Scientists from UC San Francisco found that people who are vaccinated against SARS-CoV-2, and have a history of certain mental conditions, have a heightened risk of COVID-19.
They found that patients over 65 with substance abuse, psychotic disorders, bipolar disorder, adjustment disorder and anxiety, faced increased risks of up to 24% for breakthrough COVID.
For those under 65, risks were up to 11% higher than for those without a psychiatric history.
This finding may be related to impaired immune response as well as risky behaviors associated with some disorders.
The research is published in JAMA Network Open and was conducted by Aoife O’Donovan et al.
In the study, the team tracked data from more than a quarter of a million U.S. Department of Veterans Affairs patients, who had completed their vaccine regimen and had at least one test for SARS-CoV-2.
The average age of the 263,697 participants was 66 and 90.8% were male.
Just over a half (51.4%) of the patients had received at least one psychiatric diagnosis within the last five years and 14.8% developed breakthrough COVID, confirmed by a positive test.
Overall, those participants with psychiatric disorders had a 3% increased risk for breakthrough COVID infections in 2021.
But the risk was 24% higher for over-65s with substance abuse, 23% higher for those with psychotic disorders, 16% higher for bipolar disorder, 14% for adjustment disorder and 12% for anxiety.
The findings suggest that increased breakthrough infections in people with psychiatric disorders cannot be entirely explained by socio-demographic factors or pre-existing conditions.
It’s possible that immunity following vaccination wanes more quickly or more strongly for people with psychiatric disorders and/or they could have less protection to newer variants.
Surprisingly, given the greater incidence of breakthrough infections among younger people, this study showed significantly smaller effects in the under-65s group.
The team believes the higher incidence of breakthrough infection among older participants may be due to decreased immunological response to the vaccine that has been associated with some psychiatric disorders, which may be more substantial in older adults.
It’s also possible that older adults with psychiatric disorders may require more frequent in-person care, which could increase their interactions with the health care system.
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