The effect of perceived psychological stress on the immunogenicity of the quadrivalent human papillomavirus vaccine in males.
The human papillomavirus (HPV) vaccine is recommended for male and female recipients aged 9-26 years, and is effective in preventing HPV infection and cancer precursors. However, there is variability in immunogenicity among recipients as measured by anti-HPV geometric mean titers. In this study, we explored the effect of stress level on the immunogenicity of the HPV vaccine among college age males.



220 males aged 18-25 y were randomly assigned to 6-month (0, 2, and 6) and 12-month (0, 2, and 12) dosing schedules. Antibody titers were measured before the first dose and 2-6 weeks following the final dose. We recorded participants' age and stress level, based on a 4-item Perceived Stress Scale (PSS-4) questionnaire.



The average age of participants was 21.3 y old. Inspection of titers by quartile on the stress scale generally showed highest titers with highest stress. Spearman correlation coefficients revealed significant correlation between stress and titers for HPV-6, 16, and 18 but not for HPV-16 in the group of 6-month dosing schedule; no associations were found for the 12-month dosing schedule. For most strains, linear regression revealed significant (P > 0.05) associations on antibody titer for categorical age and dosing schedule but not stress.



The evidence is mixed for an association between stress and HPV vaccine response for the 6-month dosing schedule, but no association was found for stress for the 12-month dosing schedule. Further investigations with larger and more diverse population groups are needed to explore the association between stress level and vaccine immunogenicity.
a Department of Psychology , Carnegie Mellon University , Pittsburgh , PA , USA.
Rebecca F
RF
Wu
b Department of Family Medicine , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
Richard K
RK
Zimmerman
b Department of Family Medicine , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.
Chyongchiou Jeng
CJ
Lin
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 / Q000008:administration & dosage / Q000276:immunology*; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D011897:Random Allocation; D013315:Stress, Psychological / Q000276:immunology*; D011795:Surveys and Questionnaires; D055815:Young Adult
D000914:Antibodies, Viral; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
HPV vaccine; gardasil; human papillomavirus; immunogenicity; stress
Vaccine. 2003 Jun 2;21(19-20):2523-34
12744887
Psychol Bull. 2004 Jul;130(4):601-30
15250815
Clin Diagn Lab Immunol. 2005 Aug;12(8):959-69
16085914
MMWR Recomm Rep. 2007 Mar 23;56(RR-2):1-24
17380109
Eur J Cancer Prev. 2008 Nov;17(6):545-54
18941376
MMWR Morb Mortal Wkly Rep. 2011 Dec 23;60(50):1705-8
22189893
Vaccine. 2014 Feb 3;32(6):693-9
24342252
Proc Biol Sci. 2015 Dec 22;282(1821):20143085
26702035
J Health Soc Behav. 1983 Dec;24(4):385-96
6668417