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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

Olivier Rouquette, Sze Chim Lee Orcid Logo, Marcos del Pozo Banos Orcid Logo, David Osborn, Rob Stewart, Ann John Orcid Logo

Journal of Infection and Public Health, Volume: 19, Issue: 1, Start page: 103014

Swansea University Authors: Olivier Rouquette, Sze Chim Lee Orcid Logo, Marcos del Pozo Banos Orcid Logo, Ann John Orcid Logo

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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...

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Published in: Journal of Infection and Public Health
ISSN: 1876-0341 1876-035X
Published: Elsevier BV 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa70728
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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. 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spelling 2026-03-04T16:12:16.4072114 v2 70728 2025-10-20 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 0e502db88ea48ce6b053ed0eef9a54ce Olivier Rouquette Olivier Rouquette true false 10628af4988d624b49c4de7bd78b4694 0000-0001-5822-6633 Sze Chim Lee Sze Chim Lee true false f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2025-10-20 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. Journal Article Journal of Infection and Public Health 19 1 103014 Elsevier BV 1876-0341 1876-035X Self-harm; Neurodevelopmental disorders; Mental health conditions; Severe mental illness; Covid-19 vaccine 1 1 2026 2026-01-01 10.1016/j.jiph.2025.103014 COLLEGE NANME COLLEGE CODE Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) DATAMIND, NCMH, HCRW, NIHR Maudsley Biomedical Research Centre, NIHR ARC South London, UKRI, the UK Prevention Research Partnership 2026-03-04T16:12:16.4072114 2025-10-20T11:09:20.7722362 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Olivier Rouquette 1 Sze Chim Lee 0000-0001-5822-6633 2 Marcos del Pozo Banos 0000-0003-1502-389X 3 David Osborn 4 Rob Stewart 5 Ann John 0000-0002-5657-6995 6 70728__36324__d9f4c82a6c4c48f8b6221e87ba286178.pdf 70728.VoR.pdf 2026-02-27T12:38:22.9099258 Output 1654701 application/pdf Version of Record true © 2025 The Authors. This is an open access article under the CC BY license. true eng http://creativecommons.org/licenses/by/4.0/
title 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
spellingShingle 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
Olivier Rouquette
Sze Chim Lee
Marcos del Pozo Banos
Ann John
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
author_id_str_mv 0e502db88ea48ce6b053ed0eef9a54ce
10628af4988d624b49c4de7bd78b4694
f141785b1c0ab9efe45665d35c081b84
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv 0e502db88ea48ce6b053ed0eef9a54ce_***_Olivier Rouquette
10628af4988d624b49c4de7bd78b4694_***_Sze Chim Lee
f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Olivier Rouquette
Sze Chim Lee
Marcos del Pozo Banos
Ann John
author2 Olivier Rouquette
Sze Chim Lee
Marcos del Pozo Banos
David Osborn
Rob Stewart
Ann John
format Journal article
container_title Journal of Infection and Public Health
container_volume 19
container_issue 1
container_start_page 103014
publishDate 2026
institution Swansea University
issn 1876-0341
1876-035X
doi_str_mv 10.1016/j.jiph.2025.103014
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description 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.
published_date 2026-01-01T05:36:41Z
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