Can sleep or stress harm your COVID-19 vaccination?

COVID-19 vaccines are enormously effective in repelling the deadly virus. Is there a way to make them even better?

To learn more, a major new study from UC San Francisco is recruiting 600 Bay Area residents to investigate whether a range of predictive factors – such as age, sleep, stress and emotional well-being – can influence the power and persistence of defenses of our body.

“We are measuring factors that can lead to a more robust response, as well as factors that we believe will decrease or weaken the antibody response,” said Elissa Epel, professor of psychiatry at UCSF, co-investigator on the Building Optimal Antibodies Study project.

There may be ways to make up for the vaccine’s deficiencies, recruiting emotional, behavioral or other interventions, according to the research team.

In a race against time, the United States is running to expand access to the precious COVID-19 vaccines. As of Friday, about 17% of Americans had been vaccinated.

Although very good, they are not perfect. A two-dose regimen for Pfizer and Moderna vaccines prevents 92.6% of infections two weeks after the second injection. Johnson & Johnson’s injection is 72% effective.

In some rare cases, people can still develop COVID-19, despite the vaccination. The California Department of Public Health has not released the number of so-called “innovative cases”, but said it is studying where and how often they occur.

Vaccines are designed to give the immune system a lasting memory of viral components so that it can attack when confronted with the real pathogen. He responds by implanting T cells, which identify and kill infected cells, and B cells, which produce antibodies that bind to the virus so that it does not enter the cell.

But experience with other vaccines shows that not everyone responds equally well. And our defenses weaken at different rates. Although new evidence shows that the Pfizer vaccine is effective for at least six months, its long-term durability is not known.

By measuring antibodies and T cells over time, “this study will help us understand the ‘time course’ of people’s responses,” said Aric Prather, associate professor in the Department of Psychiatry and co-investigator of the UCSF study.

“What are the factors in our lives that can really contribute and create an improved response?” he said. “Or maybe it puts people at risk, through a suboptimal response?”

For example, age is known to play a role. The flu vaccine is about 70% to 90% effective in young adults – but less than 55% effective in the elderly, according to the United States Centers for Disease Control and Prevention. As we get older, there is a decline in the number, activity and diversity of immune T-protective cells, a process that scientists call “immunosenescence”. At 50, our T-cell production is less than 10% of its peak.

Insufficient sleep is another indicator of how well our immune system responds to vaccination, according to Prather. Sleepless nights have been shown to increase a person’s susceptibility to developing a common cold. It also silences the body’s response to flu and hepatitis vaccines.

“When people don’t get the sleep they need, they are unable to build the army of T cells that are important to protect us from viruses,” said Prather.

Chronic stress is also known to impair the antibody response to a flu vaccine. Stress – like the death of a loved one, financial loss and stress from parents due to school closings – can alter the hormones that regulate the immune system.

“The adrenaline response to stress is useful for us – but if it is too extreme during the vaccination time, it can interfere with the molecular pathways of the immune response,” said Epel.

The team is making a specific call to include people of color, overwhelmed by both stress and discrimination, to see if these factors influence the response to the vaccine.

Obesity is associated with a weakened immune response to the COVID-19 virus. And vaccines for other infections often don’t work well in overweight people, suggesting that the COVID-19 vaccine may not be fully protective.

A person’s genetics, or the underlying health, can also play a role, according to Dr. Monica Gandhi of UCSF. For example, individuals who are highly immunocompromised may have a more blunt response.

All of this can mean potential problems for a COVID-19 vaccine.

Study volunteers will complete questionnaires over a six-month period. They will be asked about their state of mind, several times a day. They will also ask questions like, “What was the most stressful thing that happened to you today?” “How many hours did you sleep last night?” “How did you feel the quality of your sleep last night?”

Only unvaccinated people can participate. UCSF cannot provide the vaccine as part of the study, so volunteers must be inoculated elsewhere.

Your blood will be tested at three different times: before vaccination, one month after the second vaccination and six months after the second vaccination. They will receive up to $ 300 to complete all aspects of the study.

In the blood, scientists will measure the response of the immune system, counting the levels of antibodies and T cells. We still don’t know exactly how many cells are needed to guarantee protection, Epel said. But it is possible to assess the general vigor of an immune response.

The team will also measure the volunteers’ telomeres, the protective caps at the ends of the chromosomes. Longer telomeres indicate a younger immune system, with cells that can divide more robustly when exposed to antigens. The shorter telomere length has been associated with more severe infections with a cold virus and a poorer antibody response to influenza vaccination.

This information will be kept confidential, according to the team. It will be “unidentified,” meaning that it will be kept separate from a person’s name, phone number or email, and no one outside the study team will have access to the records, including their employer.