Association of Covid19 Vaccine with Mental Health Illness (Depression and Anxiety) and General Health Outcomes Among Older Adults in Lebanon Using Data from LSAHA: A Cross-sectional Study

Abstract

Background: The long-term mental and physical health effects of the COVID-19 vaccine remain unclear, particularly among older adults due to their high vulnerability and the presence of mixed study findings. In Lebanon, ongoing crises may further complicate this relationship. Objectives: This study investigates the association between COVID-19 vaccination and mental health (depression and anxiety) as well as self-rated health (SRH) among older adults in Lebanon. Additionally, it assesses whether social support modifies this relationship. Methods: Data were obtained from the population-based Lebanon Study on Aging and Health (LSAHA), including Lebanese adults aged 60+, with 2,874 respondents answering the COVID-19 vaccination question. Validated measures, EURO-D (depression), GAD-7 (anxiety), IQCODE (cognitive status), and mMOS-SS (social support), were used. Survey-weighted multivariable logistic regression was applied, with a Bonferroni-adjusted significance threshold (p < 0.0167). Results: The vaccination rate was 84%. In unadjusted models, vaccination was associated with lower odds of depression (OR 0.65, 95% CI: 0.49 – 0.85), but this association was no longer significant after adjusting for socioeconomic and health factors (aOR 0.80, 95% CI: 0.61 – 1.06). No significant associations were found with anxiety or poor self-rated health after adjustment. Vaccinated individuals had 37% lower odds of worse cognitive status (aOR 0.63, 95% CI: 0.43 – 0.92). Additionally, a significant interaction between vaccination and social support for SRH was found; among those with low social support, vaccination was linked to higher odds of poor self-rated health. (OR 1.53, 95% CI: 1.01 – 2.33, p = 0.045) Discussion: These findings suggest a "healthy vaccinee effect," in which vaccination status reflects social stability and health literacy more than it directly determines mental health outcomes. The association with cognitive status may indicate "cognitive vulnerability," as individuals with dementia face barriers to vaccination. The interaction with social support highlights that, for some older adults, clinical interventions such as vaccination may be perceived as additional stressors in the absence of strong support networks.