Severe mental illness and European COVID-19 vaccination strategies

The EU advises prioritising vaccination for people whose health makes them particularly at risk for severe COVID-19, but leaves it to member states to decide which medical conditions get prioritised. Ethical, neuroscientific, and public health considerations have been used to prioritise individuals with severe mental illness (ie, psychotic disorders, bipolar disorders, and severe major depressive disorders).1–3 We systematically reviewed national COVID-19 vaccine deployment plans across 20 European countries (appendix p 1–2).
Eight of 20 countries explicitly mentioned psychiatry or mental illness in their national vaccine strategy documents. Several countries prioritised institutional residents, which can include people with severe mental illness (table). Only four countries (Denmark, Germany, the Netherlands, and the UK) had some form of higher vaccination priority for outpatients with severe mental illness. Additionally, Latvia, Romania, Spain, and Sweden prioritised outpatients with disabilities, possibly including severe mental illness, whereas the Czech Republic and Sweden specified behavioural or mental problems interfering with pandemic regulation adherence as priority indication.