. 2022 May 1:304:66-77.

doi: 10.1016/j.jad.2022.02.025. Epub 2022 Feb 12.

Immune response to vaccination in adults with mental disorders: A systematic review

Affiliations

¹ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada.
² Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
³ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, ON, Canada.
⁴ School of Psychology and Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, PR China.
⁵ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore.
⁶ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Canada.
⁷ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Canada; Department of Pharmacology, University of Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada. Electronic address: roger.mcintyre@uhn.ca.

PMID: 35167926
PMCID: PMC8837484
DOI: 10.1016/j.jad.2022.02.025

Immune response to vaccination in adults with mental disorders: A systematic review

Karren Xiao et al. J Affect Disord. 2022.

. 2022 May 1:304:66-77.

doi: 10.1016/j.jad.2022.02.025. Epub 2022 Feb 12.

Authors

Affiliations

¹ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada.
² Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
³ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Institute of Medical Science, University of Toronto, ON, Canada.
⁴ School of Psychology and Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing 400715, PR China.
⁵ Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore.
⁶ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Canada.
⁷ Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Department of Psychiatry, University of Toronto, Canada; Department of Pharmacology, University of Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada. Electronic address: roger.mcintyre@uhn.ca.

PMID: 35167926
PMCID: PMC8837484
DOI: 10.1016/j.jad.2022.02.025

Abstract

Background: Mental disorders are associated with immune dysregulation as measured by serum levels of biological markers of immunity. Adults with mental disorders have also been reported to have attenuated post vaccine immune response. The COVID-19 pandemic has invited the need to determine whether individuals with mental disorders exhibit differential immune response following the administration of vaccines for other infections.

Methods: A systematic search of MEDLINE, Embase, Cochrane, and PsycInfo was conducted from inception to May 2021 investigating vaccine response in persons with mental disorders, as measured by biological markers of immunity (i.e., antibodies, cytokines).

Results: Thirteen articles were identified which evaluated vaccine efficacy in persons with mental disorders. Individuals with major depressive disorder (MDD) or schizophrenia revealed attenuated immune response to vaccination, or no statistical difference compared to control subjects. Individuals with anorexia nervosa or post-traumatic stress disorder (PTSD) displayed no attenuated post-vaccination antibody level. Individuals with insomnia displayed lower levels of antibodies after vaccination, whereas individuals with obstructive sleep apnea (OSA) displayed no difference in vaccine response compared to control subjects.

Limitations: The limitations of this review include the relatively few articles included (n = 13) and small sample sizes (less than thirty subjects) in the majority of articles.

Conclusion: Vaccine response in adults with a mental disorder remains inconclusive. Notwithstanding the heterogeneity and relatively small number of studies, available evidence does suggest attenuated immune response across disparate vaccinations. Future research is required to confirm vaccine efficacy in persons with mental disorders, especially regarding immune responses to COVID-19 vaccination.

Keywords: COVID-19; Depression; Disorders; Immune function; Inflammation; Mental illness; Mood; Public Health; Vaccination.

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Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Fig 1 — **Fig. 1**
PRISMA flow diagram for study identification and selection.

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Immune response to vaccination in adults with mental disorders: A systematic review

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Immune response to vaccination in adults with mental disorders: A systematic review

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