New study finds COVID-19 vaccination boosts mental health along with immunity

Receiving at least one vaccine dose was associated with statistically significant declines in multiple psychological distress factors, investigators report in the American Journal of Preventive Medicine

Ann Arbor, February 15, 2022

Getting vaccinated for COVID-19 measurably improved the psychological well-being of participants in the Understanding Coronavirus in America study, a large longitudinal look at the impact of the pandemic on individuals in the United States. Vaccination was associated with declines in distress and perceived risks of infection, hospitalization, and death. The study, appearing in the American Journal of Preventive Medicine, published by Elsevier, validates the intuitive but previously unanswered questions of whether becoming vaccinated reduces perceived risks associated with COVID-19, and whether the reduction of these fears leads to improvements in mental health and quality of life.

“Our study documents important psychological benefits of vaccination beyond reducing the risk of severe illness and death associated with COVID-19,” said lead investigator Jonathan Koltai, PhD, Department of Sociology, University of New Hampshire, Durham, NH, USA.

Psychologic distress and anxiety increased sharply across the population following the onset of the COVID-19 pandemic. Several factors contributed, such as widespread job and income loss, food insecurity, social isolation, caregiving burdens, substance abuse, and racialized discrimination. Depressive symptoms persisted and increased into 2021 for those experiencing an accumulation of stress exposures. Not surprisingly, many individuals are also experiencing anticipatory fears that contribute to rising mental health problems.

Data from a nationally representative study of 8,090 adults who were interviewed regularly between March 2020 and June 2021 revealed declines in COVID-related risk perceptions and psychological distress following vaccination. Specifically, adults who received at least one dose of the COVID-19 vaccine between December 2020 and June 2021 reported a 7% relative reduction in mental distress, as measured using the Patient Health Questionnaire 4 (PHQ-4) distress scores, from average levels in the survey period immediately prior to vaccination.

Reductions in distress were partially explained by declining risk perceptions following vaccination. Becoming vaccinated was associated with a 7.77 percentage point decline in perceived risk of infection, a 6.91 percentage point decline in perceived risk of hospitalization, and a 4.68 percentage point decline in perceived risk of death. Adjusting for risk perceptions decreased the vaccination−distress association by 25%.

These effects persisted and became stronger up to at least eight weeks following vaccination. It is noteworthy that while responses from vaccinated and never-vaccinated participants followed similar trends pre-vaccination, they significantly diverged post-vaccination. Becoming vaccinated made people feel safer in addition to being safer.


Receiving at least one vaccine dose was associated with statistically significant declines in multiple psychological distress factors, investigators report in the American Journal of Preventive Medicine (Credit filadendron).

The impact of vaccination on mental health varied by race/ethnicity. The largest reductions in distress were observed among American Indians (AI) and Alaska Native (AN) individuals, who have suffered disproportionately from COVID-19. The breakout among racial/ethnic groups was proportional to the overall US population during the study period, with the highest rates of vaccination observed among Asian and Pacific Islanders, and the lowest rates of vaccination observed among Black participants.

With the rapid rise of the Omicron variant in late 2021 and early 2022, urgent measures are needed to increase vaccination rates and achieve vaccine equity, both locally and globally. These efforts need to be coupled with effective communication about the benefits, both physical and mental, associated with vaccination.

Dr. Koltai stressed, “To ensure these benefits are widely shared, efforts to increase vaccination and booster rates in early 2022 need to prioritize equitable distribution and access to vaccines.”


Notes for editors
The article is“COVID-19 Vaccination and Mental Health: A Difference-In-difference Analysis of the Understanding America Study,” by Jonathan Koltai, PhD, Julia Raifman, ScD, Jacob Bor, ScD, Martin McKee, MD, DSc, and David Stuckler, PhD. ( It appears online in advance of volume 62, issue 5 (May 2022), published by Elsevier.

This article is openly available at

The study was supported by grants from the Cariplo Foundation and the Robert Wood Johnson Foundation.

Full text of this article is also available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734 936 1590 or Journalists wishing to interview the authors should contact Jonathan Koltai, PhD, at

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About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

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Media contact
Jillian B. Morgan, MPH, Managing Editor
+1 734 936 1590