The mind-body connection - a consideration for timing of your flu vaccine?

It's December 14th, which means that across the country university students are frantically studying for final exams, doing holiday shopping, arranging travel plans, writing that final term paper, blogging for the last time, etc...
Stress abound! Right?





What about getting that flu shot that you keep meaning to mark off of your to-do list? Think this frantic time is too stressful to consider being set-back by a sore arm as you have 8 more pages of a term paper to type?


Think again!  Now might just be the optimal time to roll up your sleeve and get your flu shot! At least, that what some researchers have hypothesized (Edwards et al, 2006).






While we have heard that chronic stress can induce a state of immunocompromise, could acute stress actually be "immunoenhancing"? According to a small cadre of studies related to the psychoneuroimmunology field, acute stressors have been shown to enhance antibody response. Edwards et al (2006) studied men and women under experimental conditions using the A/Panama flu strain. Subjects were randomized to one of three groups: dynamic exercise, mental stress, or control. Subjects in the intervention groups were immunized with A/Panama strain of flu vaccine immediately following their exposure to a 45-minute stress-inducing activity. A/Panama antibody titers were measured at vaccine baseline, 4 weeks post-vaccine, and 20 weeks post-vaccine. Additionally, researchers obtained serum IL-6 and cortisol levels at baseline, following the task, and after 60-minutes of recovery.

Interestingly, the Edwards et al (2006) study found the following: 

• Women in both the exercise and mental stress groups showed higher antibody titres at 4 and 20 weeks post-vaccine than those in the control group.

• Men responded similarly to women in all conditions.

• IL-6 at 60 mins into the stress recovery phase was found to be a significant predictor of subsequent antibody response in women.

  Obviously, this study was limited by its small sample size (N=60) but there's more....

But what about the flip-side of this coin? Could being un-stress / relaxed result in a diminished immune response to vaccination? Maybe yoga is contraindicated prior to vaccination?


Check out these other studies that have related but significantly different findings:

Glaser, R., Sheridan, J. F., Malarkey, W. B., MacCallum, R. C., & Kiecolt-Glaser, J. K. (2000). Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine. Psychosomatic Medicine, 62, 804-807.

Glaser, R., Robles, T. F., Malarkey, W. B., Sheridan, J. F., & Kiecolt-Glaser, J. K. (2003). Mild depressive symptoms are associated with amplified and prolonged inflammatory responses following influenza vaccination in older adults. Archives of General Psychiatry, 60, 1009-1014.

 

Well.....no one has really studied that aspect :) But there is tons of literature related to stress and immune dysfunction! So are these conflicting reports? Or is there a "middle-ground" per se for the appropriate amount and timing of stress?






 

References
Edwards, K.M. et al (2006). Acute stress exposure prior to influenza vaccination enhances antibody response in women. Brain, Behavior, and Immunity, 20(2):159-168.