Cork psychiatrist calls for those with severe mental illness to be prioritised for Covid-19 vaccine 

Those with schizophrenia are more likely to develop cardiac problems, diabetes and obesity – all risk factors associated with poor outcomes from Covid-19.

People with a severe mental illness should be moved up the list for Covid-19 vaccination, according to a Cork psychiatrist.

Dr Eric Kelleher, a consultant liaison psychiatrist at Cork University Hospital and a member of the College of Psychiatrists of Ireland, is urging the the National Immunisation Advisory Committee (NIAC) to consider prioritising those with schizophrenia spectrum disorders for vaccination, after a recent study revealed such disorders were associated with an increased risk for mortality from Covid-19.

In January, researchers at New York University found that people with schizophrenia were two to three times more likely to die from Covid-19 than people without the mental disorder.

Dr Kelleher said NIAC, which is currently reviewing the Covid-19 vaccine priority list, should consider moving those with severe mental illness, particularly those who are living in residential settings and high-support hostels, up the list in light of the research.

“In some cases, people with schizophrenia live in the community and do not live in residential settings, but a proportion do and we need to consider them as an at-risk group.”

In such settings, people with schizophrenia may have to share bedrooms and share communal facilities, he said.

Dr Eric Kelleher believes those with severe mental illnesses should be moved up the list for Covid-19 vaccination

“They may have less ability or less access to maintain social distancing. And with somebody who has a severe illness, they may be less able to for cognitive reasons or because of the nature of their mental illness, be able to follow social distancing guidelines.” 

In addition, it is “well-established” that those with schizophrenia can have “altered immune responses and variations in genetics that regulate the body's immune response”, he explained.

“They are more likely to die younger, they're more likely to develop cardiac problems, diabetes, obesity, so all the risk factors that we associate with poor outcomes from Covid."

Dr Kelleher said there were a number of schizophrenia spectrum disorders which should all be considered for prioritisation, including delusional disorders, acute and transient psychotic disorders and schizoaffective disorder.

A number of EU countries, including the UK, Germany and Denmark, have already moved to prioritise those with severe mental illness in their vaccination programmes.

“In the UK, individuals with severe mental illness are given the same priority for vaccination as those with certain physical illnesses.

“It's really about what we call ‘parity of esteem’ [valuing mental health equally with physical health] between those with severe mental illnesses, and those with physical illnesses,” Dr Kelleher said.

“I just hope NIAC will consider the risk factors that those with severe mental illness carry.”