COVID-19 vaccines and mental distress

PLoS One. 2021 Sep 8;16(9):e0256406. doi: 10.1371/journal.pone.0256406. eCollection 2021.


Background: The COVID-19 pandemic brought about large increases in mental distress. The uptake of COVID-19 vaccines is expected to significantly reduce health risks, improve economic and social outcomes, with potential benefits to mental health.

Purpose: To examine short-term changes in mental distress following the receipt of the first dose of the COVID-19 vaccine.

Methods: Participants included 8,003 adults from the address-based sampled, nationally representative Understanding America Study (UAS), surveyed at regular intervals between March 10, 2020, and March 31, 2021 who completed at least two waves of the survey. Respondents answered questions about COVID-19 vaccine status and self-reported mental distress as measured with the four-item Patient Health Questionnaire (PHQ-4). Fixed-effects regression models were used to identify the change in PHQ-4 scores and categorical indicators of mental distress resulting from the application of the first dose of the COVID-19 vaccine.

Results: People who were vaccinated between December 2020 and March 2021 reported decreased mental distress levels in the surveys conducted after receiving the first dose. The fixed-effects estimates show an average effect of receiving the vaccine equivalent to 4% of the standard deviation of PHQ-4 scores (p-value<0.01), a reduction in 1 percentage point (4% reduction from the baseline level) in the probability of being at least mildly depressed, and of 0.7 percentage points (15% reduction from the baseline level) in the probability of being severely depressed (p-value = 0.06).

Conclusions: Getting the first dose of COVID-19 resulted in significant improvements in mental health, beyond improvements already achieved since mental distress peaked in the spring of 2020.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / immunology*
  • COVID-19 / psychology*
  • COVID-19 Vaccines / immunology*
  • Female
  • Humans
  • Male
  • Mental Disorders / psychology*
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Pandemics / prevention & control
  • Patient Health Questionnaire / statistics & numerical data
  • Psychological Distress
  • SARS-CoV-2 / immunology*
  • Self Report / statistics & numerical data
  • Surveys and Questionnaires / statistics & numerical data


  • COVID-19 Vaccines