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Include Psych Patients in Next COVID Vaccine Round, APA Urges

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The American Psychiatric Association (APA) is urging the inclusion of patients with serious mental illness (SMI) and/or substance use disorders (SUD) in the next priority group for receiving one of the COVID-19 vaccines.

The organization noted in a press release that state public health authorities should add these patients “to the equivalent” of the phase 1-C prioritization schedule from the US Centers for Disease Control and Prevention (CDC).

The criteria for this upcoming phase, as defined by the CDC, are people aged 65-74 years, people who are considered to be essential workers, and people aged 16-64 years who have a high-risk medical condition.

“It’s all too common that people with [SMI or SUD] don’t have access to healthcare, are of low socioeconomic status, or, based on history, harbor mistrust toward the medical establishment,” Jeffrey Geller, MD, MPH, president of the APA, said in the same release.

“States should treat psychiatric illnesses like other high-risk conditions and prioritize this population’s access to the vaccine,” he added.

The APA’s call to action coincides with its recently released guidance document on psychiatry and the COVID-19 vaccine.

“Unique Position”

Patients with SUD and SMI “are not only at an increased risk of contracting COVID-19 but are also more likely to be hospitalized and experience serious complications, including death,” the APA notes in its guidance document.

As reported by Medscape Medical News, results from recent studies have shown that schizophrenia spectrum disorder is linked to a significantly increased risk of death from COVID-19 and that patients with SMI are at increased risk of being infected with the virus, as are those with SUD.

Although there are several barriers for individuals with mental illness to receive the COVID-19 vaccine, including reduced access to care and a mistrust of medical institutions, psychiatrists “are uniquely positioned to address many of these public health challenges and ensure equitable access to the COVID-19 vaccine,” the APA guidance document states.

“Psychiatrists should play an important role supporting healthcare systems and other entities…to develop and deliver culturally and contextually relevant public health messages to help overcome vaccine hesitancy,” it adds.

Among its recommendations, the APA notes that psychiatrists should discuss any concerns a patient may have with the vaccine, should “disseminate accurate information,” and should help determine whether a patient is capable of giving informed consent for vaccination.

“APA and its member psychiatrists have worked throughout this pandemic, many on the frontlines,” Saul Levin, MD, the APA’s medical director and chief executive officer, said in a statement.

“We will continue to promote policies that keep our patients safe, particularly getting vaccines that require two doses over time,” Levin added.

The guidance is available on the APA website’s Coronavirus/COVID-19 Information Hub page. It was created through a collaboration between the organization’s Committee on Psychiatric Dimensions of Disaster, Committee on Integrated Care, Council on Communications, Council on Minority Mental Health and Health Disparities, and Council on Healthcare Systems and Financing.

Follow Deborah Brauser on Twitter: @MedscapeDeb

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