$3.3 million NIMH grant will fund study addressing undervaccination among people with anxiety and depression

February 9, 2023

A $3.3 million grant from the National Institute of Mental Health (NIMH) will fund innovative new research to address high levels of COVID-19 vaccine hesitancy among individuals with symptoms of anxiety or depression.

Researchers from the University of North Carolina Gillings School of Global Public Health (UNC Gillings) CUNY Institute for Implementation Science in Population Health (CUNY ISPH) at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), the Harvard T.H. Chan School of Public Health and Columbia University will leverage the infrastructure of the national CHASING COVID Cohort (C3) Study to tailor and test the effectiveness of a digital intervention to increase COVID-19 vaccination among adults in the United States experiencing mental health symptoms.

Dr. Angela Parcesepe

“People with mental health disorders, including anxiety and depression, report greater vaccine hesitancy and lower COVID vaccination levels than the general population,” says UNC Gillings Assistant Professor Angela Parcesepe, PhD, one of the study’s principal investigators. “They are also more likely to be impacted by COVID-19 vaccine misinformation and disinformation.”

“In March 2021, about 40% of U.S. adults with symptoms of anxiety or depression were vaccinated compared to 53% of those without symptoms,” says CUNY SPH Distinguished Professor Denis Nash, PhD, executive director of CUNY ISPH and the other principal investigator of the study. “Undervaccination is a key driver of the preventable outcomes of hospitalizations, deaths, and long COVID, and this is what has motivated our research team to conduct this study.”

The team will conduct in-depth analyses of the C3 participant data to identify key vaccine and booster uptake determinants — including mis/disinformation — among people with depression or anxiety. This information will inform the design of an intervention tailored to people experiencing mental health symptoms who may experience unique barriers to staying up to date on vaccinations.

The intervention will help participants recognize and protect themselves against vaccine mis/disinformation with a narrative technique called “inoculation theory.” The intervention will work the way some vaccines work: By exposing people to weakened forms of mis/disinformation, reearchers hope to strengthen participants’ ability to identify and resist mis/disinformation when they encounter it in the future.

The tailored intervention will build on one shown to be effective in a recent online trial led by Harvard Research Scientist Rachael Piltch-Loeb, PhD, a co-investigator on the newly-awarded grant. Her team found that “inoculating” people against COVID-19 vaccine misinformation significantly decreased COVID-19 vaccine hesitancy and increased resistance to vaccine misinformation among unvaccinated U.S. adults. However, that intervention was not specifically tailored to people experiencing mental health symptoms.

In the new study, the team will use a three-arm randomized controlled trial to compare a tailored intervention to the original untailored intervention and to conventional public health messaging around the importance of keeping up to date on COVID-19 vaccines.

“The premise of inoculation theory is to develop psychological resistance to misinformation,” says Pilch-Loeb. “Therefore, we think a tailored intervention that focuses on the particular psychological needs among those with depression and anxiety can have an added benefit.”

“The COVID-19 pandemic both increased the rates of mental health problems — especially depression and anxiety — and worsened mental health disparities,” says Milton Wainberg, MD, a co-investigator on the study and professor of clinical psychiatry at Columbia University. “Treating mental health problems will not be enough to improve suboptimal COVID-19 vaccination rates among people with mental health symptoms. Other strategies are needed.”

Findings from this study will inform the development and implementation of strategies to increase vaccination uptake and mitigate the impact of COVID-19 among people with anxiety and depression.

This three-year project is currently recruiting for a postdoctoral fellow. Apply at the CUNY ISPH website.

About UNC Gillings

The Gillings School’s mission is to improve public health, promote individual well-being and eliminate health inequities in North Carolina and around the world. This work is done in basic science laboratories; clinical and public health settings; communities, including worksites; and community-based and other non-governmental organizations. With a special focus on the science of implementation and delivery, UNC Gillings faculty, staff and students are bridging the gap between academic research and practical public health that can make a world of difference — and a different, healthier world.

About CUNY SPH

The CUNY Graduate School of Public Health and Health Policy is committed to promoting and sustaining healthier populations in New York City and around the world through excellence in education, research and service in public health, and by advocating for sound policy and practice to advance social justice and improve health outcomes for all.

About CUNY ISPH

The CUNY Institute for Implementation Science in Population Health was founded on the notion that substantial improvements in population health can be efficiently achieved through better implementation of existing strategies, policies and interventions across multiple sectors. With that in mind, researchers study how to translate and scale up evidence-based interventions and policies within clinical and community settings in order to improve population health and reduce health disparities.

Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.