DOES SLEEP PREDICT ANTIBODY RESPONSE AND MAINTENANCE TO THE COVID-19 VACCINE?

ABSTRACT

Introduction: There is growing evidence that insufficient sleep can negatively impact the immune system, including vaccination response. Prior laboratory studies have shown that acute sleep restriction can result in impaired antibody resposne to the hepatitis A and influenza vaccine. Similarly, prospective studies have shown that short sleep duration, measured by self-report and wrist actigraphy, is associated with muted antibody responses. These prior findings have critical implications for the COVID-19 pandemic and the efficacy and durability of the COVID-19 vaccines currently available. Whether sleep accounts for variability in response to the COVID- 19 vaccination series has not been investigated. Methods: We recruited 530 healthy participants (mean age= 52.4, SD=12.1, range 18-88 years;64.1% female) who were naive to the COVID-19 vaccination series. Participants completed self-report questionaires (e.g., Pittsburgh Sleep Quality Index) and morning sleep diaries for 7-consecutive days surrounding COVID-19 vaccine administrations. Additionally, 198 participants wore a sleep tracking device (Oura ring) continuously for ~2 months beginning prior to vaccination, which provides behavioral sleep data on days prior to and following the COVID-19 vaccination series. Blood samples were collected prior to vaccination, +1 month after their final vaccine shot (peak response), and +6 months after their final vaccine shot (maintenance);neutralization assays using pseudotype virus will be carried out to quantify antibody titers. Results: Data collection concludes December 2021, with antibody assays to be completed February 2022. Initial baseline data indicates that most participants reported poor overall global sleep quality (PSQI mean=6.3, SD=3.6;52% PSQI>5). Linear mixed models will be conducted to test associations between habitual sleep duration (averaged over the measurement time points), sleep efficiency, and subjective sleep quality with antibody responses over time. Additionally, we will report on the relevance of sleep timing (midpoint) and vaccination timing (receiving the vaccine in the morning vs afternoon vs evening), and the role of self-reported sleep disorders (e.g., obstructive sleep apnea) and shift worker status. Covariates in these analyses will include age, gender, race, body mass index, prior COVID infection, and vaccine type (Moderna, Pfizer, Johnson and Johnson). Conclusion: These analyses will provide new knowledge about the role of sleep in mounting and maintaining antibody response to the COVID-19 vaccination series. These findings may provide novel insights into when and for whom improvements in sleep may result in better vaccine efficacy.