Background: 2020 brought unprecedented situations around the globe due to Coronavirus disease (Covid-19) caused by the SARS-CoV-2 virus. During the Covid-19 pandemic, the households faced isolation, fear, worry, and anxiety, which led to poor mental health of adults in the US. However, the declining risk perception following Covid-19 vaccine availability may reduce distress and improve mental health.
Objective: We assess whether COVID-19 vaccine approval and availability was associated with reducing the prevalence of Covid-19-related mental health among adults in the United States.
Methods: We adopted a cross-sectional and quasi-experimental design using data on adults (age ³ 18 years) from the Census Pulse Survey, designed to measure the social and economic impact of Covid-19 pandemic in the US. We selected June 2020 (N=68,009) and March 2021 (N=63,932) for comparison because in June 2020, individuals were subject to high stress due to prolonged health regulations, lock downs, and social isolation due to physical and social distancing. In March 2021, vaccines were approved and became available to all adults over 18 years of age. The inclusion criteria for the study were non-missing data on mental health measures. Mental health measures included depression and anxiety and were derived from PHQ-2 and GAD-2 questionnaires. Other explanatory variables comprised age, sex, food insecurity, education, income, race and ethnicity, marital status, lost work, and region. Significant group differences in the prevalence of depression and anxiety were tested with Rao-Scott chi-square. Multivariable logistic regressions were used to analyze the association of time with depression and anxiety. Pulse survey provides 80 replicate weights to generate empirically derived standard error estimates. These standard errors are used in estimating confidence intervals of the parameter estimates. All analyses were conducted with the SAS survey procedures.
Results: Overall, 25.0% in June 2020 and 24.6% in March 2021 reported depression; 31.7% in June 2020 and 30.0% in March 2021 reported anxiety. In adjusted analysis, there were no significant differences in likelihood of depression (AOR = 0.87, 95% CI = 0.65,1.16) and anxiety (AOR = 0.94, 95% CI = 0.73, 1.20) between June 2020 and March 2021. In adjusted logistic regressions, those who reported food insufficiency and never married were more likely to have depression or anxiety than those who reported food sufficiency and were married. Adults who did not lose work during the pandemic were less likely to have depression or anxiety than those who lost employment. Being a female was associated with higher odds of anxiety (AOR = 1.39, 95% CI = 1.06, 1.83) compared to males.
Conclusion: One in 4 adults had depression, and one in 3 adults had anxiety. These rates are higher than those reported by studies conducted before the pandemic, suggesting that the COVID-19 pandemic may have affected the mental health of adults in the US. The rates of depression and anxiety were not changed between June 2020 to March 2021, which suggests pandemic effect continues to persist even with widespread availability of vaccines.
