Varicella Zoster Virus-Specific Immune Responses to a Herpes Zoster Vaccine in Elderly Recipients With Major Depression and the Impact of Antidepressant Medications
Open accessAbstract
BACKGROUND: The Depression Substudy of the Shingles Prevention Study (SPS) was designed to evaluate the association between major depression and immune responses to a high-titer live attenuated varicella zoster virus (VZV) vaccine (zoster vaccine), which boosts cell-mediated immunity (CMI) to VZV and decreases the incidence and severity of herpes zoster (HZ). The Depression Substudy was a 2-year longitudinal cohort study in 92 community-dwelling adults≥60 years of age who were enrolled in the SPS, a large, double-blind, placebo-controlled Veterans Affairs Cooperative zoster vaccine efficacy study. METHODS: Forty subjects with major depressive disorder, stratified by use of antidepressant medications, and 52 age- and sex-matched controls with no history of depression or other mental illness had their VZV-CMI measured prior to vaccination with zoster vaccine or placebo and at 6 weeks, 1 year, and 2 years postvaccination. RESULTS: Depressed subjects who were not treated with antidepressant medications had lower levels of VZV-CMI following administration of zoster vaccine than nondepressed controls or depressed subjects receiving antidepressants even when antidepressant medications failed to alter depressive symptom severity (P<.005). Similar results were obtained taking into account the time-varying status of depression and use of antidepressant medications, as well as changes in depressive symptoms, during the postvaccination period. CONCLUSIONS: Depressed patients have diminished VZV-CMI responses to zoster vaccine, and treatment with antidepressant medication is associated with normalization of these responses. Because higher levels of VZV-CMI correlate with lower risk and severity of HZ, untreated depression may increase the risk and severity of HZ and reduce the efficacy of zoster vaccine.
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Prolonged stress and depression are associated with reduced antiviral immune responses.
“prolonged stress and depression have been associated with reduced antiviral immune responses”
From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Irwin et al., 2013
The Discussion (page unavailable) links untreated depression to reduced VZV-specific immune responses and reports an association between psychological stress and attenuated influenza-vaccine responses in older adults. It does not establish that the stress was prolonged, and its evidence concerns specific vaccine responses rather than antiviral immune responses generally. (LLM, conf=0.86)
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- Authors
- Irwin, M. R., Levin, M. J., Laudenslager, M. L., Olmstead, R., Lucko, A., Lang, N., Carrillo, C., Stanley, H. A., Caulfield, M. J., Weinberg, A., Chan, I. S. F., Clair, J., Smith, J. G., Marchese, R. D., Williams, H. M., Beck, D. J., McCook, P. T., Zhang, J. H., Johnson, G., & Oxman, M. N.
- Affiliations
- University of California, Los Angeles (US)
- University of Colorado Anschutz (US)
- United States Department of Veterans Affairs (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- West Haven Cooperative Studies Program Coordinating Center (US)
- Corresponding author
- Irwin, M. R.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-02-13
- Volume
- 56
- Issue
- 8
- Pages
- 1085-1093
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC3601721
- OpenAlex
- W2122510079
- Cited by
- 81
- References
- 3
- Citations by year
- 2025: 6 · 2024: 3 · 2023: 4 · 2022: 15 · 2021: 7 · 2020: 8 · 2019: 8 · 2018: 2 · 2017: 8 · 2016: 3 · 2015: 5 · 2014: 8 · 2013: 4
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (UL1TR000124)
- National Institute on Aging (R01AG026364, R01AG034588, P30AG028748)
- National Heart, Lung, and Blood Institute (R01HL079955, R01HL095799)
- National Institute of Mental Health (R01 MH55253, R01MH055253)
- National Cancer Institute (R01CA119159)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Keywords
- varicella-zoster virus, herpes zoster vaccine, major depressive disorder, antidepressants, cell-mediated immunity, vaccine response, older adults, herpes zoster
- MeSH terms
- Aged, Antidepressive Agents, Depressive Disorder, Major, Major Depressive Disorder, Female, Herpes Zoster, Humans, Immunity, Cellular, Longitudinal Studies, Male, Middle Aged, Vaccination, Herpesvirus 3, Human, Case-Control Studies, Herpes Zoster Vaccine
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