Changes in Mental Health and Preventive Behaviors before and after COVID-19 Vaccination: A Propensity Score Matching (PSM) Study

Abstract

Mass vaccination against the COVID-19 pandemic is ongoing worldwide to achieve herd immunity among the general population. However, little is known about how the COVID-19 vaccination would affect mental health and preventive behaviors toward the COVID-19 pandemic. In this study, we conducted a cross-sectional survey to address this issue among 4244 individuals at several COVID-19 vaccination sites in Guangzhou, China. Using univariate analysis and multiple linear regression models, we found that major demographic characteristics, such as biological sex, age, education level, and family per capita income, are the dominant influencing factors associated with health beliefs, mental health, and preventive behaviors. After propensity score matching (PSM) treatment, we further assessed the changes in the scores of health belief, mental health, and preventive behaviors between the pre-vaccination group and the post-vaccination group. When compared to individuals in the pre-vaccination group, a moderate but statistically significant lower score was observed in the post-vaccination group (p = 0.010), implying possibly improved psychological conditions after COVID-19 vaccination. In addition, there was also a moderate but statistically higher score of preventive behaviors in the post-vaccination group than in the pre-vaccination group (p < 0.001), suggesting a higher probability to take preventive measures after COVID-19 vaccination. These findings have implications for implementing non-pharmaceutical interventions combined with mass vaccination to control the rebound of COVID-19 outbreaks.

Keywords

• COVID-19 vaccine
• mass vaccination
• health belief
• mental health
• preventive behavior
• propensity score matching (PSM)