Contrasting Association Between COVID-19 Vaccine Hesitancy and Mental Health Status in India and Saudi Arabia-A Preliminary Evidence Collected During the Second Wave of COVID-19 Pandemic

Saikarthik Jayakumar; Saraswathi Ilango; Senthil Kumar K; Abdullah Alassaf; Abdullah Aljabr; Anand Paramasivam; Suresh Mickeymaray; Yazeed Mohammed Hawsah; Ahmed Saad Aldawish

doi:10.3389/fmed.2022.900026

Contrasting Association Between COVID-19 Vaccine Hesitancy and Mental Health Status in India and Saudi Arabia-A Preliminary Evidence Collected During the Second Wave of COVID-19 Pandemic

Front Med (Lausanne). 2022 May 4:9:900026. doi: 10.3389/fmed.2022.900026. eCollection 2022.

Authors

Affiliations

¹ Department of Basic Medical Sciences, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia.
² Department of Medical Education, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia.
³ Department of Physiology, Madha Medical College and Research Institute, Chennai, India.
⁴ Department of Preventive Dental Science, College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia.
⁵ Department of Biology, College of Science, Majmaah University, Al Majma'ah, Saudi Arabia.
⁶ College of Dentistry, Majmaah University, Al Majma'ah, Saudi Arabia.

Abstract

Background: Vaccine hesitancy is a global public health threat. Understanding the role of psychological factors in vaccine hesitancy is often neglected and relatively less explored.

Aim and objectives: To analyze the relationship between mental health and COVID-19 vaccine hesitancy before and after the advent of COVID-19 vaccines (AC19V) in the general population of India and Saudi Arabia (KSA) which vary in severity of the pandemic and vaccine mandates.

Materials and methods: A total of 677 adult participants from India and KSA participated in this cross-sectional online web-based survey. Sociodemographic details and current COVID-19 status pertaining to infection and vaccination were collected. Depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, and perceptive need for mental health support (MHS) were assessed before and after AC19V. A newly constructed and validated COVID19 vaccine hesitancy scale-12 (COVID19-VHS12) scale was used to evaluate the COVID-19 vaccine hesitancy.

Results: Prevalence and levels of depression and anxiety symptoms decreased significantly in Saudis but not in Indians after AC19V. PTSD symptoms showed a significant reduction in both India and KSA. Anxiety symptoms were higher in KSA than India before AC19V while PTSD was higher in India before and after AC19V. Except for the place of residence and employment status, the subgroups of sociodemographic variables which were at higher risk of negative mental health before AC19V showed improvement in their mental health after AC19V. The prevalence of COVID-19 vaccine hesitancy in India and KSA was 50.8% (95% CI 45.73-55.89%) and 55.7% (95% CI 50.16-61.31%), respectively. A bidirectional association between vaccine hesitancy and mental health was observed in KSA but not in India. Higher vaccine hesitancy favored higher levels of depression, anxiety, and perceptive need for MHS and vice versa in KSA. None of the mental health parameters predicted vaccine hesitancy in India, while higher vaccine hesitancy increased the risk of anxiety.

Conclusion: Vaccine hesitancy has a negative impact on mental health and vice versa over and above the impact of sociodemographic factors and COVID-19 vaccination and infection status which shows variations between India and KSA.

Keywords: COVID-19 vaccine hesitancy scale; COVID-19 vaccines; PTSD; anxiety; depression; mental health; mental health support; vaccine hesitancy.