Study of Seniors Finds Less Response to Shingles
Vaccine for Those with Untreated Depression
If antidepressants increase the effectiveness of the
shingles vaccine, it may have similar effect on depressed patients to
other important vaccines, such influenza
Feb. 15, 2013 – Senior citizens are encouraged to
get the vaccination for shingles, which can guard against the painful
condition caused by the reactivation of the varicella-zoster virus.
There has been concern, however, that the vaccine is not more
successful. Researchers seeking answers have found a link between
untreated depression in older adults and decreased effectiveness of the
More than a million new shingles cases occur each
year in the U.S. The vaccine boosts cell-mediated immunity to the virus
and can decrease the incidence and severity of the condition, according
to information published with the study in Clinical Infectious
In a two-year study, led by Michael Irwin, MD, at
the University of California-Los Angeles, researchers measured the
immune responses to shingles vaccination among 40 subjects aged 60 or
older with a major depressive disorder and compared these responses to
similar levels in 52 control patients matched by age and gender.
Measurements were taken at baseline, and then 6
weeks, 1 year, and 2 years after the patients received the shingles
vaccine or a placebo.
Depressed patients not being treated with
antidepressants (selective serotonin uptake inhibitors) had lower
cell-mediated immunity to the varicella-zoster virus - and were less
able to respond to the shingles vaccine - compared with patients who
were not depressed, or who were depressed but were receiving treatment
with antidepressants, the researchers found.
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The findings suggest that patients with untreated
depression were “poorly protected by shingles vaccination,” said Dr.
Depression treatment, on the other hand, boosted
cell-mediated immunity and increased the effectiveness of the vaccine
among those studied, even when the treatment did not lessen depression
symptoms, the researchers found.
Treating depression, noted Dr. Irwin, appeared to
“normalize the immune response to the zoster vaccine” in the study.
Larger studies are needed to evaluate the possible
relationship between untreated depression and the risk of shingles, the
study authors noted, along with research to establish what mechanisms
are responsible for patients’ reduced immune response.
The possible connection, however, is potentially
significant: If antidepressants increase the efficacy of the shingles
vaccine in those who are depressed, such treatment may have a similar
effect on the immune response of depressed patients to other important
vaccines, such those against influenza.
Diagnosis and treatment of depression in older
adults may increase of the effectiveness of the shingles vaccine and
help diminish the risk of shingles, the study authors conclude from
“Efforts are also needed to identify and diagnose
depressed elderly patients who might benefit from either a more potent
vaccine or a multi-dose vaccination schedule,” Dr. Irwin said.
The study is available online:
Varicella Zoster Virus–Specific Immune Responses to a Herpes Zoster
Vaccine in Elderly Recipients With Major Depression and the Impact of
Antidepressant Medications –
Clinical Infectious Diseases
is a leading journal in the field of infectious disease with a broad
international readership. The journal publishes articles on a variety of
subjects of interest to practitioners and researchers. It is an official
publication of the Infectious Diseases Society of America (IDSA),is a
professional society representing nearly 10,000 physicians and
scientists who specialize in infectious diseases. For more information,