Depression, Antidepressant Treatment, and Herpes Zoster Vaccine

Depression and other psychological problems may influence the effects of vaccines, as studies in psychoneuroimmunology have shown. For example, the varicella zoster virus (VZV) vaccine (zoster vaccine) is used to promote the T-cell-mediated immunity (VZV-CMI) against latent VZV to prevent the risks and reduce the severity of herpes zoster (HZ) (Levin, 2012). The zoster vaccine may help restore the declination of VZV-CMI that often occurs during aging. Factors such as age, time, and psychological status may affect the effects of the vaccine.

A two-year study was done to examine the relationship between depression and immune responses to zoster vaccine among 92 adults older than 60 (Irwin et al., 2013). The study found that those adults with major depression but did not receive antidepressant treatment had lower levels of VZV-CMI, compared with those mentally healthy adults as well as those depressed adults who received the antidepressant treatment.

The results suggested that antidepressant treatment in depressed adults may be involved in the restoration and normalization of the immune responses from the vaccination. Untreated depression may be associated with the reduction of the effects of the zoster vaccine and lead to higher risks of HZ, as the lower levels of VZV-CMI have been related to the severity of HZ.

Such studies have confirmed that psychological status and the treatment of psychiatric disorders may play important roles in the effects of vaccination. Further studies are still needed to elucidate the underlying mechanisms to promote the efficacy of vaccines and to prevent the risks of infectious diseases effectively.


Irwin MR, Levin MJ, Laudenslager ML, Olmstead R, Lucko A, Lang N, Carrillo C,  Stanley HA, Caulfield MJ, Weinberg A, Chan IS, Clair J, Smith JG, Marchese RD, Williams HM, Beck DJ, McCook PT, Zhang JH, Johnson G, Oxman MN. Varicella zoster virus-specific immune responses to a herpes zoster vaccine in elderly recipients with major depression and the impact of antidepressant medications. Clin Infect Dis. 2013 Apr;56(8):1085-93. doi: 10.1093/cid/cis1208.

Levin MJ. Immune senescence and vaccines to prevent herpes zoster in older persons. Curr Opin Immunol. 2012 Aug;24(4):494-500. doi: 10.1016/j.coi.2012.06.002.

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