Attitudes towards vaccines, intent to vaccinate and the relationship with COVID-19 vaccination rates in individuals with schizophrenia

Background

People with schizophrenia are at high risk for developing severe COVID-19 outcomes but recent evidence suggests that this population have lower vaccination rates than the general population. This gap in vaccination rates could be explained by attitudinal and structural barriers.

Aims

This study explored the role of potential attitudinal barriers by comparing schizophrenia patients with participants from the general population regarding COVID-19 vaccination rates, general attitudes towards vaccines, and willingness to take a COVID-19 vaccine.

Method

We conducted a cross-sectional study between April 2021 and October 2021. 100 schizophrenia patients and 72 controls were recruited. Attitudes towards vaccines were assessed with the Vaccination Attitudes Examination Scale. COVID-19 vaccination rates, sociodemographic, clinical and health-related variables were also assessed.

Results

In our study, the proportion of individuals with schizophrenia were under-vaccinated despite similar general attitudes towards vaccination and higher willingness to be vaccinated against COVID-19 compared to the participants from the general population. In patients, negative attitudes toward vaccines was related to higher level of negative psychotic symptoms and higher level of paranoid ideation. As a whole, participants with more negative attitudes towards vaccines were less likely to be vaccinated against COVID-19 and had lower levels of trust in institutions.

Conclusions

Vaccine hesitancy does not appear to be a major barrier for COVID-19 vaccine uptake amongst people with schizophrenia. This study suggests that disparities in COVID-19 vaccination rates in schizophrenia do not seem related to attitudinal but rather structural barriers.

Significant outcomes

• In both groups, non-vaccinated individuals had higher general negative attitudes towards vaccines.

• People with schizophrenia were under-vaccinated (64% versus 77.8%) despite similar general attitudes towards vaccination and higher willingness to be vaccinated in non vaccinated against COVID-19 compared to the controls (41.7% versus 21.5%).

• General positive attitudes towards vaccines were negatively associated with persecutory ideation and negative symptoms in patients.

Limitations

• Our two sample groups sere composed exclusively of French individuals, potentially limiting the generalizability of our results.

• The cross-sectional design of our study.