COVID-19 vaccine willingness amongst patients with mental illness compared with the general population.

Patients with mental illness are at an increased risk of COVID-19 infection, morbidity, and mortality, and prioritisation of this group for COVID-19 vaccination programmes has therefore been suggested. Vaccine uptake may, however, be compromised by vaccine hesitancy amongst patients with mental illness, posing a critical public health issue. We conducted two surveys to provide weighted estimates of vaccine willingness amongst patients with mental illness and the general population of Denmark. Vaccine willingness was high in both groups, but slightly lower amongst patients with mental illness (84.8%), compared with the general population (89.5%) (p < .001). Based on these findings, vaccine hesitancy does not appear to be a major barrier for vaccine uptake amongst patients with mental illness in Denmark, but may be so in other countries with lower general vaccine willingness. Replication of the present study in other countries is strongly warranted.

The association between physical morbidity and subtypes of severe depression.

BACKGROUND: Physical illness and depression are related, but the association between specific physical diseases and diagnostic subtypes of depression remains poorly understood. This study aimed to clarify the relationship between a number of physical diseases and the nonpsychotic and psychotic subtype of severe depression. METHODS: This is a historical prospective cohort study. The study population consisted of all patients diagnosed with ICD-10 severe depression, either nonpsychotic or psychotic subtype, in Danish psychiatric hospitals between 1994 and 2008. The patients' history of physical disease was assessed using the Danish National Patient Register. Using logistic regression it was investigated whether specific physical diseases were associated with relative increased risk for subsequent development of either the nonpsychotic or psychotic depressive subtype. RESULTS: A total of 24,173 patients with severe depression were included in the study. Of those, 8,260 (34%) were of the psychotic subtype. A history of the following physical diseases, as opposed to their absence, increased the relative risk for subsequent development of the nonpsychotic compared to the psychotic depressive subtype [adjusted incidence odds ratio (AIOR) nonpsychotic vs. psychotic]: ischemic heart disease (AIOR = 1.3, p < 0.001), hypertension (AIOR = 1.2, p = 0.008), stroke (AIOR = 1.2, p = 0.042) and chronic lower pulmonary disease (AIOR = 1.2, p = 0.005). The total load of physical disease also increased the relative risk of nonpsychotic depression [AIOR = 1.05 (per disease), p = 0.001]. CONCLUSIONS: This study revealed that, in severe depression, a history of physical disease increased the relative risk of the nonpsychotic rather than the psychotic subtype.

Public support for unequal treatment of unvaccinated citizens: Evidence from Denmark.

While billions have been vaccinated against COVID-19, unvaccinated citizens remain a challenge to public health given their higher likelihood of passing on the virus. One way for governments to reduce this concern is to enact more restrictive rules and regulations for the unvaccinated citizens in order to incentivize them to become vaccinated and/or reduce their spread of the virus. However, such rule differentiation conflicts with liberal principles of equal treatment, thereby raising a trade-off between material (public health) and principled concerns. To gain legitimacy in trading off these difficult concerns, governments are likely to look to preferences in the general population. We therefore analyze to what extent unequal treatment of the unvaccinated in terms of differentiation of various rules and regulations finds support among the general public. In a pre-registered survey experiment, we investigate public support for various COVID-19 regulations (e.g., test fees, isolation pay, and hospital prioritization). In the experiment, we randomly assign respondents to evaluate regulations that either (i) apply to adults in general or (ii) only to those adults who deliberately have chosen not to be vaccinated. This design provides a valid means to assess support for unequal treatment of the unvaccinated by minimizing various concerns relating to survey responding. Furthermore, we examine how these preferences vary by individual vaccination status, trust in institutions, as well as over-time changes in severity of the pandemic. We find significantly (both statistically and substantively) higher support for restrictive policies when targeted exclusively toward the unvaccinated, which we interpret as support for unequal treatment of this group. We also uncover strong polarization in these preferences between the vaccinated and the unvaccinated, but a much more limited role for trust and severity of the pandemic.

A positive update on COVID-19 booster vaccine willingness among Danes.

INTRODUCTION: Based on survey data from September 2021, we recently reported that an estimated 90% (weighted total) of vaccinated (completed or scheduled) adult Danes were also willing to receive a COVID-19 booster vaccine, once offered. This survey was, however, fielded before booster vaccination was recommended to the general adult population in Denmark, which may have resulted in an underestimation of booster vaccine willingness. Therefore, we conducted a follow-up survey targeting the same individuals. METHODS: The follow-up survey wave was fielded in December 2021 using the same methods as in the September 2021 wave. Using data from participants responding to both survey waves, we compared COVID-19 booster vaccine willingness between the waves by means of paired t-test. RESULTS: A total of 1,429 invitees (58%) responded to the follow-up survey. Among those, 1,324 (93%) had also responded to the initial survey on COVID-19 booster vaccine willingness. At follow-up, among the 95% reporting to be vaccinated or that COVID-19 vaccination was scheduled, a weighted proportion of 95% indicated that they were willing to receive the booster vaccine once offered. Booster vaccine willingness at follow-up (December 2021) had statistically significantly increased (p less-than 0.001) compared with the initial survey (September 2021). CONCLUSIONS: Almost all of the COVID-19-vaccinated Danes seem willing to receive a booster dose of the vaccine, which bodes very well for the COVID-19 immunisation state in Denmark. FUNDING: The study was funded by a grant from the Novo Nordisk Foundation. TRIAL REGISTRATION: not relevant.

Running on empty: a longitudinal global study of psychological well-being among runners during the COVID-19 pandemic.

OBJECTIVES: There are indications that the COVID-19 pandemic has had a profound negative effect on psychological well-being. Here, we investigated this hypothesis using longitudinal data from a large global cohort of runners, providing unprecedented leverage for understanding how the temporal development in the pandemic pressure relates to well-being across countries. DESIGN: Prospective cohort study. SETTING: Global. PARTICIPANTS: We used data from the worldwide Garmin-RUNSAFE cohort that recruited runners with a Garmin Connect account, which is used for storing running activities tracked by a Garmin device. A total of 7808 Garmin Connect users from 86 countries participated. PRIMARY AND SECONDARY OUTCOME MEASURES: From 1 August 2019 (prepandemic) to 31 December 2020, participants completed surveys every second week that included the five-item WHO Well-Being Index (WHO-5). Pandemic pressure was proxied by the number of COVID-19-related deaths per country, retrieved from the Coronavirus Resource Centre at Johns Hopkins University. Panel data regression including individual- and time-fixed effects was used to study the association between country-level COVID-19-related deaths over the past 14 days and individual-level self-reported well-being over the past 14 days. RESULTS: The 7808 participants completed a total of 125 409 WHO-5 records over the study period. We found a statistically significant inverse relationship between the number of COVID-19-related deaths and the level of psychological well-being-independent of running activity and running injuries (a reduction of 1.42 WHO-5 points per COVID-19-related death per 10 000 individuals, p<0.001). CONCLUSIONS: This study suggests that the COVID-19 pandemic has had a negative effect on the psychological well-being of the affected populations, which is concerning from a global mental health perspective.

Sustained COVID-19 vaccine willingness after safety concerns over the Oxford-AstraZeneca vaccine.

INTRODUCTION Prompted by reports of thromboembolic events - some with fatal outcomes - among people who had received the ChAdOx1 nCoV-19 (AZD1222) vaccine from Oxford-AstraZeneca against COVID-19, a number of European countries paused vaccination with this vaccine in early and mid-March 2021. Prior studies have suggested that vaccine willingness is highly dependent on public trust in the safety of vaccines. We therefore investigated whether vaccine willingness dropped in the wake of the reported cases of thromboembolic events in relation to the Oxford-AstraZeneca COVID-19 vaccine. METHODS Using longitudinal survey data from Denmark, we compared vaccine willingness shortly before and after the reported cases of thromboembolic events, as well as the perceived safety of the two most widely used COVID-19 vaccines in Denmark - those from Pfizer-BioNTech and Oxford-AstraZeneca - in the wake of these events. RESULTS We found sustained vaccine willingness after the reported cases of thromboembolic events (89% both before and after). However, the safety of the Oxford-AstraZeneca COVID-19 vaccine was perceived to be significantly and substantially lower than the safety of the vaccine from Pfizer-BioNTech, and this difference was particularly pronounced among those who were vaccine-hesitant. CONCLUSIONS The vaccine willingness of Danes does not seem to have been affected by the reports of thromboembolic events in relation to the Oxford-AstraZeneca COVID-19 vaccine. FUNDING The study was funded by a grant from the Novo Nordisk Foundation (grant number: NNF20SA0062874). TRIAL REGISTRATION not relevant.

COVID-19 booster vaccine willingness.

INTRODUCTION: As the protection from the COVID-19 vaccines diminishes over time, health authorities are currently considering how to maintain immunity by means of vaccine booster doses. In a recent survey, we investigated COVID-19 booster vaccine willingness among Danes, a population with a high acceptance of the initial round of COVID-19 vaccination. METHODS: The data were derived from the sixth wave of the longitudinal COVID-19 Consequences Denmark Panel Survey 2020, which included questions on booster vaccine willingness. The data from the respondents were primarily analysed using descriptive statistics. The association between age, gender, level of education, region, type of received vaccine and booster vaccine willingness was analysed using multivariate logistic regression. RESULTS: Among those reporting to be vaccinated against COVID-19 or that their vaccination was scheduled, a weighted total of 90% indicated that they were willing to receive the booster vaccine, if/once offered. The only characteristic associated with booster vaccine willingness at the set level of statistical significance (0.05) was age (increased willingness with age; adjusted odds ratio per year: 1.04, 95% confidence interval: 1.02-1.06). CONCLUSIONS: The willingness to receive a booster dose of a COVID-19 vaccine is high among Danes. If health authorities decide to offer COVID-19 booster vaccines to the young, they may consider providing specific information targeted at this population to increase uptake. FUNDING: The Novo Nordisk Foundation. TRIAL REGISTRATION: not relevant.

Quantifying the value of markers in screening programmes.

Existing methods used to rank the value of individual screening markers in screening programmes are inadequate. We have developed a simple Screening Marker Index: (Screening Marker Index = Positive Predictive Value x Sensitivity). The Screening Marker Index proved to be superior to existing indices in ranking screening markers according to their ability to identify the conditions sought.

Reacting to Neighborhood Cues? Political Sophistication Moderates the Effect of Exposure to Immigrants.

Drawing on insights from political psychology regarding political information processing, this paper argues that politically sophisticated individuals are less sensitive to the social cues manifested in the ethnic composition of their neighborhood when they form political opinions. This prediction is founded on politically sophisticated individuals having a greater comprehension of news and other mass-mediated sources, which makes them less likely to rely on neighborhood cues as sources of information relevant for political attitudes. Based on a unique panel data set with fine-grained information about the ethnic composition of the immediate neighborhood, the paper finds consistent support for the hypothesis: While neighborhood exposure to non-Western immigrants reduces anti-immigration attitudes among individuals with low political sophistication, there is no effect among individuals with high political sophistication. These results thus partially support contact theory and demonstrate that integrating the information processing and ethnic diversity literatures enhances our understanding of outgroup exposure effects.