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COVID-19, Stress, Vaccines, and Your Immune System

If you’ve felt a higher level of stress over the past year, you’re not alone. One study found that earlier in the pandemic, stress, depression, and anxiety each were present in about 30% of people (for comparison, in the US, about 12% of adults had a major depressive episode in 2017, pre-pandemic). The global pandemic has led to worry on so many fronts: the devastating effects of illness itself, fear of infection, financial stress, food insecurity, social isolation, managing child care while working, and more. If you’re navigating a cancer diagnosis and treatment on top of all that, your stress level may have skyrocketed.

All this stress takes a toll on the immune system—whose job is to fight off infections, like SARS-CoV-2. It’s long been established that stress impacts immune function through complex interactions in your body. During stress, increased hormones (such as epinephrine and cortisol) affect your infection-fighting white blood cells. These cells produce chemicals called cytokines to communicate with each other, and also to provide feedback to the brain. Some of these cytokines cause increased inflammation—which, over the long-term, is associated with chronic disease, including prostate cancer. Decades ago, scientists demonstrated that subjects who had higher stress levels were more susceptible to infection with respiratory viruses, including a different (less-dangerous) type of coronavirus. More recently, research suggests that the stress hormone cortisol is implicated in worse COVID-19 outcomes. In one study of patients hospitalized with COVID-19, those with higher blood cortisol levels were more likely to die.

When you get vaccinated against COVID-19, your immune system also has the job of making antibodies to protect you, if you are exposed to the virus in the future. In fact, psychological factors can influence your body’s response to the vaccine. Researchers at The Ohio State University have described how stress, depression, loneliness, and poor health behaviors—all of which are common during the pandemic—can decrease your body’s ability to mount a strong immune response to a vaccine, making it potentially less effective for you.

Are we stuck in a vicious cycle of pandemic stress, a hobbled infection-fighting system, and potential increased risk of COVID-19 (and other infections)? Fortunately, there is hope. Vaccines are rolling out across the US and around the world. While there is much more work to be done to vaccinate broadly and equitably, vaccination is an important step in returning to a calmer, more connected “new normal.” Anecdotally, people have reported feeling a sense of relief and joy after receiving their jab.

Beyond vaccination, recommendations to “boost your immune system” overlap with the recommendations for general overall health. There’s no single “magic bullet” or vitamin supplement for immune function. PCF’s guide to The Science of Living Well, Beyond Cancer, has tips on rest, exercise, and nutrition. Different strategies work for different people, and you may need to modify them based on your situation and what you’re struggling with the most. For example, in-person wellness classes may not yet be happening, and it’s hard to get out anyway if you’re doing double-duty with work and child care—consider a quick (masked) walk with a friend to get some exercise AND companionship

Becky Campbell
Becky Campbell develops medical content at the Prostate Cancer Foundation. She has previously worked in outcomes research and in science education.

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