Preprint Article Version 1 This version is not peer-reviewed

Effect of Distress, Anxiety, and Depressive Symptoms on SARS-CoV-2 mRNA BNT162b2 Vaccine Efficacy in Cancer Patients

GABRIELLA RONDANINA
,
TANIA BUTTIRON WEBBER
* ,
ORIANA D'ECCLESIIS
,
MARCO MUSSO
,
IRENE MARIA BRIATA
,
NICOLETTA PROVINCIALI
,
MONICA BOITANO
,
MATTEO CLAVAREZZA
,
MAURO D'AMICO
,
CARLOTTA DEFFERRARI
,
ALBERTO GOZZA
,
LEONELLO INNOCENTI
,
ALESSIO CARBONE
,
MARTINO OLIVA
,
EMANUELA MARCENARO
,
FRANCESCA FILAURO
,
SARA GANDINI
,
ANDREA DECENSI
*
Version 1 : Received: 28 October 2024 / Approved: 28 October 2024 / Online: 28 October 2024 (17:41:07 CET)

How to cite: RONDANINA, G.; BUTTIRON WEBBER, T.; D'ECCLESIIS, O.; MUSSO, M.; BRIATA, I. M.; PROVINCIALI, N.; BOITANO, M.; CLAVAREZZA, M.; D'AMICO, M.; DEFFERRARI, C.; GOZZA, A.; INNOCENTI, L.; CARBONE, A.; OLIVA, M.; MARCENARO, E.; FILAURO, F.; GANDINI, S.; DECENSI, A. Effect of Distress, Anxiety, and Depressive Symptoms on SARS-CoV-2 mRNA BNT162b2 Vaccine Efficacy in Cancer Patients. Preprints 2024, 2024102215. https://doi.org/10.20944/preprints202410.2215.v1 RONDANINA, G.; BUTTIRON WEBBER, T.; D'ECCLESIIS, O.; MUSSO, M.; BRIATA, I. M.; PROVINCIALI, N.; BOITANO, M.; CLAVAREZZA, M.; D'AMICO, M.; DEFFERRARI, C.; GOZZA, A.; INNOCENTI, L.; CARBONE, A.; OLIVA, M.; MARCENARO, E.; FILAURO, F.; GANDINI, S.; DECENSI, A. Effect of Distress, Anxiety, and Depressive Symptoms on SARS-CoV-2 mRNA BNT162b2 Vaccine Efficacy in Cancer Patients. Preprints 2024, 2024102215. https://doi.org/10.20944/preprints202410.2215.v1

Abstract

In 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 stage of metastatic disease and high stress levels (OR=2.46, 95% CI, 1.05-5.77, p=0.04). Notably, nonresponders showed twice the prevalence of distress than responders (21% vs. 10%, p=0.04). Longitudinal measurements of IgG levels indicated that participants with high depressive symptoms at baseline maintained lower antibody levels over six months (p=0.003). In addition, women with high anxiety showed reduced levels of D-dimer at 6 month time (p=0.03). The data also showed that smokers and former smokers had significantly lower antibody levels than their nonsmoking counterparts (p=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, higher educational level was related to increased distress among women (p=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.

Keywords

COVID-19 Vaccines; Immunogenicity; Vaccine; Neoplasms; Psychological distress; depressive disorder; Anxiety disorders; C Reactive Protein; D dimer.

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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