Do sleep, stress, and age affect the longevity of the COVID-19 vaccine? UCSF researchers plan to find out


As COVID-19 vaccines continue to roll out across the country, information on how effective they are has been slow to catch up. It was only this week — three months after the first dose was administered in San Francisco — that the Center for Disease Control and Prevention released some guidelines on what vaccinated people can and can’t do. For much of this process, we’ve been flying blind.

But behind the scenes, scientists have been trying to catch up. This week, the University of California San Francisco announced the launch of a major study to examine the longevity of the COVID-19 vaccines effectiveness, and how factors like stress or sleep play a role. And — they’re paying people $300 to participate.

The study is christened BOOST, an acronym creatively sourced from Building Optimal AntibOdies Study. The team of researchers hope to recruit 500 people from diverse backgrounds, but are particularly interested in older participants who are more likely to have a weakened immune response.

“While the COVID vaccination is extremely effective in the short run, if antibodies are not well maintained, people may lose protection from the virus,” said Elissa Epel, PhD, a professor and vice chair of UCSF’s Department of Psychiatry. She explained that further understanding how to maintain antibodies “will become a critical public health issue in our future.”

Dozens of studies over the years have shown a connection between mental health, stress, sleep, and immune response. Dr. Aric Prather, who is a primary investigator on BOOST, published one such study on sleep and hepatitis B in 2012, and another on susceptibility to the common cold in 2015. However, UCSF’s study would be one of the first in the nation to look specifically at COVID-19.

“Insufficient sleep has emerged as a key predictor of how well our immune system responds to vaccination,” said Prather, who is also an associate professor in the Department of Psychiatry. “This study will help shed light on when sleep might be critical during the vaccination process to mount the strongest protective response.”

Mental health crises caused by the pandemic and subsequent shelter-in-place orders have been covered extensively by researchers. Social isolation, financial stress, and the caretaking of sick relatives can all have a major psychological impact, and mental health professionals have repeatedly voiced concerns about rising rates of suicide.

But until now, few studies have taken into account the mental toll of the pandemic and how it may impact COVID-19 response. The UCSF research team plans to approach this through the study of telomeres, described as “protective caps at the end of chromosomes.” Healthy immune systems have longer telomeres, but if you add in insomnia and chronic stress, those telomeres can shorten. Shortened telomeres can result in more severe symptoms from colds, flu, and COVID-19.

The study will do a blood draw from participants before they receive the vaccine to determine their baseline level of antibodies, another one month after the second vaccination, and a third five months after that. Questionnaires around mental health will be included.

“The study will provide information on how to optimize vaccine response in the future,” Epel told the Examiner. “What are the most important aspects of lifestyle, types of stress, and types of well being, that are linked to optimal antibody responses, especially for people of older age?”

Once the study is complete, it will provide valuable information on how long COVID-19 antibodies last, which can inform whether, or how often, booster shots are needed. It could also support mental health treatment as an ongoing tool to combat COVID-19.

“An important aspect to this study is that many of the factors we are investigating are modifiable,” Prather said in an email. “If we find that say stress or poor sleep impairs vaccine response, or that things like positive emotion enhance this response, those become obvious targets of intervention for not only this vaccine but potentially other vaccines into the future.”

To find out more about the BOOST study, visit

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