BENGALURU: Both the Covishield and Covaxin fact sheets state that people must declare to the vaccinators if they have long-term medications or illnesses. One of the categories of patients not spoken about till now are those with psychiatric disorders, many of whom are on lifelong medication for chronic conditions such as schizophrenia, bipolar affective disorder, dementia, OCD, depression and anxiety.
However, experts state that these patients need not worry and can take the COVID vaccine as until now, there is no evidence of contraindications to it. "Psychiatric medication only improves the condition of neurotransmitters. For example, with schizophrenia, they reduce the dopamine levels and with depression they increase serotonin levels," said Dr H Chandrashekar, medical adviser, Karnataka State Mental Health Authority, and Professor and HOD of Psychiatry, Bangalore Medical College and Research Institute.
"As such there is no evidence that the COVID vaccine can harm long-term psychiatric patients. These patients are, in fact, more vulnerable to COVID-19 owing to their behavioural issues," he added. The Covid vaccine mainly works in creating antibodies to boost the body’s defence mechanism and is not related to the psychiatric medication.
These patients must be educated, informed about the vaccine, its safety, benefits and adverse effects, Dr Chandrashekar said. He added that Adverse Events Following Immunization (AEFI)-led anxiety in seven vaccine beneficiaries in Karnataka was not related to this.
No clinical trials have happened to explore contraindications specifically to do with psychiatric medication and no such issues have been raised by the vaccine manufacturing companies, experts said. "Psychiatric patients are just as vulnerable as those with hypertension, diabetes and heart issues. For Covishield, as per the fact sheet, there is no explicit mention of contraindication with respect to mental health medication. Hence, patients can take it. For Covaxin, they can take a call after discussing with their physician," said Dr Shashidhar HN, psychiatrist and Resident Medical Officer, National Institute of Mental Health and Neuro Sciences.
On July 11, 2020, the Indian Psychiatric Society (IPS) wrote to Dr Vinod K Paul, Member, Niti Aayog & Chairman, NEGVAC (National Expert Group On Vaccine Administration for COVID-19), for inclusion of one more High Priority Group for Vaccination – Persons with Severe Mental Illnesses (SMIs). They asked to prioritise this group for vaccination which includes persons with SMIs.
Dr T S Sathyanarayana Rao, General Secretary of IPS and Professor, Department of Psychiatry, JSS Medical College and Hospital, Mysuru, said, "People with mental problems can take the Covid vaccine and it is completely safe for them. They can continue their daily medication as well. The vaccine is crucial for them as they belong to the high risk category, wherein they have no idea about following Covid safety norms and will be prone to infection."
The letter stated that the vulnerability of Persons with Severe Mental Illnesses (SMIs) to all forms of infection, including the COVID-19 virus infection, is well established with many factors contributing to this vulnerability including the neglect of self-care, poor living conditions, compromised immune status and possibly inadequate COVID adherent behaviour.