Psychological effects and associated factors among vaccinated and unvaccinated general population against COVID-19 infection in Bangladesh

Abstract

BackgroundThe global effort to develop herd immunity in the general public against the COVID-19 pandemic is currently ongoing. However, to the best of our knowledge, there have been no studies on how the COVID-19 vaccine affects mental health in the context of the COVID-19 pandemic in Bangladesh. The present study investigated the psychological effects and associated factors among vaccinated and unvaccinated general populations against COVID-19 infection in Bangladesh.MethodsA nationwide online cross-sectional survey was conducted in Bangladesh from June 23 to December 25, 2021. The frequency of symptoms of psychological distress, depression, anxiety, stress, post-traumatic stress disorder (PTSD), insomnia, and fear was assessed using the Bangla versions of the GHQ-12, PHQ-2, GAD-2, PSS-4, PC-PTSD-5, ISI, and FCV-19S scales, respectively.ResultsThe study included 3,013 persons from all eight divisions of Bangladesh, with 1,272 (42.2%) being vaccinated and 1,741 (57.8%) being unvaccinated. Compared with unvaccinated populations, vaccinated populations had significantly lower prevalence rates of psychological distress (36.4 vs. 51.5%), depression (21.1 vs. 37.9%), anxiety (25.1 vs. 44.9%), stress (19.4 vs. 30.4%), PTSD (29.4 vs. 38.3%), insomnia (18.7 vs. 39.4%), and fear symptoms (16.1 vs. 27.5%). Among vaccinated populations, respondents who lived in nuclear families were significantly associated with higher risk of psychological distress (AOR, 1.38; 95% CI, 1.09–1.78), depression (AOR, 1.49; 95% CI, 1.11–1.98), anxiety (AOR, 1.77; 95% CI, 1.21–1.98), and fear (AOR, 1.43; 95% CI, 1.11–1.83) symptoms. Participants who lost family members, friends, or colleagues due to the COVID-19 pandemic had significantly higher risk of symptoms of psychological distress (AOR, 1.35; 95% CI, 1.02–1.79), anxiety (AOR, 1.41; 95% CI, 1.11–1.87), and PTSD (AOR, 1.76; 95% CI, 1.24–2.19). On the other hand, unvaccinated populations who lived in the Dhaka division were significantly associated with an increased risk of depression (AOR, 2.06; 95% CI, 1.40–2.52), anxiety (AOR, 1.86; 95% CI, 1.15–2.47), stress (AOR, 1.92; 95% CI, 1.12–2.88), and insomnia (AOR, 1.88; 95% CI, 1.20–2.94) symptoms. Except for PTSD and fear symptoms, unemployed participants had considerably higher rates of psychological distress, depression, anxiety, stress, and insomnia symptoms (e.g., psychological distress: AOR, 1.83; 95% CI, 1.10–2.62; depression: AOR, 1.74; 95% CI, 1.37–2.19).ConclusionsThis study recommends immunizing unvaccinated populations as soon as possible to prevent infection and boost mental health. Vulnerable people needed special care, health-related education, and psychological assistance.

Psychological benefits of the COVID‐19 vaccination: A Bangladeshi comparative study

“…1 In comparison with the previous studies conducted among the vaccine receivers, 15.6% and 21.2% of depression among healthcare professionals and the general population, respectively, were reported in the country, where 22.3% and 29.4% prevalence were found for PTSD, respectively; and those rates were higher in those people without vaccination. 16,17 The present study found that females are more likely to suffer from mental health problems than males. A Bangladeshi study comprising a total of 10,000 subjects during the COVID-19 pandemic found a 1.52and 1.76-times higher risk of depression and suicidality for the female participants, respectively.…”

“…For instance, a meta‐analysis estimated the prevalence of mental health problems among nearly 50,000 Bangladeshis from a total of 24 studies; that is, about 47% prevalence for depression was reported, whereas it was 44% and 47% for stress and anxiety 1 . In comparison with the previous studies conducted among the vaccine receivers, 15.6% and 21.2% of depression among healthcare professionals and the general population, respectively, were reported in the country, where 22.3% and 29.4% prevalence were found for PTSD, respectively; and those rates were higher in those people without vaccination 16,17 . This is a good sign that COVID‐19 vaccinated people are out of COVID‐19 infection risk in general; at the same time, they are psychologically more stable than nonvaccinated individuals.…”

“…For assessing sample size, the abovementioned formula was used. Considering the prevalence of depression among general Bangladeshi people as estimated by a previous study, 17 the sample size was calculated to be 257 (where p = 21.2%, Z = 1.96, d = 5%), while given the assumption of a 10% nonresponse rate, the final sample size was estimated to be 283. However, a total of 459 data was collected, including vaccinated and non‐vaccinated participants (where 374 were vaccinated participants).…”

“…For instance, lower levels of psychiatric problems were found among the Bangladeshi healthcare professionals who received COVID‐19 vaccination than the nonvaccinated healthcare professionals (i.e., 16.7% vs. 59.1% for general health problems, 15.6% vs. 31.9% for depression, 22.3% vs. 30.8% for posttraumatic stress disorder [PTSD], and 13.9% vs. 21.8% for loneliness symptoms) 16 . In another study, 51.5% of the general population who did not receive a vaccine had psychological distress, and it was 36.4% for those who received it; whereas 37.9% versus 21.2% had depression, 4.9% versus 25.1% had anxiety, 39.4% versus 19.4% had stress, 38.2% versus 29.4% had PTSD compared to those who did not receive COVID‐19 vaccination 17 . Those two studies were conducted using the short version of the scales to assess mental health conditions, where most symptoms of a particular problem were not possibly considered.…”

“… 16 In another study, 51.5% of the general population who did not receive a vaccine had psychological distress, and it was 36.4% for those who received it; whereas 37.9% versus 21.2% had depression, 4.9% versus 25.1% had anxiety, 39.4% versus 19.4% had stress, 38.2% versus 29.4% had PTSD compared to those who did not receive COVID‐19 vaccination. 17 Those two studies were conducted using the short version of the scales to assess mental health conditions, where most symptoms of a particular problem were not possibly considered. In this study, therefore, the prevalence of mental health problems using established full‐version tools among general people with respect to their vaccination status was investigated to fulfill the knowledge gap in the country.…”