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Record W4406189737 · doi:10.1371/journal.pone.0313157

Relationship between mental health and substance abuse on COVID-19 vaccine hesitancy in youth: A mixed methods longitudinal cohort study

2025· article· en· W4406189737 on OpenAlexafffund
Louis Everest, Joanna Henderson, Clement Ma, Matthew Prebeg, Jacqueline Relihan, Lisa D. Hawke

Bibliographic record

VenuePLoS ONE · 2025
Typearticle
Languageen
FieldSocial Sciences
TopicVaccine Coverage and Hesitancy
Canadian institutionsUniversity of TorontoCentre for Addiction and Mental Health
FundersCanadian Institutes of Health Research
KeywordsMental healthLongitudinal studyPandemicMedicineOddsSubstance useAdolescent healthYoung adultLogistic regressionOdds ratioSubstance abuseCoronavirus disease 2019 (COVID-19)Family medicinePsychologyPsychiatryGerontologyNursingDiseaseInternal medicineInfectious disease (medical specialty)

Abstract

fetched live from OpenAlex

BACKGROUND: Mental health and substance use challenges are highly correlated in youth and have been speculated to be associated with COVID-19 vaccine hesitancy. Literature has also suggested that mental health challenges in youth have increased during the COVID-19 pandemic. However, the longitudinal relationship between mental health challenges in youth and COVID-19 vaccine hesitancy is not well established. OBJECTIVE: We examined the relationship between mental health, substance use and COVID-19 vaccine hesitancy in youth during the COVID-19 pandemic. METHODS: Youth ages 14 to 29-years participated in a longitudinal survey study. Participants provided sociodemographic, mental health, and substance use data, as well as qualitative and quantitative information on their vaccine perspectives every two months between February 2021 to August 2021, and on February 2022. Generalized estimating equation logistic regression models were used to analyze the effect of mental health and substance use on vaccine hesitancy over time. Qualitative content area analyses were used to identify trends in vaccine attitudes. RESULTS: Mental health challenges and substance use frequency were associated with vaccine hesitancy, and significantly increased the odds of vaccine hesitancy over time. Additionally, mental health challenges were associated with decreases in vaccine hesitancy (OR: 0.80 (95% CI 0.66, 0.97)) when vaccines first began to emerge, but increases in vaccine hesitancy (OR: 1.72 (95% CI 1.32, 2.26)) one year later. Participants reported perceptions regarding vaccine safety and efficacy were the primary determinants influencing hesitant, uncertain, and acceptant vaccine attitudes. Additionally, changes in vaccine attitudes over time for some participants, were associated with changes in mental health. CONCLUSIONS: Increases in mental health challenges and substance use were associated with increases in COVID-19 vaccine hesitancy in youth over the COVID-19 pandemic. Health policy agencies should be aware of the potential impact of mental health challenges and substance use in youth, when developing vaccine policy and programs.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.004
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.039
Threshold uncertainty score0.077

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0030.004
Meta-epidemiology (narrow)0.0000.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0010.000
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.152
GPT teacher head0.406
Teacher spread0.254 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations2
Published2025
Admission routes2
Has abstractyes

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