Is vaccine hesitancy related to mental health after the adjustment of the zero-COVID-19 strategy in the elderly? A mediation analysis in China

With the global Omicron pandemic and the adjustment of the zero-coronavirus disease 2019 (zero-COVID-19) strategy in China, there is a critical need to improve vaccination rates among older adults while addressing the mental health issues associated with vaccination. This study investigated levels of COVID-19-related anxiety, depression, benefit finding, and fear in older adults and explored the relationship between vaccine hesitancy, sociodemographic factors, and mental health. Participants aged 60 and older (n = 658) were recruited from several cities in the eastern, central, and western China regions. Of these, 347 exhibited vaccine hesitancy. The effects of residence, education, health status, and COVID-19 vaccination on anxiety/depression/benefit-finding were found to be mediated/suppressed by vaccine hesitancy. Additionally, in investigating psychological antecedents, older people without vaccine hesitancy showed higher confidence, lower complacency, fewer constraints, and a greater sense of collective responsibility. This study advances our understanding of mental health differences in anxiety, depression, and benefit-finding across sociodemographic characteristics. It is essential to improve population confidence related to vaccines, accessibility to vaccination services, and responsibility to mitigate vaccine hesitancy while paying close attention to the mental health associated with vaccination in older adults.伴随全球奥密克戎疫情大流行以及中国调整新型冠状病毒肺炎（COVID-19）零感染防控策略，当前亟需提升老年人群的新冠疫苗接种率，同时妥善解决与疫苗接种相关的心理健康问题。本研究针对老年人群展开调查，评估其与新冠相关的焦虑、抑郁、获益发现及恐惧水平，并探究疫苗犹豫（vaccine hesitancy）、社会人口学因素与心理健康之间的关联。本研究招募了中国东、中、西部多个城市的60岁及以上老年参与者共658名，其中347名存在疫苗犹豫行为。研究发现，居住状况、受教育程度、健康状况以及新冠疫苗接种对焦虑、抑郁及获益发现的影响，可通过疫苗犹豫产生中介/抑制效应。此外，在探究心理前因变量时，无疫苗犹豫的老年群体展现出更高的疫苗接种信心、更低的自满情绪、更少的接种阻碍感知以及更强的集体责任感。本研究深化了我们对不同社会人口学特征群体间焦虑、抑郁及获益发现水平差异的认知。亟需提升民众对疫苗的接种信心、优化疫苗接种服务可及性，并强化责任意识以缓解疫苗犹豫，同时密切关注老年人群中与疫苗接种相关的心理健康问题。