Social participation and mental health of immunocompromised individuals before and after COVID-19 vaccination–Results of a longitudinal observational study over three time points

Abstract

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic impacted how people perform their daily lives in manifold and sometimes massive ways. Particularly, individuals who are at high risk for a severe disease progression, like immunocompromised people, may have experienced drastic changes in social participation during the pandemic. A COVID-19 basic vaccination may have changed the safety behavior of immunocompromised individuals in terms of infection risk and thereby influence social participation and mental wellbeing.MethodsThis study aims to investigate self-perceived social participation at baseline before and at follow-up 1 and 6 months after basic vaccination. Beginning in March 2021, 274 immunocompromised persons 18 years or older were enrolled in the COVID-19 Contact Immune study (CoCo study) in Lower Saxony, Germany. Measurements were performed at three time points regarding social participation [Index for the Assessment of Health Impairments (IMET)], mental health [Patient Health Questionnaire-4 (PHQ-4)], subjective health status (five-point Likert-scale) and quality of life (five-point Likert-scale).ResultsIn total, 126 participants were included in the final analysis. About 60% of the participants showed increasing social participation over time. The greatest increase in social participation was observed within the first month after basic vaccination (p < 0.001). During the following 5 months, social participation remained stable. The domains “social activities,” “recreation and leisure” and “close personal relationships” were responsible for the overall change in social participation. No association was found between social participation and mental health, sociodemographic or medical factors (except hypertension).DiscussionIt is unclear why social participation increased after basic vaccination. Perceived vaccine efficacy and a feeling of being protected by the vaccine may have caused relaxed social distancing behaviors. Reducing safety behaviors may, however, increase the risk of a COVID-19 infection for immunocompromised individuals. Further investigations are needed to explore the health-related consequences of more social participation among immunocompromised persons.

Effects of antineoplastic and immunomodulating agents on postvaccination SARS-CoV-2 breakthrough infections, antibody response, and serological cytokine profile

“…Risk mitigation behaviors change with patient impression of protection conveyed by immunization, as demonstrated by immunocompromised patients increasing their levels of social participation after vaccination. 26 However, the results of the present study suggest that immunization against COVID-19 does not achieve the same protective levels in these immunocompromised cohorts and that patients treated with PD-1/PD-L1 monoclonal antibody inhibitors, CD20 monoclonal antibody inhibitors, and calcineurin inhibitors should be identified for additional counseling regarding avoidance strategies. Although increased severity of COVID-19 has been observed with CD20 inhibition, immune checkpoint inhibitor therapy and calcineurin inhibitors are not associated with increased risk of COVID-19 Intensive Care Unit admission or COVID-19-related death.…”

Evusheld Prophylaxis Improves Social Interactions, Anxiety, Depression, Agoraphobia, and Quality of Life in Blood Cancer Patients

“…Previous research has identified poor psychological health consequences arising from the COVID-19 pandemic, with several studies focusing on immunocompromised groups including previous or current cancer patients [5][6][7][8]. One study investigated the effect of COVID-19 vaccination on mental health and concluded that vaccination is associated with decreased distress and perceived risk of infection, hospitalization and death [13].…”

“…However, anecdotal reports suggest there are additional psychological benefits from Evusheld prophylaxis, particularly in specific immunosuppressed patient groups, although objective supporting data are lacking. Other research has identified poor psychological health consequences arising from the COVID-19 pandemic, with several studies focusing on immunocompromised groups including previous or current cancer patients, but to our knowledge, no studies have specifically addressed potential psychological benefits of using a pre-exposure prophylaxis intervention in a high-risk patient group and seeing whether this improved objective measures of psychological health [5][6][7][8]. In this study, we created a questionnaire to assess four well-established psychological health parameters in blood cancer patients who did or did not receive Evusheld to assess whether Evusheld treatment improved their psychological health.…”

Association of long COVID with health-related Quality of Life and Social Participation in Germany: Finding from an online-based cross-sectional survey

“…Norm data for the IMET is available for health individuals and various chronic conditions from 2014 [ 48 ]. The IMET has been used by various authors to measure social impairment during the COVID-19 pandemic [ 25 , [49] , [50] , [51] , [52] ].…”