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Ehrlich KB, Lyle SM, Corallo KL, Lavner JA, Ross TM. Changes in depressive symptoms and antibody production following influenza vaccination in adolescents and adults. Vaccine 2024; 42:3585-3591. [PMID: 38702230 PMCID: PMC11128339 DOI: 10.1016/j.vaccine.2024.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE Psychological distress has been associated with dampened antibody production following vaccination. Questions remain, however, about whether psychological distress influences vaccine response uniformly across the lifespan, and whether changes in distress result in changes in antibody production across the same period. METHODS Participants (N = 148; Mage = 32.2 years, SD = 19.7, range = 12-80 years) took part in consecutive vaccine studies during the 2017-2018 and 2018-2019 influenza seasons. Each influenza season, they reported on their depressive symptoms, provided blood samples, and received the standard influenza vaccine. Participants then provided a second blood sample one month later. Antibody titers were examined pre- and post-vaccination. RESULTS Analyses examined both within-season and across-season effects of depressive symptoms, age, and their interaction on vaccine response. Within-season analyses revealed that age predicted antibody response during both seasons (2017-2018 and 2018-2019). Neither depressive symptoms nor the interaction with age were associated with antibody response to vaccination within either season. Across the two seasons, age significantly moderated the association between change in depressive symptoms and change in antibody production. For people who were 48 or older, increases in depressive symptoms across the two seasons were associated with a less robust response to the vaccine in the second season relative to the first season. For people younger than 48, changes in depressive symptoms were not significantly related to changes in antibody production. CONCLUSIONS These findings highlight the important role of mental health for older adults' vaccine response, which could have clinical relevance for protection against disease.
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Affiliation(s)
- Katherine B Ehrlich
- Department of Psychology, University of Georgia, Athens, GA 30602, USA; Center for Family Research, University of Georgia, Athens, GA 30602, USA.
| | - Sarah M Lyle
- Psychology Discipline, Eckerd College, St. Petersburg, FL, USA
| | - Kelsey L Corallo
- Georgia Health Policy Center, Georgia State University, Atlanta GA, USA
| | - Justin A Lavner
- Department of Psychology, University of Georgia, Athens, GA 30602, USA
| | - Ted M Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA; Department of Infectious Diseases, University of Georgia, Athens, GA, USA
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Grignoli N, Petrocchi S, Polito A, Gagliano V, Sallusto F, Uguccioni M, Gabutti L. The interplay between previous infection and mental health condition on antibody response to COVID-19 mRNA vaccination. Brain Behav Immun Health 2023; 33:100677. [PMID: 37701787 PMCID: PMC10493882 DOI: 10.1016/j.bbih.2023.100677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/06/2023] [Accepted: 08/21/2023] [Indexed: 09/14/2023] Open
Abstract
Increasing evidence has been pointing towards the existence of a bi-directional interplay between mental health condition and immunity. Data collected during the COVID-19 outbreak suggest that depressive symptoms may impact the production of antibodies against SARS-CoV-2, while a previous infection could affect the immune response and cause neuropsychological disturbances. A prospective observational study was designed to investigate the association between mental health conditions and immune response over time. We analyzed the mental health at baseline and the antibodies before and after immunization with the COVID-19 mRNA vaccine in a cohort of healthcare professionals in southern Switzerland. One-hundred and six subjects were enrolled. Anxiety, distress and depression correlated to each other. There were no correlations between the mentioned variables and the vaccine induced IgG antibodies against the receptor binding domain (RBD) of the spike protein. For those who had a previous COVID-19 infection, the antibodies increased according to the grade of depression. For those who did not, the anti-RBD IgG levels remained similar when comparing presence or absence of depression symptoms. Our results show that previous SARS-CoV-2 natural infection in subjects with mental health conditions enhances the immune response to COVID-19 mRNA vaccination. The correlation between immune response to COVID-19 vaccination, a previous exposure to the virus, and symptoms of mood disorders, makes it necessary to explore the direction of the causality between immune response and depressive symptoms.
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Affiliation(s)
- Nicola Grignoli
- Department of Internal Medicine, Regional Hospital of Bellinzona and Valleys, Ente Ospedaliero Cantonale, Bellinzona and Università della Svizzera italiana, Lugano, Switzerland
- Cantonal Sociopsychiatric Organisation, Public Health Division, Department of Health and Social Care, Repubblica e Cantone Ticino, Mendrisio, Switzerland
| | - Serena Petrocchi
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Andrea Polito
- Department of Anesthesiology, Regional Hospital of Mendrisio and Università della Svizzera italiana, Lugano, Switzerland
| | - Vanessa Gagliano
- Department of Internal Medicine, Regional Hospital of Bellinzona and Valleys, Ente Ospedaliero Cantonale, Bellinzona and Università della Svizzera italiana, Lugano, Switzerland
| | - Federica Sallusto
- Institute of Microbiology, ETH Zurich, Zurich, Switzerland
- Institute for Research in Biomedicine, Università della Svizzera italiana, Bellinzona, Switzerland
| | - Mariagrazia Uguccioni
- Institute for Research in Biomedicine, Università della Svizzera italiana, Bellinzona, Switzerland
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luca Gabutti
- Department of Internal Medicine, Regional Hospital of Bellinzona and Valleys, Ente Ospedaliero Cantonale, Bellinzona and Università della Svizzera italiana, Lugano, Switzerland
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Whittaker AC, De Nys L, Brindle RC, Drayson MT. Physical activity and sleep relate to antibody maintenance following naturalistic infection and/or vaccination in older adults. Brain Behav Immun Health 2023; 32:100661. [PMID: 37456624 PMCID: PMC10344668 DOI: 10.1016/j.bbih.2023.100661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Health behaviours such as being physically active and having good quality sleep have been associated with decreased susceptibility to infection and stronger antibody responses to vaccination. Less is known about how such factors might influence the maintenance of immunity following naturalistic infection and/or prior vaccination, particularly among older adults who may have formed initial antibodies some time ago. This analysis explored antibody levels against a range of common infectious diseases in 104 older adults (60 women) aged 65+ years, and whether these relate to self-reported physical activity (PA) and sleep. PA and sleep were measured subjectively through standardized questions. Antibody levels to a range of common pathogens, including pneumococcal (Pn) and meningococcal (Men) serotypes, Haemophilus influenza type b, diphtheria, and tetanus were assayed using Multiplex technology. Higher PA at baseline related to higher antibody levels against three Pn serotypes and MenY, and higher PA at one month with higher levels against six Pn serotypes. Longer time in bed related to higher antibody levels against Pn4, and longer sleep related to higher levels against Pn19f. More difficulty staying awake in the day related to lower antibodies against Pn19a, Pn19f, MenA and MenY, and more frequent daytime napping related to lower levels against three Pn serotypes and MenY. Using clinically protective antibody thresholds as an outcome showed similar results for PA, but effects for sleep became non-significant, with the exception of time in bed. This extends beyond existing literature demonstrating associations between PA and sleep and peak antibody response to vaccination to antibody maintenance. Longitudinal research with objective measures of health behaviours is warranted.
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Affiliation(s)
| | - Len De Nys
- Faculty of Health Sciences and Sport, University of Stirling, UK
| | - Ryan C. Brindle
- Department of Cognitive and Behavioural Science & Neuroscience Program, Washington and Lee University, USA
| | - Mark T. Drayson
- Institute of Immunology and Immunotherapy, University of Birmingham, UK
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COVID-19 seroprevalence after the first UK wave of the pandemic and its association with the physical and mental wellbeing of secondary care healthcare workers. Brain Behav Immun Health 2022; 24:100492. [PMID: 35957800 PMCID: PMC9355737 DOI: 10.1016/j.bbih.2022.100492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/14/2022] [Accepted: 07/18/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives To determine the seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) antibody status amongst healthcare workers (HCWs) working through the first wave of the Coronavirus (COVID-19) pandemic in 2020. To examine the association of seroprevalence and self-reported COVID-19 symptoms with occupation, sex, and ethnicity; and how these factors were associated with physical and mental wellbeing. Design Single-centre cohort study. Setting Large public hospital in the United Kingdom. Intervention All HCWs who had been tested for anti-SARS-CoV-2 immunoglobulin (Ig) G nucleocapsid antibody in summer 2020 were asked to complete an electronic survey focusing on their physical and mental health in Winter 2020-21. This survey was comprised of the Short Form 12v2, Physical Component Summary (PCS), Mental Component Summary (MCS), and Generalised Anxiety Disorder 7-item (GAD-7) questionnaires. Results 7604/9781 (77.7%) HCWs were antibody tested, of which 1082 completed the full survey. Antibody testing was conducted between 17/06/20-30/07/20, during which time our seroprevalence rate was 28% (299/1082). Of those self-reporting COVID-19 symptoms, 51% (201/395) were antibody positive. Antibody-positive participants had lower PCS scores (p = 0.016), indicating poorer physical health. Lower PCS scores were also found in those deemed high risk for COVID-19 by their GP (p = 0.001), and those aged >44 years (p = 0.009). Antibody-negative participants had lower MCS scores (p = 0.044), indicating poorer mental health. Those who self-reported COVID-19 symptoms had lower PCS scores (p=<0.001) than those with no symptoms. Lower MCS scores were found in women (p = 0.001), Caucasians (p = 0.018), non-clinicians (p = 0.001), and those aged <44 years (p = 0.009). Significantly higher GAD-7 anxiety scores were evident in staff aged <44 years (p = 0.023), and those with self-reported COVID symptoms (p = 0.031). Doctors had lower GAD-7 anxiety scores (p = 0.009). Conclusion Self-reported symptoms did not correlate with seroprevalence; data surrounding this can be useful for future workforce planning. Interventions are needed to reduce the mental and physical burden of the pandemic on HCWs. Further work is needed to identify which particular HCWs may require further support, to ensure well-being and effective patient care. Trial registration Sponsor Protocol number - 2020COV112, Clinicaltrials.gov number -NCT04527432.
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Gallagher S, Howard S, Muldoon OT, Whittaker AC. Social cohesion and loneliness are associated with the antibody response to COVID-19 vaccination. Brain Behav Immun 2022; 103:179-185. [PMID: 35470012 PMCID: PMC9027289 DOI: 10.1016/j.bbi.2022.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/29/2022] [Accepted: 04/20/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Recent research has suggested that psychosocial factors influence the antibody response to vaccine, including SARS-CoV-2 (COVID-19) vaccines. Here we investigated whether social cohesion and loneliness were predictive of antibody response to a single dose of a COVID-19 vaccine. We also tested if the association between social cohesion and antibody response was mediated by feelings of loneliness. METHODS Participants (N = 676) COVID-19 antibody data were extracted from March 2021 wave of the Understanding Society COVID-19 study from the UK. Relevant socio-demographics, health and lifestyle, loneliness, social cohesion indices were also used in a series of hierarchical linear regression to test our main hypotheses. RESULTS After controlling for covariates (e.g., age and chronic health conditions), lower social cohesion was associated with a lower antibody response. Further, the association between social cohesion and poorer antibody responses was mediated by loneliness; those reporting lower social cohesion also reported higher loneliness, which in turn was associated with lower antibody response. CONCLUSION This study confirms that feelings of 'being in it together' relate to the strength of the antibody response to COVID-19 vaccination, emphasising the importance of the social cohesion agenda during the pandemic.
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Affiliation(s)
- Stephen Gallagher
- Centre for Social Issues, Department of Psychology, University of Limerick, Castletroy, Limerick, Ireland; Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.
| | - Siobhán Howard
- Centre for Social Issues, Department of Psychology, University of Limerick, Castletroy, Limerick, Ireland; Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
| | - Orla T Muldoon
- Centre for Social Issues, Department of Psychology, University of Limerick, Castletroy, Limerick, Ireland
| | - Anna C Whittaker
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Whittaker AC, Gallagher S, Drayson M. Time of day of vaccination does not relate to antibody response to thymus-independent vaccinations. Vaccine X 2022; 11:100178. [PMID: 35719326 PMCID: PMC9204387 DOI: 10.1016/j.jvacx.2022.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/11/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Abstract
Variable responses to vaccination are of historical and current concern, particularly among vulnerable groups. Biochemical and behavioural methods of improving vaccination response have been examined. There is some evidence that vaccinating in the morning could enhance vaccine responses, however, this has consistently been shown in thymus-dependent vaccinations, such as influenza. The present analysis of data from two observational studies of the association between psychosocial factors and vaccination response. These data included response to a thymus-independent vaccination - pneumococcal polysaccharide vaccine, examined morning versus afternoon vaccine administration in 75 healthy young adults and 61 parents, including 32 caregivers of a child with a development disability and 29 control parents. In both datasets, timing of vaccination was not related to antibody response. This suggests that effects of time of day may be limited to thymus-dependent vaccinations although replication in a large randomised controlled trial using other thymus-dependent vaccinations is required.
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Affiliation(s)
- Anna C. Whittaker
- Faculty of Health Sciences & Sport, University of Stirling, UK,School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK,Corresponding author at: Faculty of Health Sciences & Sport, University of Stirling, Scotland FK4 1UG UK.
| | | | - Mark Drayson
- Institute of Immunology and Immunotherapy, School of Medicine, University of Birmingham, UK
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Maternal Distress and Social Support Are Linked to Human Milk Immune Properties. Nutrients 2021; 13:nu13061857. [PMID: 34072410 PMCID: PMC8226629 DOI: 10.3390/nu13061857] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 12/31/2022] Open
Abstract
Possible alterations of maternal immune function due to psychological stress may reflect immunoactive factor levels in breast milk. This study aimed to assess the association between maternal distress and breast milk levels of secretory IgA (SIgA), IgM, IgG, and lactoferrin (LF). We hypothesized that this association is moderated by maternal social support achieved from others during lactation. The study group included 103 lactating mothers and their healthy five-month-old infants. Maternal distress was determined based on the State Anxiety Inventory and the level of salivary cortisol. Social support was assessed using the Berlin Social Support Scales. Breast milk samples were collected to test for SIgA, IgM, IgG, and LF using the ELISA method. Milk immunoactive factors were regressed against maternal anxiety, social support, salivary cortisol, and infant gestational age using the general regression model. Maternal anxiety was negatively associated with milk levels of LF (β = -0.23, p = 0.028) and SIgA (β = -0.30, p = 0.004), while social support was positively associated with milk IgG (β = 0.25, p = 0.017). Neither anxiety nor social support were related to milk IgM. No association was found between the level of maternal salivary cortisol and immunoactive factors in milk. Our results suggest that maternal psychological wellbeing and social support may affect milk immune properties.
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Pathways to well-being: Untangling the causal relationships among biopsychosocial variables. Soc Sci Med 2021; 272:112846. [DOI: 10.1016/j.socscimed.2020.112846] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 12/30/2019] [Accepted: 02/08/2020] [Indexed: 02/07/2023]
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Dowd JB, Fletcher HA, Boccia D. Social determinants and BCG efficacy: a call for a socio-biological approach to TB prevention. F1000Res 2018; 7:224. [PMID: 29904590 PMCID: PMC5974585 DOI: 10.12688/f1000research.14085.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 01/14/2023] Open
Abstract
A high burden of TB mortality persists despite the long-term availability of the bacillus Calmette-Guérin (BCG) vaccine, whose efficacy has been highly variable across populations. Innovative and alternative approaches to TB prevention are urgently needed while optimal biomedical tools continue to be developed. We call for new interdisciplinary collaborations to expand and integrate our understanding of how social determinants influence the biological processes that lead to TB disease, how this translates into differential BCG efficacy and, ultimately, how social protection interventions can play a role in reducing the global burden of TB. After providing an overview of the immune pathways important for the establishment of a response to the BCG vaccine, we outline how social determinants and psychosocial stressors can contribute to the observed variation in BCG efficacy above and beyond these biological factors. We conclude by proposing a new interdisciplinary research model based on the integration of social epidemiology theories with biomedical knowledge.
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Affiliation(s)
- Jennifer B. Dowd
- Department of Global Health and Social Medicine, King’s College London, London, UK
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Helen A Fletcher
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, UK
| | - Delia Boccia
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Lucas SJ, Breen L, Phillips AC. Exercising our brains, muscles and cells to fight the ageing process. Sci Prog 2015; 98:413-5. [PMID: 26790179 PMCID: PMC10365453 DOI: 10.3184/003685015x14467218232110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Samuel J.E. Lucas
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Leigh Breen
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Anna C. Phillips
- School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
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