Abstract
AIMS: The enduring impact of the COVID-19 pandemic on mental health and its implications for COVID-19 vaccine uptake necessitate comprehensive investigation. We aimed to characterize the persistence of moderate to severe anxiety and depression symptoms from July 2020 to July 2023, explore demographic associations with symptom persistence, and assess how these symptoms affected COVID-19 vaccination uptake between May 2021 and July 2023. METHODS: Participants from the national community-based CHASING COVID Cohort were enrolled between March and June 2020 and completed quarterly follow-ups until December 2023. Scores ≥10 on the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaire 8-item at 14 follow-up assessments indicated moderate to severe anxiety and depression symptoms, respectively. Missing scores were imputed. Persistent anxiety and depression were defined as experiencing moderate to severe anxiety and depression symptoms ≥7 out of 14 follow-up assessments, respectively. RESULTS: Among 4,851 participants, 15.9% experienced persistent anxiety symptoms and 19.3% persistent depression symptoms from July 2020 to July 2023. Demographic factors associated with symptom persistence included younger age, female or non-binary gender, Hispanic ethnicity, lower education level, household income <$100k, presence of children <18 in the household, greater healthcare barriers and comorbidities. Participants with ongoing moderate to severe anxiety and depression symptoms had 0.95 (95% CI: 0.94, 0.97) and 0.95 (95% CI: 0.93, 0.96) times rates of receiving additional COVID-19 vaccine doses between May 2021 and July 2023, respectively. CONCLUSIONS: Customized support for individuals with mental disorders may mitigate barriers to vaccine uptake. Further investigation is warranted to validate these findings and inform targeted interventions.