Background/Objectives: Our previous study of 291 cancer patients, we showed that 20% did not respond to two doses of COVID-19 vaccine administered six weeks apart. Methods: Here, we investigated if psychological factors (distress, anxiety, and depressive symptoms) affected antibody response and markers of vaccine activation (D-dimer) after 6 months from initial vaccination. Results: Overall, 31 subjects (14.2%) had no antibody response at 6 months. Our analysis revealed significant predictors of vaccine failure, including the stage of metastatic disease and high-stress levels (OR = 2.46, 95% CI, 1.05–5.77,p= 0.04). Notably, nonresponders showed twice the prevalence of distress than responders (21% vs. 10%,p= 0.04). Longitudinal measurements of IgG levels indicated that participants with high depressive symptoms at baseline maintained lower antibody levels over six months (p= 0.003). In addition, women with high anxiety showed reduced levels of D-dimer at 6 months (p= 0.03). These data also showed that smokers and former smokers had significantly lower antibody levels than their nonsmoking counterparts (p= 0.0004). At baseline, the high discomfort rate (≥5) was 34.4% in women and 23.8% in men; only men experienced an increase in median discomfort during the observation period. Moreover, a higher educational level was related to increased distress among women (p= 0.046). Conclusions: These findings underscore a critical association between elevated psychological distress and reduced immune responses to the COVID-19 vaccine, emphasizing the urgent need for targeted psychological and behavioral support within this vulnerable population.
背景/目的：我们先前对291名癌症患者的研究显示，20%的患者对间隔六周接种的两剂COVID-19疫苗无应答。方法：本研究探讨了心理因素（心理困扰、焦虑和抑郁症状）在初次接种6个月后对抗体反应及疫苗激活标志物（D-二聚体）的影响。结果：总体而言，31名受试者（14.2%）在6个月时未产生抗体反应。分析显示疫苗失败的重要预测因素包括转移性疾病分期和高压力水平（OR = 2.46，95% CI 1.05–5.77，p=0.04）。值得注意的是，无应答者的心理困扰发生率是有应答者的两倍（21% vs. 10%，p=0.04）。IgG水平的纵向测量表明，基线期抑郁症状严重的参与者在六个月内抗体水平持续较低（p=0.003）。此外，高焦虑水平女性在6个月时D-二聚体水平降低（p=0.03）。数据还显示，吸烟者和既往吸烟者的抗体水平显著低于非吸烟者（p=0.0004）。基线期女性高不适感率（≥5分）为34.4%，男性为23.8%；仅在观察期间男性中位不适感有所上升。此外，较高教育水平与女性心理困扰增加相关（p=0.046）。结论：这些发现揭示了心理困扰加剧与COVID-19疫苗免疫反应降低之间的关键关联，强调在这一脆弱人群中迫切需要针对性的心理和行为支持。
肿瘤(癌症)患者之家