Humoral response to anti SARS-CoV2 vaccination at one and seven months is not different in shift workers and non-shift workers

Abstract

Since previous studies, mostly performed in healthy adults, show that sleep restriction around time of vaccination impairs antibody response and shift work affects sleep, aim of the study was to test the hypothesis that the antibody response to vaccination is impaired in shift workers, when compared to non-shift workers. Employees (n = 445; mean age 44 ± 11 years; 35 % men) of the Centro Cardiologico Monzino, IRCCS (Milan, Italy) were vaccinated against SARS-CoV2 in February 2021 with an mRNA-based vaccine. Antibody titers were assayed 1 and 7 months later. Differences between groups were assessed using ANOVA, after log-transformation of variables with right-skewed distribution. We report that the antibody titer was significantly higher in shift workers (33 % of employees) compared to non-shift workers at first assay [median (IQR): 2495 (1700; 4665) vs 2060 (1619; 2970) BAU/mL, p = 0.0123], as well as at the second one, and that this difference was abolished after adjustment for previous development of symptomatic COVID-19. Results were not affected by age or sex at birth. These results show that shift workers were able to mount an unimpaired antibody response to vaccination. Since vaccinations were performed during the pandemic urgency, our retrospective study has several limitations, nevertheless it underlines the need for large prospective, controlled studies on the effects of acute and chronic sleep restriction on response to vaccination in the general population and on the impact of shift work on immune response.

Keywords: COVID-19; Shift work schedule; Sleep; Vaccination.

Legend to Fig. 1

Box plots of the distribution of antibody titers induced by vaccination against SARS-CoV2 at 1 month in shift and non-shift workers. Antibody titers are shown after log transformation (Log (Ab)).

Legend to Fig. 2

Box plots of the distribution of the antibody titers (log transformed) in non-shift (pale grey) and shift (dark grey) workers with either no COVID-19 (none) or symptomatic (with or without hospitalization) COVID-19 (only delta wave was considered). Differences in antibody titers were not significant (p = 0.6112).