0099 Impact of Sleep and Timing of Vaccination on Neutralizing Antibody Responses to the COVID-19 Vaccine

Abstract Introduction Vaccines remain the primary mitigating strategy to reduce the burden of disease caused by COVID-19. As such, there is a pressing need to identify factors that promote more robust and durable immune responses to vaccination. Sleep and circadian processes, such as the timing of vaccine administration, have been hypothesized to play a meaningful role in predicting durability of antibody responses; however, empirical data supporting links between sleep and timing on COVID-19 vaccine response is limited. Methods We recruited 428 adults (aged 18-88 years old) naive to the COVID-19 vaccination series and SARS-CoV-2 infection who received the mRNA COVID-19 vaccine series (% Pfizer; % Moderna) and underwent blood draws to quantify neutralizing antibody responses (nAB) 1 and 6 months post vaccination series. They completed sleep questionnaires (Pittsburgh Sleep Quality Index) and a week of sleep diaries at three time points. In addition, 198 participants wore a wearable device (Oura Ring) for 2 months to capture behavioral sleep metrics. Time of day of vaccine was obtained by self-report as part of the daily diaries. Results Analyses revealed that independent of age, sex, BMI, smoking status, and vaccine type, poorer global sleep quality was associated with lower nABs 6-months post vaccination (F(1, 424.3)=5.30, p=0.02). We also did detected a trend-level 3-way interaction between vaccine type, time point, and OURA based sleep duration indicating that shorter sleep duration was associated with lower 6-month nAB in those who received the Pfizer vaccine (b=0.17, SE=0.07, p=0.009). In analyses examining the impact of time of day of vaccine administration on nABs, we failed to find any evidence that timing of vaccine administration was associated with nABs at 1 or 6 months post vaccination (Dose 1: F(1, 330.1)=0.01, p=0.91; Dose 2: F(1, 344.5)=0.46, p=0.50). Conclusion Findings suggest that better global sleep quality is associated with greater nAB durability to the COVID-19 vaccine, and among those who received the Pfizer vaccine, longer average sleep duration promoted higher nAB 6-months post-vaccination. However, there was no clear evidence indicating that timing of vaccination administration was relevant to nAB responses. Further research is warranted including investigations into whether sleep interventions can enhance vaccine efficacy. Support (if any) R24AG048024