Maximizing the Uptake of a COVID-19 Vaccine in People with Severe Mental Illness: A Public Health Priority

Abstract

eople with serious mental illness (SMI) are at increased risk of being infected by coronavirus disease 2019 (COVID-19) and have higher subsequent rates of hospitalization, morbidity, and mortality.1,2 Factors that contribute to worse outcomes include concomitant medications, poorer premorbid general health, physical comorbidity, reduced access to medical care, and environmental and lifestyle factors such as lower socioeconomic status, overcrowding, smoking, or obesity. In light of these vulnerabilities, it is important that people with SMI are a priority group to receive a vaccination, should one be developed and deemed safe and effective.3 De Hert and colleagues3 noted that there is an ethical duty to prioritize vaccination for people with SMI given their increased risk of worse outcomes following COVID-19 infection and the structural barriers faced by people with SMI in accessing a vaccine. In addressing the Framework for Equitable Allocation of the COVID-19 Vaccine4 principle mitigation of health inequities, people with SMI should be included with other priority groups, including Indigenous people, older adults, and people with physical health comorbidities.