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Chronic Stress Reduces Effectiveness of Pneumonia Vaccine
in Older Adults

WESTPORT, CT (Reuters Health) Dec 05 - Researchers have found that the stability of the IgG antibody response to a bacterial pneumonia vaccine is inhibited in older adults who live with chronic stress.

"We found that psychological stress associated with caregiving for an Alzheimer's patient...modulated the immune response to the pneumococcal vaccine," Dr. Ronald Glaser from Ohio State University, Columbus, told Reuters Health. This effect, he said, has already been demonstrated for influenza vaccine, and "since pneumonia and influenza are among the leading causes of death among older people, it is a major public health problem."

Dr. Glaser and colleagues studied unvaccinated 52 adults, 24 of whom were or had been caregivers to spouses with dementia. Eleven were current caregivers (mean age 68.09 years), 13 were former caregivers (mean age 72.46 years) and the remaining 28 subjects were non-caregiver controls (mean age 69.54 years), according to their report in the December issue of Psychosomatic Medicine.

Based on an analysis of blood samples obtained before pneumococcal vaccination and again at 2 weeks, 3 months and 6 months after vaccination, the researchers found that the current caregivers had a lower antibody response to the vaccination than the former caregivers and controls. Although initially all three groups had similar antibody responses, after 6 months current caregivers had lower antibody titers, according to Dr. Glaser's team.

The investigators believe that chronic stress in current caregivers either produces physiological changes in the immune response, resulting in fewer IgG-producing B-cells, or B-cells are unable to maintain IgG synthesis over time. In any case, they believe that this is "the first evidence that chronic stress can affect the stability of IgG antibody levels to a bacterial vaccine over time."

"Stress reduction programs for older people with chronic stress might be helpful," Dr. Glaser told Reuters Health. In spite of the increase in data on the effects of stress on health, he added, "managed care is limiting the ability of our healthcare system to deal with stress. For example, there is no money for stress support groups," he pointed out. "This is an important public health problem that will have to be faced sooner or later."

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