Impact of phased COVID-19 vaccine rollout on anxiety and depression among US adult population, January 2019–February 2023: a population-based interrupted time series analysis

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES Lancet Regional Health-Americas Pub Date : 2024-09-01 DOI:10.1016/j.lana.2024.100852
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Abstract

Background

Existing research lacks information on the potential impacts of multi-phased coronavirus disease 2019 (COVID-19) vaccine rollouts on population mental health. This study aims to evaluate the impact of various COVID-19 vaccine rollout phases on trends and prevalence of anxiety and depression among US adults at a population level.

Methods

We performed a US population-based multi-intervention interrupted time series analysis through Deep Learning and autoregressive integrated moving average (ARIMA) approaches, analyzing 4 waves of US CDC's Behavioral Risk Factor Surveillance System (BRFSS) data (January 2019–February 2023) to assess changes in the weekly prevalence of anxiety and depression following interruptions, including all major COVID-19 vaccine rollout phases from 2020 to early 2023 while considering pandemic-related events.

Findings

Among 1,615,643 US adults (1,011,300 [76.4%] aged 18–64 years, 867,826 [51.2%] female, 126,594 [16.9%] Hispanic, 120,380 [11.9%] non-Hispanic Black, 1,191,668 [61.7%] non-Hispanic White, and 113,461 [9.5%] other non-Hispanic people of color), we found that three COVID-19 vaccine rollout phases (ie, prioritization for educational/childcare workers, boosters for all US adults, authorization for young children) were associated with a 0.93 percentage-point (95% CI −1.81 to −0.04, p = 0.041), 1.28 percentage-point (95% CI −2.32 to −0.24, p = 0.017), and 0.89 percentage-point (95% CI −1.56 to −0.22, p = 0.010) reduction, respectively, in anxiety and depression prevalence among the general US adult population despite an upward trend in the prevalence of anxiety and depression from 2019 to early 2023. Among different population groups, Phase 1 was associated with increases in anxiety and depression prevalence among Black/African Americans (2.26 percentage-point, 95% CI 0.24–4.28, p = 0.029), other non-Hispanic people of color (2.68 percentage-point, 95% CI 0.36–5.00, p = 0.024), and lower-income individuals (3.95 percentage-point, 95% CI 2.20–5.71, p < 0.0001).

Interpretation

Our findings suggest disparate effects of phased COVID-19 vaccine rollout on mental health across US populations, underlining the need for careful planning in future strategies for phased disease prevention and interventions.

Funding

None.

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分阶段推广 COVID-19 疫苗对 2019 年 1 月至 2023 年 2 月美国成年人焦虑和抑郁情绪的影响:基于人群的间断时间序列分析
背景现有研究缺乏有关分阶段推广 2019 年冠状病毒病(COVID-19)疫苗对人群心理健康的潜在影响的信息。本研究旨在评估不同阶段的 COVID-19 疫苗推广对美国成年人焦虑症和抑郁症的趋势和患病率的影响。方法我们通过深度学习和自回归综合移动平均(ARIMA)方法进行了基于美国人口的多干预中断时间序列分析,分析了美国疾病预防控制中心行为风险因素监测系统(BRFSS)的4波数据(2019年1月至2023年2月),以评估中断后焦虑症和抑郁症每周患病率的变化,包括2020年至2023年初的所有主要COVID-19疫苗推广阶段,同时考虑了大流行相关事件。研究结果在 1,615,643 名美国成年人中(1,011,300 [76.4%] 18-64 岁,867,826 [51.2%]女性、126,594 [16.9%] 西班牙裔、120,380 [11.9%] 非西班牙裔黑人、1,191,668 [61.7%] 非西班牙裔白人和 113,461 [9.5%] 其他非西班牙裔有色人种)中,我们发现 COVID-19 疫苗的三个推广阶段(即教育/保育工作者优先、所有美国成年人加强接种、幼儿授权)与 0.93个百分点(95% CI -1.81至-0.04,p = 0.041)、1.28个百分点(95% CI -2.32至-0.24,p = 0.017)和0.89个百分点(95% CI -1.56至-0.22,p = 0.010),尽管焦虑和抑郁患病率在2019年至2023年初呈上升趋势。在不同人群中,第 1 阶段与美国黑人/非洲裔(2.26 个百分点,95% CI 0.24-4.28,p = 0.029)、其他非西班牙裔有色人种(2.68 个百分点,95% CI 0.36-5.00,p = 0.024)和低收入人群(3.95个百分点,95% CI 2.20-5.71,p < 0.0001).Interpretation我们的研究结果表明,COVID-19疫苗的分阶段推广对美国不同人群的心理健康产生了不同的影响,这强调了在未来的分阶段疾病预防和干预策略中需要谨慎规划.FundingNone.
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期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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