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Depression Linked to Belief in Misinformation About COVID-19 Vaccines

Key findings

  • This analysis used data from a nationally representative U.S. survey of 15,464 adults to examine the association between depression and susceptibility to misinformation about COVID-19 vaccines
  • Individuals who reported moderate or severe depressive symptoms were two-fold more likely than others to say statements of misinformation about the vaccines were accurate
  • This discrepancy persisted even after taking into account the respondents' sociodemographic characteristics, political ideology, political party affiliation, social media use, sources of COVID-19 news and willingness to trust physicians and scientists
  • In a subset of 2,809 people who re-took the survey, those who had depression the first time were 72% more likely than others to label even more misinformation as accurate—so depression probably preceded their misinformed status rather than causing it
  • Addressing depressive symptoms might reduce the number of individuals who accept misinformation and let it influence their decisions about vaccination

There's ample evidence that in a variety of situations, adults display "negativity bias"—a tendency to pay more attention to negative information than positive information. For example, many people—particularly those with depression and other mood disorders—remember and focus on a criticism more than a compliment.

Negativity bias is relevant to COVID-19 vaccine misinformation because the myths and falsehoods about the vaccines are meant to elicit fear, anxiety and other negative emotions.

Roy Perlis, MD, MSc, associate chief for research in the Department of Psychiatry, and director of the Center for Quantitative Health in the Division of Clinical Research at Massachusetts General Hospital, and colleagues recently found in a nationwide survey that individuals with moderate or severe depression are more receptive than others to COVID-19 vaccine misinformation. Their report appears in JAMA Network Open.

Study Methods

The researchers have posted an internet survey for adults every six weeks since April 2020. Participants aren't aware it focuses on COVID-19. The survey applies quotas and weighting to approximate the U.S. adult population in each state.

This analysis of survey data included 15,464 adults who responded between April 1 and May 3, 2021. The survey included the Patient Health Questionnaire–9, and 27% of respondents had a score ≥10, indicating at least moderate depressive symptoms.

Respondents were asked to indicate whether the following statements are accurate or inaccurate (or say they were unsure): "The COVID-19 vaccines…":

  • "…will alter people's DNA"
  • "…contain microchips that could track people"
  • "…contain the lung tissue of aborted fetuses"
  • "…can cause infertility, making it more difficult to get pregnant"

19% of respondents said at least one of those statements was accurate. (Participants were informed at the end of the survey that all items are untrue, lest the survey itself spread misinformation.)

Depression and Misinformation

The presence of depression doubled the odds that a respondent would believe misinformation. This was true even after the research team accounted for age, gender, race/ethnicity, level of education, zip code, ideology (seven-point scale, extremely liberal to extremely conservative), and political party affiliation.

Other Considerations

The association between depression and misinformation was changed by less than 10% when the researchers also accounted for:

  • Social media use (Twitter, Facebook, TikTok and Instagram)
  • Sources of COVID-19 information within the past 24 hours (Biden administration, CNN, Facebook, Fox News, MSNBC and Newsmax)
  • Trust in institutions (CDC, FDA, White House), hospitals and physicians, scientists, and news media

Effect of Misinformation on Vaccination Status

Respondents who agreed with at least one untruth about COVID-19 vaccines were significantly less likely than others to:

  • Be vaccinated (55% less likely)
  • Have a vaccinated family member (45% less likely)
  • Be willing to ever get vaccinated (2.7 times less likely)

Which Comes First, Depression or Believing Misinformation?

The researchers analyzed a subgroup of 2,809 participants who re-took the survey between June 9 and July 7, 2021. Those who reported depressive symptoms the first time were 72% more likely than other respondents to show an increase in the number of misinformation items they considered accurate.

Since depression preceded misinformation, it's unlikely that believing in misinformation caused the depression.

Implications for Clinicians and Public Health Officials

The subgroup analysis suggests future research may be able to establish a causative relationship between depression and susceptibility to misinformation about COVID-19 vaccines. By treating depression, it may be possible to diminish negativity bias and, in turn, reduce the number of people who ruminate about misinformation, spread it and let it affect their decisions about vaccination.

of U.S. adults consider at least one statement of misinformation about COVID-19 vaccines to be accurate

greater odds of vaccine resistance among U.S. adults who consider misinformation about COVID-19 vaccines to be accurate

greater odds, compared with nondepressed adults, that U.S. adults who report at least moderate symptoms of depression consider misinformation about COVID-19 vaccines to be accurate

greater odds, compared with nondepressed adults, that U.S. adults who report at least moderate symptoms of depression will come to believe a greater amount of misinformation about COVID-19 vaccines over time

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Roy H. Perlis, MD, MSc, of the Department of Psychiatry, and colleagues compared features of major depressive disorder in individuals with or without prior COVID-19. They found indirect evidence that symptoms are a sequela of COVID-19 pathophysiology in a subset of individuals.