Researchers from University of California San Francisco and the San Francisco Veterans Affairs Health Care System conducted a cohort study of over 260,0000 fully vaccinated US Department of Veterans Affairs patients, and published the findings in JAMA Network Open. The study found an association between psychiatric disorder diagnoses and an increased incidence of SARS-CoV-2 breakthrough infection despite completion of the vaccination regime. Those with a history of substance abuse, psychotic disorders, bipolar disorder, adjustment disorder, and anxiety are those at greater risk for breakthrough COVID.
The average age of the patient was 66, and 90% of the patients were male. 51.4% of the patients had received at least one psychiatric diagnosis within the last five years, and 14.8% contracted breakthrough COVID. The study found that some factors were associated with higher probability of experiencing breakthrough COVID. Patients over 65 with substance abuse had a 24% higher risk, those with psychotic disorders had 23% risk, 16% higher for bipolar disorder, 14% for adjustment disorder and 12% for anxiety.
Researchers noted several factors may contribute to the increased likelihood of getting breakthrough COVID. Patients with mental health issues may have a decreased immunological response to the vaccine, and they may require more in-person health care which increases the amount of interactions they have with health care workers who may be infected. Some individuals with psychiatric disorders may engage in behaviors that increase their risk. In addition, it is common for people with psychiatric disorders to also have serious medical conditions such as heart disease and diabetes.
Although those who are fully vaccinated are less likely to transmit the disease and are contagious for a shorter period of time than unvaccinated people, older vaccinated individuals dealing with mental health issues need to take additional precautions.
The study indicated the need for targeted preventative health care campaigns to help reduce the risk of breakthrough COVID. According to senior study author Aoife O’Donovan, “Mental health is important to consider in conjunction with other risk factors, and some patients should be prioritized for boosters and other critical preventive efforts.” Identifying risk factors for those with mental health challenges is the first step in preventing breakthrough COVID.