The need of the specific targeting of psychiatric patients in vaccine campaigns.

Dear editor,

The coronavirus disease (COVID-19) pandemic is the crisis of a generation, with significant implications in the lives of billions of people worldwide. The consequences of the pandemic are not related only to the direct influence of the virus and the infection, but also to the many changes that have come with it. Widely used measures for the control of the virus, including quarantine and social distancing, and the disruption in society have contributed to the increased levels of psychological distress being reported in the affected populations [1], [2]. In addition, evidence suggests that the mental health impact of the COVID-19 pandemic may be higher in low and middle income countries, with the response to these issues in some of these countries being scarce, fragmented and resource-limited, mainly among more vulnerable populations [3].

Taking into account this context, the COVID-19 vaccines rise as a hope and an urgent need. To this date, several vaccine candidates have been investigated, with these options presenting ranging values in terms of efficacy and side-effects, with some already being approved for use in several countries [4]. Furthermore, some countries present a history of recent success in their vaccination campaigns, including Israel, Italy, France and Spain, with the effects of these successful public health responses presenting positive effects on several COVID-19 related outcomes [5].

Nevertheless, there are several challenges that may arise during this process of vaccinating the population, including the anti vaccine movement and the hesitancy to receive the vaccine. Anti-vax groups spread misinformation and pseudoscientific concepts about the safety and efficacy of the vaccines [6]. In this context, patients with psychiatric conditions may be especially vulnerable to these movements. For instance, preliminary empirical evidence suggests that vaccine hesitancy is significantly more prevalent in people with specific mental health conditions [7].

In addition, the availability of the vaccine across populations worldwide is another issue to be addressed. This aspect presents itself not only across countries, but also within countries. For instance, several nations have created vaccination programs giving priorities to specific groups such as elderly; healthcare professionals; patients with diabetes, malignancies, cardiac and renal diseases, and other medical chronic conditions [8]. Even though this procedure is advisable due to the limited availability of the vaccine in some nations and the potential of the COVID-19 being associated with adverse outcomes in these populations, other groups including patients with mental health conditions may present increased vulnerability to poor outcomes of the COVID-19 infection, which are independent of the presence of physical illnesses [7], [9].

Therefore, we advocate the need of special programs targeting mental health patients in vaccination programs. Homeless people, pregnant women, and those living in remote rural areas also should be the target of these specific policies. These campaigns also should ensure that any discrimination based on culture, gender, and minority groups be addressed. In addition, these populations may need to be the target of specific educational programs, about the safety and efficacy of the vaccine, in order to ensure less hesitancy to receive it.

Funding

None.

Disclosure of interest

The authors declare that they have no competing interest.