No Link Found Between Mental Health, Sleep Quality, and COVID-19 Vaccine Response

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The study revealed that healthcare workers with psychiatric disorders had slightly lower Anti-SARS-CoV-2-Spike IgG levels before their third COVID-19 vaccination, but this effect was mediated by age and body mass index.

New findings revealed healthcare workers with psychiatric disorders had slightly lower Anti-SARS-CoV-2-Spike IgG levels before their third COVID-19 vaccination.

The data expanded the understanding of the relationship between mental health, sleep quality, and COVID-19 vaccine response. Influencing factors of vaccine efficacy and safety were illuminated that can inform healthcare professionals in making recommendations regarding COVID-19 booster vaccinations for individuals with mental health and sleep-related issues.

Investigators led by Isabell Wagenhäuser, an MD student at the Infection Control and Antimicrobial Stewardship Unit, University Hospital Würzburg, sought to evaluate the influence of mental health and sleep quality on the immunogenicity of COVID-19 vaccinations and the impact of COVID-19 vaccinations on sleep quality.

The Relationship of Sleep, Mental Health and Immune Response

According to the study, the relationship between sleep, mental health, and the immune system has been acknowledged, with sleep playing a crucial role in modulating immune responses. The association between sleep loss and reduced vaccine immunogenicity was noted, also citing that immune responses can affect sleep patterns.

The prospective CoVacSer study monitored mental health, sleep quality, and Anti-SARS-CoV-2-Spike IgG titers in a cohort of 1082 healthcare workers from September 2021-December 2022. Questionnaires and blood samples were collected before the third COVID-19 vaccination and at 14 days and 3 months after the third vaccination.

Among the cohort of individuals receiving the third COVID-19 vaccination (n = 1082), 86.0% (921) reported no psychiatric disorders, while 14.0% (n = 161) reported at least 1 psychiatric disorder.

Analyzing the data by specific psychiatric disorders, there was no statistically significant difference in terms of gender composition. However, there was a notable trend towards a higher prevalence of psychiatric disorders among women (P = 0.05, Fisher's exact test).

In terms of sleep quality, the study found no significant association between sleep quality and the humoral immunogenicity of COVID-19 vaccinations. Additionally, the COVID-19 vaccinations did not result in a sustained deterioration of self-reported sleep quality.

The Fourth COVID-19 Booster

In addition, 154 participants underwent the fourth COVID-19 vaccination, and their data was collected before and 14 days after the booster vaccination.

Among those who received the fourth COVID-19 vaccination, the data revealed no significant difference in antibody titers at baseline (P = 0.59, Mann-Whitney U-test) or 14 days after vaccination (P = 0.48, Mann-Whitney U-test) between participants without psychiatric disorders and those with psychiatric disorders.

Overall, investigators found these results indicated that COVID-19 vaccinations are unlikely to be a precipitating factor for insomnia or have a lasting negative effect on sleep patterns.

"Mental health, sleep, and immune function are interlinked, and it is of great clinical relevance to clarify if individuals with psychiatric conditions or poor sleepers are at risk of an insufficient response to COVID-19 booster vaccinations or if booster vaccinations might cause a sustained deterioration of sleep quality," investigators wrote.


  1. Wagenhäuser, I., Reusch, J., Gabel, A., Mees, J., Nyawale, H., Frey, A., Lâm, T.-T., Schubert-Unkmeir, A., Dölken, L., Kurzai, O., Frantz, S., Petri, N., Krone, M., & Krone, L. B. (2023). The relationship between mental health, sleep quality and the immunogenicity of COVID-19 vaccinations. Journal of Sleep Research, e13929.