Attitudes toward COVID-19 vaccination and willingness to pay: comparison of people with and without mental disorders in China

Fengyi Hao; Bokun Wang; Wanqiu Tan; Syeda Fabeha Husain; Roger S McIntyre; Xiangdong Tang; Ling Zhang; Xiaofan Han; Li Jiang; Nicholas W S Chew; Benjamin Yong-Qiang Tan; Bach Tran; Zhisong Zhang; Gia Linh Vu; Giang Thu Vu; Roger Ho; Cyrus S Ho; Vijay K Sharma

doi:10.1192/bjo.2021.979

Attitudes toward COVID-19 vaccination and willingness to pay: comparison of people with and without mental disorders in China

BJPsych Open. 2021 Aug 11;7(5):e146. doi: 10.1192/bjo.2021.979. eCollection 2021 Sep.

Authors

Fengyi Hao¹, Bokun Wang², Wanqiu Tan³, Syeda Fabeha Husain⁴, Roger S McIntyre⁵, Xiangdong Tang⁶, Ling Zhang⁷, Xiaofan Han⁷, Li Jiang⁷, Nicholas W S Chew⁸, Benjamin Yong-Qiang Tan⁸, Bach Tran⁹, Zhisong Zhang¹⁰, Gia Linh Vu¹¹, Giang Thu Vu¹², Roger Ho¹³, Cyrus S Ho⁴, Vijay K Sharma¹⁴

Affiliations

¹ Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, China; Mental Health Center, West China Hospital, Sichuan University, China; Translational Neuroscience Center, West China Hospital, Sichuan University, China; State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China; and Department of Psychiatry, The First People's Hospital of Chongqing Liang Jiang New Area, China.
² Modern Service Industry Bureau, Chongqing Liangjiang New Area Administration Committee, China.
³ Department of Psychiatry, National University of Singapore (Chongqing) Research Institute, China.
⁴ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁵ Mood Disorders Psychopharmacology Unit, University Health Network, Ontario, Canada.
⁶ Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, China; Mental Health Center, West China Hospital, Sichuan University, China; Translational Neuroscience Center, West China Hospital, Sichuan University, China; and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, China.
⁷ Department of Psychiatry, The First People's Hospital of Chongqing Liang Jiang New Area, China.
⁸ Department of Medicine, National University Health System, Singapore.
⁹ Institute for Preventive Medicine and Public Health, Hanoi Medical University, Vietnam; and Bloomberg School of Public Health, Johns Hopkins University, Maryland, USA.
¹⁰ Faculty of Education, Huaibei Normal University, China.
¹¹ Institute for Global Health Innovations and Faculty of Medicine, Duy Tan University, Vietnam.
¹² Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Vietnam.
¹³ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; and Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore.
¹⁴ Division of Neurology, Department of Medicine, National University Health System, Singapore; and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Abstract

Background: Acceptance and willingness to pay for the COVID-19 vaccine are unknown.

Aims: We compared attitudes toward COVID-19 vaccination in people suffering from depression or anxiety disorder and people without mental disorders, and their willingness to pay for it.

Method: Adults with depression or anxiety disorder (n = 79) and healthy controls (n = 134) living in Chongqing, China, completed a cross-sectional study between 13 and 26 January 2021. We used a validated survey to assess eight aspects related to attitudes toward the COVID-19 vaccines. Psychiatric symptoms were assessed by the 21-item Depression, Anxiety and Stress Scale.

Results: Seventy-six people with depression or anxiety disorder (96.2%) and 134 healthy controls (100%) reported willingness to receive the COVID-19 vaccine. A significantly higher proportion of people with depression or anxiety disorder (64.5%) were more willing to pay for the COVID-19 vaccine than healthy controls (38.1%) (P ≤ 0.001). After multivariate adjustment, severity of depression and anxiety was significantly associated with willingness to pay for COVID-19 vaccination among psychiatric patients (P = 0.048). Non-healthcare workers (P = 0.039), health insurance (P = 0.003), living with children (P = 0.006) and internalised stigma (P = 0.002) were significant factors associated with willingness to pay for COVID-19 vaccine in healthy controls.

Conclusions: To conclude, psychiatric patients in Chongqing, China, showed high acceptance and willingness to pay for the COVID-19 vaccine. Factors associated with willingness to pay for the COVID-19 vaccine differed between psychiatric patients and healthy controls.

Keywords: Anxiety; COVID-19; depression; insomnia; vaccine.