The impact of mental health and substance use issues on COVID-19 vaccine readiness: a cross sectional community-based survey in Ontario, Canada

Abstract

Background: COVID-19 vaccines have been approved for use in Canada since December 2020. However, data about factors associated with vaccine hesitancy and the impact of mental health and/or substance use (MHSU) issues on vaccine uptake are currently not available. The goal of this study was to explore factors, particularly MHSU factors, that impact COVID-19 vaccination intentions in Ontario, Canada. Methods: A community-based cross-sectional survey with recruitment based on age, gender, and geographical location (to ensure a representative population of Ontario), was conducted in February 2021. Multinomial logistic regression was used to test the relationship between COVID-19 vaccination status and plans and sociodemographic background, social support, anxiety about contracting COVID-19, and MHSU concerns. Results: Of the total sample of 2528 respondents, 1932 (76.4%) were vaccine ready, 381 (15.1%) were hesitant, and 181 (7.1%) were resistant. Significant independent predictors of vaccine hesitancy compared with vaccine readiness included younger age (OR=2.11, 95%CI=1.62-2.74), female gender (OR=1.36, 95%CI=1.06-1.74), Black ethnicity (OR=2.11, 95%CI=1.19-3.75), lower education (OR=1.69, 95%CI=1.30-2.20), lower SES status (OR=.88, 95%CI=.84-.93), lower anxiety about self or someone close contracting COVID-19 (OR=2.06, 95%CI=1.50-2.82), and lower depression score (OR=.90, 95%CI=.82-.98). Significant independent predictors of vaccine resistance compared with readiness included younger age (OR=1.72, 95%CI=1.19-2.50), female gender (OR=1.57, 95%CI=1.10-2.24), being married (OR=1.50, 95%CI=1.04-2.16), lower SES (OR=.80, 95%CI=.74-.86), lower satisfaction with social support (OR=.78, 95%CI=.70-.88), lower anxiety about contracting COVID-19 (OR=7.51, 95%CI=5.18-10.91), and lower depression score (OR=.85, 95%CI=.76-.96). Interpretation: COVID-19 vaccination intention is affected by sociodemographic factors, anxiety about contracting COVID-19, and select mental health issues.

The Association between Socio-Demographics and Mental Distress Following COVID-19 Vaccination—Mediation of Vaccine Hesitancy

“…This study found that vaccine hesitancy was significantly associated with gender, employment status, and education. Among our participants, females are more hesitant about receiving the COVID-19 vaccine, which is in line with previous studies in China and abroad [ 23 , 24 , 25 , 26 ]. It might be explained that women are more concerned with the side effects and have a higher chance of having medical contraindications, such as during pregnancy and breastfeeding [ 23 , 24 , 25 , 26 ].…”

“…Among our participants, females are more hesitant about receiving the COVID-19 vaccine, which is in line with previous studies in China and abroad [ 23 , 24 , 25 , 26 ]. It might be explained that women are more concerned with the side effects and have a higher chance of having medical contraindications, such as during pregnancy and breastfeeding [ 23 , 24 , 25 , 26 ]. In addition, a higher education level was associated with higher vaccine hesitancy levels, which is supported by the previous literature [ 26 , 27 ].…”

“…Thus, health hesitancy may suppress/mediate between socio-demographic characteristics and mental health outcomes. For instance, females, who are reportedly more hesitant in making vaccination decisions [ 23 , 24 , 25 , 26 ], might develop a high level of anxiety/depression. Similarly, highly educated and employed, who are more uncertain [ 26 , 27 , 28 ], might also develop more significant anxiety/depressive symptoms.…”

Impact of the COVID-19 Pandemic on Black Communities in Canada

“…Though our findings did not uncover demographic trends among vaccine hesitancy, our research may deepen the understanding gained from previous quantitative studies that do break down demographic predictors. For example, one study from Ontario found that being Black, being a woman, having lower levels of income and education, and being younger were all factors that increased the likelihood of being vaccine-hesitant or resistant [ 48 ]. Taken together, these data and our results show that community divides may fall along specific demographic characteristics or have implications for some groups over others.…”