Key result
Shift work shows no independent link to higher antibody titers after adjusting for prior COVID-19.
Why the study?
Because sleep restriction around vaccination impairs antibody response and shift work affects sleep, the study evaluated whether the antibody response to SARS-CoV-2 vaccination is impaired in shift workers compared to non-shift workers.
Does shift work impair the antibody response to mRNA-based SARS-CoV2 vaccination in hospital employees?
Observational (n=445)
No
Does shift work impair the antibody response to mRNA-based SARS-CoV2 vaccination in hospital employees?
Absolute Event Rate: 2495% vs 2060%
p-value: p=0.0123
Shift workers mount an unimpaired antibody response to SARS-CoV2 mRNA vaccination compared to non-shift workers, with initial differences explained by prior COVID-19 infection.
Shift work does not impair antibody response to mRNA vaccination after adjustment; leaves open causal effects of circadian disruption on immunogenicity.
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.
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Faioni et al. (2024) conducted an observational in SARS-CoV2 vaccination (n=445). Shift work vs. Non-shift workers was evaluated on Antibody titer at 1 month (p=0.0123). Shift work was associated with higher initial antibody titers than non-shift work (median 2495 vs 2060 BAU/mL, p=0.0123), but this difference was abolished after adjusting for prior COVID-19.
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