key: cord-0998246-a22046xt
authors: Samaâli, Samir; Karoui, Mehdi; Maaroufi, Arij; Kamoun, Rania; Nefzi, Houssem; Salah, Kafa Ben; Ellouze, Faten
title: Covid-19, vaccine decision and schizophrenia
date: 2022-02-07
journal: Encephale
DOI: 10.1016/j.encep.2022.01.004
sha: 233be8a8f5d80ab4f0389bdb7aa051833495da71
doc_id: 998246
cord_uid: a22046xt

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The majority of the participants (81.2%) knew that the vaccination campaign was already underway. The different modes of access to vaccination information were as follows: the media represented 55.4%, their close relatives represented 20.5%, their attending physicians represented 3.6% and social networks represented 2.7%.

Only 5.4% of participants were registered on the Evax.tn vaccination platform and 52.7% of patients refused to be vaccinated. 35.7% of our subjects were afraid of the side effects of the vaccine. Regarding the severity of psychotic symptoms, the median Clinician-Rated Dimensions of Psychosis Symptom Severity score (CRDPSS) was 7.5±6 and it was significantly associated with refusal to be vaccinated (p=0, 02).

The role and responsibility of a psychiatrist in the process have been highlighted : the World Psychiatric Association ethics committee has recommended that psychiatrists should have an accurate knowledge about COVID-19 and act accordingly [4] . In case of refusal of the vaccine, the psychiatrist could be confronted with an ethical dilemma: on the one hand the autonomy and the free decision of the patient must be respected. But on the other hand, the health prerogative of the patient and the community must also be taken into consideration [5] .

At the start of the vaccination campaign, the present study highlighted the fact that patients with severe mental illnesses were not a priority and risked being excluded from this campaign. This lack of access and adherence has raised ethical and social issues.

Many clinical and neurocognitive factors linked to the nature of psychotic disorders lead us to think that despite the wide availability of Covid-19, the vaccination rate in the psychiatric population might be low. Larger studies will be needed to assess access to the COVID-19 vaccine in Tunisians with mental disorders. The role of the psychiatrist is fundamental in informing the patient of his own vulnerabilities to COVID-19 in order to provide him with optimal vaccination guidance.

The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research

Stratégie de vaccination contre le Sars-Cov-2 -Actualisation des facteurs de risque de formes graves de la covid-19 et des recommandations sur la stratégie de priorisation des populations à vacciner

COVID-19 and psychiatrists' responsibilities: a WPA position paper. World Psychiatry

COVID-19 vaccination for people with severe mental illness: why, what, and how? The Lancet Psychiatry