Effects of vaccination against COVID-19 on the emotional health of Peruvian older adults

  1. Christoper A. Alarcon-Ruiz
  2. Zoila Romero-Albino
  3. Percy Soto-Becerra
  4. Jeff Huarcaya-Victoria
  5. Fernando M. Runzer-Colmenares
  6. Elisa Romani-Huacani
  7. David Villarreal-Zegarra
  8. Jorge L. Maguiña
  9. Moises Apolaya-Segura
  10. Sofía Cuba-Fuentes

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Abstract

Background

COVID-19 vaccination may reduce anxiety and depression. However, the pandemic significantly impacted the elderly from low-middle-income countries. Therefore, we aimed to estimate the effect of vaccination against COVID-19 on the emotional health of older adults.

Methods

We selected a nationally stratified sample of non-hospitalized adults aged 60 to 79 years who intended to receive the COVID-19 vaccine or had already received it during recruitment. We assess the fear, anxiety, and worry about COVID-19, general anxiety, and depression at baseline and after a month. We estimated the adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for each altered emotional health outcomes in those who had one and two doses, compared with those who were not vaccinated using multilevel logistic regression with mixed effects.

Results

We recruited 861 older adults. Loss to follow-up was 20.8%. At baseline, 43.9% had only one dose of the vaccine, and 49.1% had two doses. In the analysis during follow-up, those who had two doses had less fear (ORa: 0.19; CI95%: 0.07 to 0.51) and anxiety to COVID-19 (ORa: 0.45; CI95%: 0.22 to 0.89), compared to non-vaccinated. We observed no effects in those with only one dose.

Limitations

Inability to obtain the planned sample size for primary analysis. There is a selection bias during recruitment and a measurement bias because of self-reported vaccination.

Conclusions

COVID-19 vaccination with two doses in elders improves the perception of COVID-19 infection consequences. This information could be integrated into the vaccination campaign as its beneficial effect.

Highlights

  • Up to 90% of elders in a Peruvian sample had at least one dose of COVID-19 vaccine

  • Two doses of COVID-19 vaccine reduced the levels of fear and anxiety for COVID-19

  • Only one dose of vaccine didn’t had effect in any emotional mental outcome

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  1. ScreenIT

    SciScore for 10.1101/2022.01.24.22269781: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    NIH rigor criteria are not applicable to paper type.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    However, the Peruvian Ministry of Health indicated that vaccination should be prioritized with BNT162b2 (BioNTech, Pfizer) for older adults with 60 years or older (Ministry of Health, 2021).
    BioNTech
    suggested: None
    Data analysis: All the information collected was automatically recorded in a Microsoft Excel sheet (Microsoft, WA, United States).
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)
    Statistical software STATA MP v17
    STATA
    suggested: (Stata, RRID:SCR_012763)
    (StataCorp, Texas, USA) was used for the analysis.
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations and strengths: The interpretation of the results of this study must consider the following limitations. First, we were unable to obtain the planned sample size for the primary analysis, making the statistical power of our results insufficient to find statistically significant results. Thus, we do not rule out the effect of the vaccine on worry for COVID-19 and general anxiety, which should be evaluated in future studies. In addition, the low representativeness of the older adults affiliated with EsSalud registered in the CAM database, the high refusal to participate in the study, and the loss during follow-up could have caused selection bias. Thus, it is likely that older adults in CAMs have greater access to receiving the vaccine and to activities that improve their mental health, so the effect that we measured in the study may be overestimated. Additionally, the way to determine the vaccination status was by self-report, so the measurement of this variable could have been overestimated due to the social desirability bias. On the other hand, even though we did not conduct clinical interviews to evaluate the emotional health in the present study, we used different specific psychometric instruments for the perception of COVID-19 and general anxiety and depression. These tools have robust evidence of psychometric validity in our population of interest, making reliable the constructs that we measured.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2022.01.24.22269781v1 on medRxiv