistical significance. SMI patients remain at increased risk compared to their peers in COVID-19-related outcomes even after vaccination. Vaccination appears an effective approach to prevent severe COVID-19 illness in SMI patients, and actions should be taken by healthcare providers to improve vaccination coverage in these vulnerable groups. |
| format | Article |
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| institution | OA Journals |
| issn | 2076-393X |
| language | English |
| publishDate | 2024-09-01 |
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| series | Vaccines |
| spelling | doaj-art-9e0740c5f8ca4d35a65cc9a13731abac2025-08-20T01:55:57ZengMDPI AGVaccines2076-393X2024-09-01129106410.3390/vaccines12091064Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-AnalysisWen Dang0Iman Long1Yiwei Zhao2Yu-Tao Xiang3Robert David Smith4Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaUnit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, ChinaPrior to the introduction of COVID-19 vaccines, patients with severe mental illness (SMI) were at greater risk of COVID-19-related outcomes than the general population. It is not yet clear whether COVID-19 vaccines have reduced the risk gap. We systematically searched nine international databases and three Chinese databases to identify relevant studies from December 2020 to December 2023 to compare the risk of COVID-19-related outcomes for SMI patients to those without SMI after vaccination. Random effects meta-analysis was performed to estimate the pooled odds ratio (OR) with 95% confidence intervals (CI). Subgroup analysis, sensitivity analysis, and publication bias analysis were conducted with R software 4.3.0. A total of 11 observational studies were included. Compared with controls, SMI patients were associated with a slightly increased risk of infection (pooled OR = 1.10, 95% CI, 1.03–1.17, <i>I</i><sup>2</sup> = 43.4%), while showing a 2-fold higher risk of hospitalization (pooled OR = 2.66, 95% CI, 1.13–6.22, <i>I</i><sup>2</sup> = 99.6%), even after both groups have received COVID-19 vaccines. Limited evidence suggests a higher mortality risk among SMI patients compared to controls post vaccination, but the findings did not reach statistical significance. SMI patients remain at increased risk compared to their peers in COVID-19-related outcomes even after vaccination. Vaccination appears an effective approach to prevent severe COVID-19 illness in SMI patients, and actions should be taken by healthcare providers to improve vaccination coverage in these vulnerable groups.https://www.mdpi.com/2076-393X/12/9/1064severe mental illnessschizophreniabipolar disordermajor depressive disorderCOVID-19 vaccines |
| spellingShingle | Wen Dang Iman Long Yiwei Zhao Yu-Tao Xiang Robert David Smith Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis Vaccines severe mental illness schizophrenia bipolar disorder major depressive disorder COVID-19 vaccines |
| title | Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis |
| title_full | Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis |
| title_fullStr | Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis |
| title_short | Effectiveness of COVID-19 Vaccines in People with Severe Mental Illness: A Systematic Review and Meta-Analysis |
| title_sort | effectiveness of covid 19 vaccines in people with severe mental illness a systematic review and meta analysis |
| topic | severe mental illness schizophrenia bipolar disorder major depressive disorder COVID-19 vaccines |
| url | https://www.mdpi.com/2076-393X/12/9/1064 |
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