One-year results from the vaccination campaign against COVID-19 infection in 47 million individuals with severe mental disorders and other chronic diseases

Data sources and population

In this nationwide population-based study, we used data from the French national medico-administrative database (SNDS) and the COVID Vaccine teleservice from January 4, 2021 (date of activation of the teleservice) to January 30th, 2022. The SNDS covers approximately 99% of the population for which medical data are systematically collected. A mapping of chronic diseases according to a validated algorithm developed by the French National Health Insurance is available [4]. This information system centralizes individual COVID-19 vaccination data to ensure traceability for pharmacovigilance and vaccination campaign management purposes. The vaccination data were matched to the SNDS in order to provide vaccination rates according to diagnoses of chronic medical and psychiatric diseases.

Indicators’ definition

The first injection rate is the number of patients who received at least one first injection of vaccine. The initial completed vaccination rate is the percentage of patients whose vaccination was considered completed, defined as: two vaccine injections (general case), a single vaccine injection with COVID-19 infection (before or after the first injection), a single injection with Janssen vaccine, or three vaccine injections for immunocompromised patients.

Mental disorders were defined by the International Classification of Disease codes and the use of some treatments when specific of a disorder. The algorithms that define the disease groups use some of the following elements:

codes from the 10th International Classification of Diseases (ICD-10).

drugs that are quasi-specific to certain diseases.

ICD-10 codes for hospitalization diagnoses (principal diagnosis, related diagnosis, and associated diagnosis).

The following groups of mental disorders were defined: alcohol use disorders (F10*), opioid use disorders (F11*), schizophrenia-spectrum disorders [F20* to F29*] or chronic antipsychotic treatment (ATC code N05A except for NO5AN01 and N05AL06), anxiety and mood disorders ([F30* to F48*] or chronic antidepressant or mood regulator treatment (N06A, N05AN01, N03AG01, N03AG02), neurodevelopmental psychiatric disorders (F80*–F89*). The identification of a condition in year n may use data from up to 5 years (years n to n − 4). The diseases are mostly non-exclusive as the same individual may be affected by several conditions. For example, a person being treated for cancer and a psychiatric condition will fall into both groups of conditions. The details for group definitions are available at https://www.epi-phare.fr/. The detailed method to define the schizophrenia-spectrum disorders or chronic antipsychotic treatment group is available on the French Assurance website and detailed in Appendix [5]. The chronic antipsychotic treatment was included to identify outpatients followed up in the private sector.

Ethical considerations

Since the data were anonymized, no informed consent was required.

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