Contrasting Association Between COVID-19 Vaccine Hesitancy and Mental Health Status in India and Saudi Arabia—A Preliminary Evidence Collected During the Second Wave of COVID-19 Pandemic

Abstract

BackgroundVaccine hesitancy is a global public health threat. Understanding the role of psychological factors in vaccine hesitancy is often neglected and relatively less explored.Aim and ObjectivesTo analyze the relationship between mental health and COVID-19 vaccine hesitancy before and after the advent of COVID-19 vaccines (AC19V) in the general population of India and Saudi Arabia (KSA) which vary in severity of the pandemic and vaccine mandates.Materials and MethodsA total of 677 adult participants from India and KSA participated in this cross-sectional online web-based survey. Sociodemographic details and current COVID-19 status pertaining to infection and vaccination were collected. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and perceptive need for mental health support (MHS) were assessed before and after AC19V. A newly constructed and validated COVID19 vaccine hesitancy scale-12 (COVID19-VHS12) scale was used to evaluate the COVID-19 vaccine hesitancy.ResultsPrevalence and levels of depression and anxiety symptoms decreased significantly in Saudis but not in Indians after AC19V. PTSD symptoms showed a significant reduction in both India and KSA. Anxiety symptoms were higher in KSA than India before AC19V while PTSD was higher in India before and after AC19V. Except for the place of residence and employment status, the subgroups of sociodemographic variables which were at higher risk of negative mental health before AC19V showed improvement in their mental health after AC19V. The prevalence of COVID-19 vaccine hesitancy in India and KSA was 50.8% (95% CI 45.73–55.89%) and 55.7% (95% CI 50.16–61.31%), respectively. A bidirectional association between vaccine hesitancy and mental health was observed in KSA but not in India. Higher vaccine hesitancy favored higher levels of depression, anxiety, and perceptive need for MHS and vice versa in KSA. None of the mental health parameters predicted vaccine hesitancy in India, while higher vaccine hesitancy increased the risk of anxiety.ConclusionVaccine hesitancy has a negative impact on mental health and vice versa over and above the impact of sociodemographic factors and COVID-19 vaccination and infection status which shows variations between India and KSA.

Factors related to COVID-19 vaccine hesitancy among middle-income and low-income adults in the USA

“…It has also been shown that patients with COVID-19, comprising more non-vaxxers than vaxxers in our study, have greater mental distress than the general population 25 26. This is supported by several studies; however, others have found no discernible differences 29…”

“…Other studies, particularly one among Israelis28 and another in Indians,29 showed negative psychological outcomes after vaccination but a bidirectional association of vaccine hesitancy and mental health among Saudis 29. In support of the causal direction of vaccine hesitancy on psychiatric outcomes, Zhang et al found that vaccine hesitancy mediated the effect of sociodemographics on anxiety and depression among their Chinese study population 30.…”

Fears and misconceptions toward COVID‐19 vaccination among Syrian population: A cross‐sectional study

“…COVID-19 vaccine is a secret plan to reduce the population 787 ( Another factor that has proven to significantly affect acceptance rates is the vaccine's country of origin, with the majority of the population trusting the AstraZeneca vaccine of a British origin the most, followed by Pfizer-BioNTech of a US origin and Sputnik light/Sputnik V of a Russian origin; This is consistent with some studies but contrasts with others that have reported higher levels of trust in vaccines of other shown that 44% of them had severe mental disorder, 36.9% had full PTSD symptoms and 27% had both severe mental disorder and full PTSD symptoms. 26 It was reported that mental health disorders negatively affected vaccine hesitancy, 27 which could be the case in our study. Further research is required to study the mental healthspecific effects on vaccine acceptance.…”

Symptoms of anxiety and depression in Denmark during the first year of the COVID‐19 pandemic: A two‐wave matched‐control study

“…Conversely, the finding may be a spurious association. Our null findings regarding vaccine hesitancy contradict previous research revealing that higher anxiety symptom scores were associated with COVID‐19 vaccine hesitancy (Jayakumar et al ., 2022; Sekizawa, Hashimoto, Denda, Ochi, & So, 2022) and that COVID‐19 vaccine hesitancy is driven by anxiety (Palgi, Bergman, Ben‐David, & Bodner, 2021; Bullock, Lane, & LeRon, 2022).…”