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. 2021 Aug:96:100-105.
doi: 10.1016/j.bbi.2021.05.016. Epub 2021 May 20.

Pre-pandemic cognitive function and COVID-19 vaccine hesitancy: cohort study

G David Batty  1 , Ian J Deary  2 , Chloe Fawns-Ritchie  3 , Catharine R Gale  4 , Drew Altschul  3
Affiliations

Pre-pandemic cognitive function and COVID-19 vaccine hesitancy: cohort study

G David Batty et al. Brain Behav Immun. 2021 Aug.

Abstract

Background: Whereas several predictors of COVID-19 vaccine hesitancy have been reported, the role of cognitive function is largely unknown. Accordingly, our objective was to evaluate the association between scores from an array of cognitive function tests and self-reported vaccine hesitancy after the announcement of the successful testing of the first COVID-19 vaccine (Oxford University/AstraZeneca).

Methods: We used individual-level data from a pandemic-focused study ('COVID Survey'), a prospective cohort study nested within United Kingdom Understanding Society ('Main Survey'). In the week immediately following the announcement of successful testing of the first efficacious inoculation (November/December 2020), data on vaccine intentionality were collected in 11,740 individuals (6702 women) aged 16-95 years. Pre-pandemic scores on general cognitive function, ascertained from a battery of six tests, were captured in 2011/12 wave of the Main Survey. Study members self-reported their intention to take up a vaccination in the COVID-19 Survey.

Results: Of the study sample, 17.2% (N = 1842) indicated they were hesitant about having the vaccine. After adjustment for age, sex, and ethnicity, study members with a lower baseline cognition score were markedly more likely to be vaccine hesitant (odds ratio per standard deviation lower score in cognition; 95% confidence interval: 1.76; 1.62, 1.90). Adjustment for mental and physical health plus household shielding status had no impact on these results, whereas controlling for educational attainment led to partial attenuation but the probability of hesitancy was still elevated (1.52; 1.37, 1.67). There was a linear association for vaccine hesitancy across the full range of cognition scores (p for trend: p < 0.0001).

Conclusions: Erroneous social media reports might have complicated personal decision-making, leading to people with lower cognitive ability being vaccine-hesitant. With individuals with lower cognition also experiencing higher rates of COVID-19 in studies conducted prior to vaccine distribution, these new findings are suggestive of a potential additional disease burden.

Keywords: COVID-19; Cognitive ability; Cognitive function; Cohort; IQ; Mental ability; Vaccine hesitancy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow of cohort members into the analytical sample: Main Survey and COVID Survey in Understanding Society
Fig. 2
Fig. 2
Odds ratios (95% CI) for the relation of general cognitive function with COVID-19 vaccine hesitancy in Understanding Society
See this image and copyright information in PMC

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