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Association of Covid-19 vaccination uptake with recorded self-harm, neurodevelopmental disorders and mental health conditions during the Covid-19 pandemic: A nationwide e-cohort study in Wales, UK
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Marcos del Pozo Banos ,
David Osborn,
Rob Stewart,
Ann John
Journal of Infection and Public Health, Volume: 19, Issue: 1, Start page: 103014
Swansea University Authors:
Olivier Rouquette, Sze Chim Lee , Marcos del Pozo Banos , Ann John
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© 2025 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license.
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DOI (Published version): 10.1016/j.jiph.2025.103014
Abstract
Background: Understanding COVID-19 vaccine uptake among individuals who self-harm or with mental health conditions is critical to addressing health inequalities and guiding public health strategies/pandemic preparedness. Evidence on temporal trends and sociodemographic factors shaping vaccine uptake...
| Published in: | Journal of Infection and Public Health |
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| ISSN: | 1876-0341 |
| Published: |
Elsevier BV
2026
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa70728 |
| Abstract: |
Background: Understanding COVID-19 vaccine uptake among individuals who self-harm or with mental health conditions is critical to addressing health inequalities and guiding public health strategies/pandemic preparedness. Evidence on temporal trends and sociodemographic factors shaping vaccine uptake within these populations remains limited.Methods: We linked Wales Immunisation System data to demographic and healthcare records for 2.2 million individuals. Using modified Poisson regressions and growth models, we explored the association between self-harm, neurodevelopmental disorders, mental health conditions, and vaccine uptake from 8 December 2020 to 8 December 2023. Models were adjusted for age, sex, deprivation, ethnicity, and physical comorbidities.Findings: Attention Deficit Hyperactivity Disorder (ADHD), conduct disorder, drug use, and, to a lesser extent, self-harm were associated with lower incidence of vaccination. Conversely, those with autism spectrum disorder, or learning difficulty had slightly higher incidence of vaccination. Individuals with severe mental illness (SMI: schizophrenia, bipolar disorder and other psychotic disorders) exhibited a steeper initial increase and earlier peak in uptake, but their final coverage was lower. Belonging to an ethnic minority group and, to a lesser extent, being male, younger, or leaving in highly deprived areas were also associated with reduced uptake.Interpretation: Disparities in vaccine uptake exist among individuals with self-harm and mental health conditions, driven by intersecting health and social factors. Tailored interventions, effective communication, and trust-building strategies are critical to reducing these inequities. Underserved groups including those with SMI, ADHD, and self-harm, should be prioritised in future vaccination campaigns to improve equity. |
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| Keywords: |
Self-harm; Neurodevelopmental disorders; Mental health conditions; Severe mental illness; Covid-19 vaccine |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
DATAMIND, NCMH, HCRW, NIHR Maudsley Biomedical Research Centre, NIHR ARC South London, UKRI, the UK Prevention Research Partnership |
| Issue: |
1 |
| Start Page: |
103014 |