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COVID-19 vaccines also depend on our head

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Kuldeep Singh
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As countries carry out their vaccination campaigns against COVID-19, the world population sees a closer end to the pandemic. However, studies reveal that a person’s immune response to inoculation can be affected in cases of stress and depression, among other mental disorders.

In addition to the health problems and economic crises involved, one of the most talked about issues under the COVID-19 pandemic has been its long number of consequences on people’s mental health.

Isolation and confinement raised concern among mental health professionals due to the medium-term consequences, they can have on people. Anxiety, depression, and stress are some of the most frequently mentioned mental disorders. Suicide, on the other hand, is another element that has set off alarms internationally.

To make matters worse, since the beginning of the pandemic, critical mental health services have been interrupted or stopped in 93% of countries around the world, despite the fact that the demand for mental health is increasing, as reported by the WHO in October.

Against this background, an irony arises: mental illnesses can negatively affect the immune response that a body generates to the vaccine for COVID-19. In other words, excess stress, depression, and anxiety can play a dirty trick and make it difficult for the dose you receive to be effective.

This has been indicated by a review of 49 human vaccine studies from the last 30 years, prepared by researchers at Ohio State University. The results of these studies that indicate that mental disorders “may negatively affect the body’s immune response to vaccination”, and suggest “improving (mental) health factors” to improve that response. 

How can mental health affect the effectiveness of vaccines?

In the papers reviewed, the researchers identified three categories of problematic immune responses in people suffering from mental illness: “interference with the development of antibodies against the pathogen, more rapid erosion of antibody protection that develops, or intensification of the side effects of vaccination”.

“When we think of vaccine efficacy, we often think of the vaccine itself. My motivation was to draw attention to the fact that we bring important factors to the table as well – and those factors are modifiable,” said the lead author of the study, Annelise Madison. 

For this reason, the researcher reiterated that the more the person works on their mental health, the greater will be “the opportunity to make our response to the vaccine faster, more solid and lasting.” But how does this work?

In short, the studies included in this review point out the relevance of the psychological factors that operate in the behavior of the immune system against different types of vaccines: influenza, hepatitis B, typhoid fever and pneumonia. Although there were no studies on the SARS-CoV-2 vaccine, similar findings in several vaccines make it possible to consider that SARS-CoV-2 vaccine can give the same results. 

An illustrative example? A study on the hepatitis B vaccine showed that patients who manifested more stress and anxiety took longer than those who did not to develop antibodies

An another study carried out on older adults vaccinated against pneumococcal pneumonia showed that although all the participants initially developed antibodies in the same way, after months those living with spouses with dementia saw their response levels very low, due to the stress involved in caring for people in that situation. In both cases, mental disorders interfered with the immune response, as indicated by the first category.

“These findings suggest that with the COVID-19 vaccine, when people are more stressed and more anxious, it may take a little longer to develop antibodies, so they should probably allow a little more time before they assume they’re protected,” said Janice Kiecolt-Glaser, director of the Ohio State Behavioral Medicine Research Institute and professor of psychiatry and psychology at the School of Medicine. 

Another possibility—the second category identified by the team of researchers—is that stress erodes protection more quickly. One example suggested by this study found that only 20% of older adults who are under stress develop antibodies after being vaccinated against the flu.

Finally, another negative effect can be triggered by poor mental health: side effects are more likely to appear in a person who does enjoy emotional balance. 

On this, they recalled a study that showed that patients suffering from depression experienced after vaccination side effects such as lethargy, discomfort and irritability for longer than those without depression. 

Still, scientists remember that side effects are normal, and not entirely bad. “The side effects come from an inflammatory response to the vaccine, which is good,” Kiecolt-Glaser said. 

“It is one of the reasons why we know that the vaccine is effective. On the other hand, the absence of a response does not mean it is not effective”.

Tips for getting vaccinated 

If it’s not your turn to get vaccinated against COVID-19, or any other disease, and you’re afraid of any of these conditions, perhaps some of these tips will help you. Getting a massage, writing what we feel, exercising —especially arm movements 25 minutes before the injection—are ways to keep your mind calmer before inoculation, suggest other research reviewed by the team.

“And when you know you’re going to get the vaccine the next day, try to get a good night’s sleep. Just one night, and coming in fully rested, can help,” Kiecolt-Glaser added. For her part, Madison insisted that good mental health habits are important at all times, to increase the effectiveness of the vaccine and for everything else. 

The review was accepted for publication by the scientific journal Perspectives on Psychological Science.

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