Resumo

SACADURA-LEITE, Ema et al. Association between chronic stress and immune response to influenza vaccine in healthcare workers. Rev. Port. Sau. Pub. [online]. 2014, vol.32, n.1, pp.18-26. ISSN 0870-9025.

Introduction: Chronic stress can influence immune response to vaccines. Healthcare workers are exposed to stressors and biological hazards, the health effects of which may be prevented through vaccination. Objectives: This study aims to evaluate the association between stress in nurses and: (1) insufficient response to influenza vaccine, assessed one month after vaccination (T₁); (2) the drop in haemagglutination-inhibition (HAI) antibodies (ab) six months after vaccination (T₆). Methods: A nested case-control study was carried out with 136 healthy hospital nurses. Individual interviews, the General Health Questionnaire (GHQ₁₂) and Maslach Burnout Inventory (MBI-HSS) were applied in order to determine the presence of stress, using the triangulation method at the beginning of the study (T₀). Influenza vaccine was administered and titres of HAI above each strain composing influenza vaccine before vaccination (T₀), at T₁ and T₆ were assessed. Results: There was no statistically relevant (5%) relationship between stress and the insufficient immune response to the vaccine at T₁. Nevertheless, there was an association between stress and the drop in HAI ab AH₁ at T₆, when we assessed stress by the triangulation method using an interview (p = 0.006), GHQ₁₂ (p = 0.045) and combination of criteria (p = 0.001), even after multivariate analysis (respectively, p = 0.01, p < 0.05 and p = 0.002). The odds ratios were, respectively, 3.64, 2.73 and 5.22. Conclusions: The association we found, between chronic stress and the drop in HAI ab at T₆, corroborates the hypothesis that stress can negatively influence immune response. Therefore, it seems reasonable to consider this issue when we implement vaccination programmes for healthcare workers.

Palavras-chave : Antibody response; Healthcare workers; Influenza vaccine; Psychological stress.

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