Examining the Effect of SARS-CoV-2 Pandemic-Induced Stress and Anxiety on Humoral Immunity in Health Care Workers

Valerie S. Stark, Erin C. Williams, Felipe Echeverri Tribin, Jennifer Coto, Adam Carrico, Juan Manuel Carreño, Dominika Bielak, Parnavi Desai, Florian Krammer, Michael E. Hoffer, Suresh Pallikkuth, Savita Pahwa

Research output: Contribution to journalArticlepeer-review


Objective: The effect of stress on vaccine-induced humoral immunity and therapeutic interventions to mitigate pandemic-related stress remain underexplored. Method: Participants in a longitudinal cohort study (n = 189) completed a validated measure, GAD-7, and 10-instrument stress measure to assess stress and anxiety after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Serum was collected to obtain SARS-CoV-2 antibody titer levels. Results: Participants experienced increased stress due to the SARS-CoV-2 pandemic with a positive correlation between GAD-7 scores and peak antibody titers overall; however, there was a negative association with scores commensurate with severe anxiety. Health care workers and younger participants were more significantly affected by anxiety. Conclusions: Mild anxiety levels may have immune-enhancing effects, whereas severe anxiety may cause antibody generation reduction. Mental health–focused interventions are imperative for younger adults and health care workers. Young adults may be more resilient to increased stress levels.

Original languageEnglish
Pages (from-to)E48-E53
JournalJournal of Occupational and Environmental Medicine
Issue number2
StatePublished - 1 Feb 2024


  • COVID-19
  • SARS-CoV-2
  • anxiety
  • humoral immunity
  • psychosocial Interventions
  • public health
  • stress


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