Rondanina Gabriella, Buttiron Webber Tania, D'Ecclesiis Oriana, Musso Marco, Briata Irene Maria, Provinciali Nicoletta, Boitano Monica, Clavarezza Matteo, D'Amico Mauro, Defferrari Carlotta, Gozza Alberto, Innocenti Leonello, Carbone Alessio, Oliva Martino, Marcenaro Emanuela, Filauro Francesca, Gandini Sara, DeCensi Andrea
Oncology Department, E.O. Ospedali Galliera, 16128 Genoa, Italy.
European Institute of Oncology IRCCS, 20141 Milan, Italy.
Cancers (Basel). 2024 Nov 29;16(23):4012. doi: 10.3390/cancers16234012.
BACKGROUND/OBJECTIVES: Our previous study of 291 cancer patients, we showed that 20% did not respond to two doses of COVID-19 vaccine administered six weeks apart.
Here, we investigated if psychological factors (distress, anxiety, and depressive symptoms) affected antibody response and markers of vaccine activation (D-dimer) after 6 months from initial vaccination.
Overall, 31 subjects (14.2%) had no antibody response at 6 months. Our analysis revealed significant predictors of vaccine failure, including the stage of metastatic disease and high-stress levels (OR = 2.46, 95% CI, 1.05-5.77, = 0.04). Notably, nonresponders showed twice the prevalence of distress than responders (21% vs. 10%, = 0.04). Longitudinal measurements of IgG levels indicated that participants with high depressive symptoms at baseline maintained lower antibody levels over six months ( = 0.003). In addition, women with high anxiety showed reduced levels of D-dimer at 6 months ( = 0.03). These data also showed that smokers and former smokers had significantly lower antibody levels than their nonsmoking counterparts ( = 0.0004). At baseline, the high discomfort rate (≥5) was 34.4% in women and 23.8% in men; only men experienced an increase in median discomfort during the observation period. Moreover, a higher educational level was related to increased distress among women ( = 0.046).
These findings underscore a critical association between elevated psychological distress and reduced immune responses to the COVID-19 vaccine, emphasizing the urgent need for targeted psychological and behavioral support within this vulnerable population.
背景/目的：在我们之前对291名癌症患者的研究中，我们发现20%的患者对间隔六周接种的两剂新冠疫苗无反应。
在此，我们调查了心理因素（痛苦、焦虑和抑郁症状）是否会在初次接种疫苗6个月后影响抗体反应和疫苗激活标志物（D - 二聚体）。
总体而言，31名受试者（14.2%）在6个月时无抗体反应。我们的分析揭示了疫苗接种失败的显著预测因素，包括转移性疾病阶段和高压力水平（OR = 2.46，95% CI，1.05 - 5.77，P = 0.04）。值得注意的是，无反应者出现痛苦情绪的患病率是有反应者的两倍（21%对10%，P = 0.04）。IgG水平的纵向测量表明，基线时抑郁症状严重的参与者在六个月内抗体水平维持较低（P = 0.003）。此外，焦虑程度高的女性在6个月时D - 二聚体水平降低（P = 0.03）。这些数据还表明，吸烟者和曾经吸烟者的抗体水平显著低于不吸烟者（P = 0.0004）。在基线时，女性的高不适率（≥5）为34.4%，男性为23.8%；只有男性在观察期内中位不适程度有所增加。此外，较高的教育水平与女性的痛苦情绪增加有关（P = 0.046）。
这些发现强调了心理痛苦加剧与新冠疫苗免疫反应降低之间的关键关联，强调了在这一脆弱人群中迫切需要有针对性的心理和行为支持。
