Implementation and Outcomes of COVID-19 Vaccinations at a Child and Adolescent Psychiatric Hospital

Mental health conditions and COVID-19 vaccine outcomes: A scoping review

OBJECTIVE

Research shows that people with a history of mental health conditions were at increased risk of COVID-19 infection, hospitalisation, and mortality. However, the relationship between mental health conditions and COVID-19 vaccine outcomes such as vaccine intention, uptake and vaccine breakthrough is not yet well-understood.

METHODS

We conducted a systematic search on the topics of COVID-19 vaccine intentions, vaccine uptake, and vaccine breakthrough, in relation to mental health conditions (e.g., depression, schizophrenia), in four databases: PubMed, MEDLINE, SCOPUS, and PsychINFO, and the publication lists of Clinical Practice Research Datalink (CPRD), The Health Improvement Network (THIN), OpenSAFELY, and QResearch. Inclusion criteria focussed on studies reporting any of the aforementioned COVID-19 vaccine outcomes among people with mental health conditions.

RESULTS

Of 251 publications initially identified, 32 met our inclusion criteria. Overall, the evidence is inconclusive regarding the levels of intention to accept COVID-19 vaccines among people with mental health conditions. People with mental health conditions were more likely to have lower uptake of COVID-19 vaccines, compared to people without. Common barriers to COVID-19 vaccine uptake included concerns about the safety, effectiveness, and side effects of the vaccines. Limited evidence also suggests that vaccine breakthrough may be a particular risk for those with substance use disorder.

CONCLUSIONS

Evidence for the association between COVID-19 vaccine intentions and mental health conditions is mixed. Vaccine uptake might be lower in people with mental health conditions compared to people without, yielding interventions to encourage vaccine uptake in this population. Our understanding of COVID-19 vaccine breakthrough in this population also needs enhancing.

Increasing COVID-19 Immunization Rates through a Vaccination Program for Hospitalized Children

Introduction

Inpatient coronavirus disease 2019 (COVID-19) vaccination initiatives offer a novel strategy to eliminate barriers to care, provide access to interprofessional teams, and decrease COVID-19 morbidity and mortality. Our inpatient vaccination initiative aimed to triple the baseline rate of eligible hospitalized children vaccinated against COVID-19 from 0.95% to 2.85% from December 2021 to June 2022.

Methods

We implemented a COVID-19 vaccination program for pediatric inpatients eligible to receive a dose based on age, current guidelines, and prior doses received. Key drivers included immunization counseling training, identification of eligible patients, and a streamlined workflow. The outcome measure was the percentage of eligible patients who received a vaccine dose during hospitalization. The process measures included the percentage of age-eligible patients who were appropriately screened for prior doses on admission. We designed a clinical decision support system to enhance eligibility identification. The team performed a health equity analysis which stratified patients by social vulnerability index.

Results

During the study period, the average percentage of eligible hospitalized patients vaccinated increased from 0.9% to 3.5%, representing special cause variation and a centerline shift. The average percentage of age-eligible patients screened for prior vaccine doses on admission increased from 66.5% to 81.5%. Patients were more likely to be vaccinated if their clinician was exposed to the clinical decision support system (P < 0.01). The social vulnerability index analysis showed no significant differences.

Conclusions

This COVID-19 vaccination initiative highlights how an interprofessional approach can increase vaccination rates in hospitalized children; however, overall inpatient COVID-19 vaccination rates in this setting remained low.

Determining the Health Problems Experienced by Young Adults in Turkey, Who Received the COVID-19 Vaccine

Aim: The aim of this study was to determine the health problems experienced by young adults after the COVID-19 vaccine. Method: This study is a quantitative and descriptive study and was completed with 590 undergraduate students studying at a state university in Central Anatolia in the spring semester of the 2021–2022 academic year. The data were collected by the researcher through a one-to-one interview with the students and a questionnaire prepared in line with the literature. Number, percentage and chi-square tests were used in the analysis of the data. Results: A total of 81.4% of the students participating in the study had the BioNTech–Pfizer vaccine. A total of 67.3% of them had two doses of COVID-19 vaccine, 35.9% of the vaccinated students experienced some health problems in the days following the vaccination, and the most common health problems were fatigue, a cough, sleep disturbance, psychological discomfort, a heart ache feeling and sweating. Most of the post-vaccine health problems lasted for 2 days, 3.7% of the participants were diagnosed with hypertension, 2.7% were diagnosed with diabetes mellitus and 10.52% of the female participants went to the doctor due to menstrual irregularity and received treatment. It was determined that 12.2% of the vaccinated students gained weight after vaccination and 63.89% of those who gained weight attributed this to increased appetite, 9.2% continued to have a cough and 9.2% used herbal products. Conclusion: It was determined that one out of every three young adults experienced a health problem after the COVID-19 vaccine. It is recommended that studies be conducted in different sample groups.

COVID-19 vaccination coverage among adolescents aged 12–17 years in three provinces of eastern China: A cross-sectional survey, 2021

High vaccination coverage is essential to prevent and control the spread of the COVID-19 epidemic. Currently, the real-world acceptance of COVID-19 vaccines among adolescents aged 12–17 years in China has not been reported. We aimed to assess the acceptance rate of COVID-19 vaccination among adolescents in eastern China and to identify factors associated with the intention to get vaccinated against COVID-19. We conduct a cross-sectional questionnaire survey among adolescents from three provinces in the eastern part of China from 16 August to 28 October 2021. The questionnaires were distributed to 2,100 students, and 2,048 students completed the questionnaires. The results showed that 98.4% (2,016/2,048) of adolescents had received at least one dose of the COVID-19 vaccine and 1.6% (32/2,048) declined the vaccination. The participants from rural districts, or whose parents were vaccinated, were more likely to accept the vaccine. The main reason for declining vaccination was worry about vaccine safety (25%). The main adverse event after the vaccination was pain at the injection site. In conclusion, the vaccine coverage rate reached 98.4% among the adolescents in this study, which met the criteria for herd immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high vaccination rate is beneficial to the prevention and control of the COVID-19 pandemic.