Psychological Stress and Antibody Response to Influenza Vaccination: When Is the Critical Period for Stress, and How Does It Get Inside the Body?

Abstract

Objectives: This study attempted to determine whether stress of moderate intensity could modulate the antibody response to an influenza vaccination in healthy young adults, identify critical periods during which stress could influence antibody response, and delineate behavioral and biological pathways that might explain relations between stress and antibody. Methods: A cohort of 83 healthy young adults underwent 13 days of ambulatory monitoring before, during, and after vaccination. Four times daily, subjects reported the extent to which they felt stressed and overwhelmed and collected a saliva sample that was later used to measure cortisol. A battery of health practices (cigarette smoking, alcohol use, physical activity, sleep hygiene) was assessed daily. Antibody titers to the vaccine components were measured at baseline and at 1-month and 4-month follow-up assessments. Results and Conclusions: To the extent that they reported higher levels of stress across the monitoring period, subjects exhibited poorer antibody responses to the New Caledonia strain of the vaccine. Stress ratings on the 2 days before the vaccine and the day it was given were not associated with antibody response. However, the 10 days afterward appeared to be a window of opportunity during which stress could shape the long-term antibody response to varying degrees. With respect to potential mediating pathways, little evidence emerged in favor of cortisol secretion, alcohol consumption, physical activity, or cigarette smoking. However, analyses were consistent with a pattern in which feelings of stress and loss of sleep become locked into a feed-forward circuit that ultimately diminishes the humoral immune response. These findings may shed light on the mechanisms through which stress increase vulnerability to infectious disease.

Bereavement and marriage are associated with antibody response to influenza vaccination in the elderly

“…Other studies of the antibody response to influenza vaccination have also shown effects that appear only for certain strains (Burns et al, 2003a;Miller et al, 2004;Phillips et al, 2005a;Phillips et al, 2005b;Vedhara et al, 1999a). It is difficult at this stage to determine why particular vaccine strains are sensitive to certain types of psychosocial influence, although differences in strain novelty and participants' prior exposure to each viral strain have been proposed as possible explanations (Vedhara et al, 1999a).…”

“…A regression strategy of this sort using the logged titer data controlling for baseline has been used in a number of recent influenza vaccination studies (Miller et al, 2004;Phillips et al, 2005a;Phillips, Carroll, Burns & Drayson, 2005b;Pressman et al, 2005). Any variations in degrees of freedom reflect occasional missing data.…”

Population Levels of Psychological Stress, Herpesvirus Reactivation and HIV

“…1). Indeed, there is abundant evidence that chronic stressors directly influence the immune system, including enhanced susceptibility to viral and bacterial infections among individuals exposed during human challenge trials and vaccination (Biondi and Zannino 1997;Bonneau et al 2007;Miller et al 2004;Morag et al 1999). If ecologic stressors, such as concentrated disadvantage and segregation, determine the distribution of psychological stress in a community, then it is likely that stress-related changes in immune function may also vary by neighborhood context.…”

Infant Sleep After Immunization: Randomized Controlled Trial of Prophylactic Acetaminophen

“…9 Studies have suggested that sleep quantity is a potential mediator of antibody responses to vaccines in adults, perhaps through stressrelated modulation of cytokine production by activated T cells. 23,24 Although antibody development can take several weeks, 2 studies demonstrated that even relatively brief periods of sleep restriction could disrupt adult antibody responses. 4,24 It was beyond the scope of this study to determine whether infant sleep quantity on a sin- In this RCT, infants were assigned randomly to 3 groups, namely, control mothers with infants who received usual care, intervention mothers with infants who received usual care, and intervention mothers with intervention infants, who were instructed to provide prophylactic and continuing doses of acetaminophen.…”

“…23,24 Although antibody development can take several weeks, 2 studies demonstrated that even relatively brief periods of sleep restriction could disrupt adult antibody responses. 4,24 It was beyond the scope of this study to determine whether infant sleep quantity on a sin- In this RCT, infants were assigned randomly to 3 groups, namely, control mothers with infants who received usual care, intervention mothers with infants who received usual care, and intervention mothers with intervention infants, who were instructed to provide prophylactic and continuing doses of acetaminophen. Although group assignment had no effect on postimmunization sleep in intent-to- The dependent variable was increased infant sleep in the 24 hours after immunization, compared with the 24 hours before immunization.…”