How staying positive on the day of your vaccination might help your level of immunity

TORONTO — Excited about the prospect of receiving a COVID-19 vaccination soon? There’s more than one reason to be cheerful the day you go in to get your shot, researchers say.

According to studies performed with other vaccines, many factors can affect the immune response your body has in response to a vaccination — and one of those factors may be your mood.

A positive outlook may enhance how our bodies respond to immunizations, studies say.

Anna Marsland, a psychologist at the University of Pittsburgh in Pennsylvania told CTV News that while this phenomenon hasn’t been studied with COVID-19 vaccines, previous studies looking at the association of mood with different vaccines can provide insights into factors that might affect the COVID-19 vaccines.

“We do know that individuals who are more positive, […] people who are happier, who described themselves as more energetic, these individuals do mount better responses to other vaccines,” Marsland said.

“Some of my own research has shown that individuals who have these more positive tendencies mount better responses to hepatitis B vaccination […] and also are better protected against the disease.”

A 2017 study by researchers from the University of Nottingham found similar results with the flu shot, she said. But it found that the impact of mood goes beyond being an inherently happy person.

One of the aspects the study looked at was the mood of participants on the exact day they received the shot.

“[They found that] mood on the day of getting a vaccine is related to magnitude of response to flu shots,” Marsland said.

“So individuals who are more positive on that day actually mounted [a] larger response to the flu shot.”

Marsland’s work is in a field called psychoneuroimmunology, which looks at how the central nervous system and the immune system interact.

“Those of us working with in this field have been interested in the association of psychological and lifestyle factors with risk for infectious disease and with response to vaccination,” she said.

“I think the work that we have done […] is relevant to the current pandemic.”

While a good mood might correlate to a better or faster immune response, stress, on the other hand, impairs the immune response, studies say.

Annelise Madison, a doctoral student at the Ohio State University College of Medicine, is lead author of a study published in the journal Perspectives on Psychological Science in January, which describes various studies that outline factors that have affected immunization in other vaccines.

“We reviewed 49 different human clinical trials showing that generally things like chronic stress, anxiety, depression, poor health behaviours like sedentary illness, smoking, excessive alcohol use, poor diet — these factors all can negatively impact the antibody and T-cell responses to vaccines,” she told CTV News.

None of these studies suggested that these factors could fully negate the protective effects of a vaccine, but found that these factors could correlate with a slower build-up of immunity or a lower level of antibodies produced.

One of the most interesting examples highlighting stress as a key factor was a study performed on medical students during an extremely stressful time period: exam week.

“They had vaccinated young, healthy medical students with the hepatitis B vaccine, and importantly, the hepatitis B vaccine is very effective, almost on par with a COVID-19 vaccine,” Madison said.

“And in that study, what they found was that the medical students who are more stressed and anxious during the three day exam period were the ones that took longer to develop clinically protective antibody levels.”

The reason that you can’t start hugging strangers immediately after you’ve received your COVID-19 vaccine shot is because the immunity provided by the vaccine takes time to develop in your system. Researchers believe that the speed of that immunity development can be impacted by these personal factors.

“For instance, it might take more than two weeks to become immune […] if you’re undergoing chronic stress,” Madison said.

But is it sufficient, let alone possible, to change our mood on the day of vaccination to improve our response, or is a more long-term change in mindset necessary? In this study, the students’ stress levels and social support as a group had been fairly similar across the academic year, suggesting that their divergent vaccine response was related to the exam period, and stress levels specifically around the time of vaccination.

Another study suggested that stress levels in the 10 days following a vaccination might be more important than the two days prior to receiving the vaccination — something that is heartening, considering many who have received the COVID-19 vaccine have reported feeling relief and less stress following the shot.

The research is all the more crucial given the mental toll and stress caused by the pandemic and social distancing. It’s pretty hard not to be stressed during a global pandemic.

Madison said for those struggling with depression or anxiety — a reality for more people than usual during the pandemic, studies have shown — a vaccine appointment might be a signal to rally and “engage in self care, including seeking mental health care.”

Other studies show that having social support around at the time of vaccination helps boost immune responses.

“Social support can really buffer against the negative effect that stress has on our body and our immune system and so really trying to still prioritize social connection in and around the time that you’re getting the vaccine [could help],” Madison said.

Another big factor is sleep, research shows.

“There’s compelling evidence actually to suggest that […] sleep is related to magnitude of antibody response to vaccination,” Marsland said.

In one study covered in Madison’s paper, young adults who were not permitted to sleep for 36 hours after receiving a hepatitis A vaccine had half of the antibodies one month later compared to those who were allowed a full night’s sleep after their shot of the vaccine.

Marsland suggested people with an upcoming appointment for the COVID-19 vaccine make sure they’re “trying to get a good night’s sleep, trying not to be too ragged around the time of getting the vaccination.”

Both scientists said that there needs to be more research into these phenomenons and how they interact with COVID-19 vaccines in particular.

But the research that has gone into the field gives us an idea of how we can prepare for receiving a COVID-19 vaccine.

“There’s been this line of research [that] has been going on for about the past 30 years, with a lot of different vaccine types, including influenza virus vaccine and pneumococcal pneumonia vaccine, hepatitis, HIV vaccines, […] showing that psychological and behavioral responses are two facets of the adaptive immune response to a vaccine,” Madison said.

“So even though this has yet to be tested with the COVID vaccine, there’s every reason to believe that these same factors would hold up.”

Madison pointed out that several studies suggest “even relatively short term interventions had a positive effect on vaccine responses,” such as getting a good night’s sleep or minimizing stress in the few days prior to receiving a vaccine.

She called this “the most hopeful part,” saying it showed that even if someone is struggling with numerous aspects of their life, even little steps can aid the vaccine’s effectiveness.

“Anything that can help you be in a more positive mind frame on the day of getting the vaccination, it’s worth trying to get the best response you can from this vaccination to handle this pandemic and protect yourself in the best way you possibly can,” Marsland added.

It’s important to remember that this research doesn’t mean that the COVID-19 vaccine won’t work if you show up to your appointment feeling a little anxious.

But the takeaway is that those who can should try to show up to their appointment rested and feeling as positive and stress-free as they can.

Advice to make that important shot in the arm go even further.

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