Title: Vaccine preventable conditions and severe mental illness: how much do we know?
Author(s): Michael Lau, Grant Sara
Introduction: Primary prevention strategies such as vaccination must be part of the complex response to premature mortality in people living with mental illness. However, there is limited evidence on the impacts of this issue, or on strategies for improving vaccination. Our aim was to review the literature on vaccine-preventable conditions in people living with mental illness.
Method: We conducted a systematic review and narrative synthesis of peer-reviewed literature published between 1980 and 2020. We included all studies examining vaccine preventable condition in people with serious mental illness. We summarised information on (i) prevalence of vaccine-preventable conditions (ii) vaccination rates, (iii) barriers to vaccination and (iv) strategies to increase vaccination rates in people living with mental illness.
Results and findings: Many studies have found a higher prevalence of hepatitis B in people living with mental illness, partly associated with past intravenous substance use. There are fewer studies on other conditions. There is evidence of reduced vaccination rates and increased prevalence of other vaccine-preventable conditions such as influenza, pneumococcal pneumonia and herpes zoster. People living with mental illness have increased rates of hospitalisation for vaccine-preventable respiratory infections such as influenza and pneumococcal pneumonia. Integrated care models have been shown to enhance health care and increase vaccination rates in people with chronic illness.
Discussion: Vaccine preventable conditions are an under-recognised physical comorbidity in mental health and have significant impacts on people living with mental illness. COVID-19 underlines the health impacts of vaccine-preventable conditions, and the risks of unequal outcomes and increasing gaps for people not accessing vaccination. A greater focus on this issue in research and service improvement may be one strategy for reducing mortality and morbidity in this group.