Mental health outcomes after SARS-CoV-2 vaccination in the United States: A national cross-sectional study

Background: Worsening of anxiety and depressive symptoms have been widely described during the COVID-19 pandemic. It can be hypothesized that vaccination could link to reduced symptoms of anxiety and/or depression. However, to date, no study has assessed this. This study aims to examine anxiety and depressive symptoms after vaccination in US adults, meanwhile test sociodemographic disparities in these outcomes. Methods: Data from the January 6-June 7 2021, cross-sectional Household Pulse Survey were analyzed. Using survey-weighted logistic regression, we assessed the relationships between SARS-CoV-2 vaccination and anxiety and/or depressive symptoms, both on overall and sociodemographic subgroups. We controlled for a variety of potential socioeconomic and demographic confounding factors. Results: Of the 453,167 participants studied, 52.2% of the participants had received the COVID-19 vaccine, and 26.5% and 20.3% of the participants reported anxiety and depression, respectively. Compared to those not vaccinated, the vaccinated participants had a 13% lower odds of anxiety (adjusted odds ratio [AOR] = 0.85, 95% CI 0.83-0.90) and 17% lower odds of depression (AOR = 0.83, 95%CI 0.79-0.85). Disparities on the above associations were identified in age, marital status, education level, ethnic/race, and income level, but not on gender. Limitations: The causal inference was not able to be investigated due to the cross-sectional study design. Conclusion: Being vaccinated for SARS-CoV-2 was associated with lower odds of anxiety and/or depressive symptoms. While those more middle-aged or more affluent, were more likely to show these negative associations, the contrary was observed in ethnic minorities and those with lower educational attainment. More strategic and demography-sensitive public health communications could perhaps temper these issues.