Experts Warn Depression, Stress Could Lessen Efficacy of COVID-19 Vaccines

Based on earlier research showing that depression, stress, loneliness, and poor health behaviors can weaken the body’s immune system and lower the effectiveness of certain vaccines, a new report suggests that the same may be true for the coronavirus disease 2019 (COVID-19) vaccines.

Vaccines are among the safest and most effective advances in medical history, according to the report published in Perspectives on Psychological Science. Their success, however, depends on ensuring that a critical percentage of the population is effectively vaccinated to achieve herd immunity.

Despite rigorous testing showing that the COVID-19 vaccines approved for distribution in the United States are highly effective and safe, not all recipients will experience the full benefit. Environmental and genetic factors, as well as factors such as physical and mental health, can weaken the body’s immune system and slow the response to the vaccine.

These effects are concerning as COVID-19 continues to spread, triggering a concurrent mental health crisis caused by isolation, economic stress, and uncertainty about the future. These stressors are the same factors that have been shown in earlier research to weaken vaccine efficacy, particularly among elderly patients. Fortunately, the report authors said it is possible to reduce these negative effects with simple steps like exercise and sleep.

“In addition to the physical toll of COVID-19, the pandemic has an equally troubling mental health component, causing anxiety and depression, among many other related problems,” said lead author Annelise Madison, a PhD candidate at Ohio State University, in a press release. “Emotional stressors like these can affect a person’s immune system, impairing their ability to ward off infections. Our new study sheds light on vaccine efficacy and how health behaviors and emotional stressors can alter the body’s ability to develop an immune response. The trouble is that the pandemic in and of itself could be amplifying these risk factors.”

Vaccines work by creating an innate, general immune response on the cellular level as the body recognizes a potential biological threat. This response is eventually helped by the production of antibodies, which target specific pathogens. The continued production of antibodies helps determine how effective a vaccine is at conferring long-term protection.

“In our research, we focus most heavily on the antibody response, though it is just one facet of the adaptive immune system’s response,” said senior author Janice Kiecolt-Glaser, PhD, director of the Institute for Behavioral Medicine Research at Ohio State University, in a press release.

According to the researchers, the good news is that the COVID-19 vaccines already in circulation are approximately 95% effective. However, these psychological and behavioral factors can lengthen the amount of time it takes to develop immunity and can shorten the duration of effectiveness.

“The thing that excites me is that some of these factors are modifiable,” Kiecolt-Glaser said. “It’s possible to do some simple things to maximize the vaccine’s initial effectiveness.”

The researchers noted that one potential strategy could be to engage in vigorous exercise and get a good night’s sleep in the 24 hours before vaccination, to ensure the immune system is operating at peak performance. This may help encourage the best and strongest immune response.

“Prior research suggests that psychological and behavioral interventions can improve vaccine responsiveness,” Madison concluded. “Even shorter-term interventions can be effective. Therefore, now is the time to identify those at risk for a poor immune response and intervene on those risk factors.”

REFERENCE

Depression and Stress Could Dampen Efficacy of COVID-19 Vaccines: Interventions and Health Behavior Changes Could Boost Immunity [news release]. Association for Psychological Science; January 13, 2021. Accessed January 19, 2021. https://www.psychologicalscience.org/news/releases/2021-jan-depression-covid-vaccines.html