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Optimizing mood prior to influenza vaccination in older adults: A three-arm randomized controlled trial

Ayling, Kieran; Brown, Michaela; Carlisle, Sophie; Bennett, Robert; Buchanan, Heather; Dumbleton, Jennifer; Hawkey, Christopher; Hoschler, Katja; Jack, Ruth H; Nguyen-Van-Tam, Jonathan; Royal, Simon; Turner, David; Zambon, Maria; Fairclough, Lucy; Vedhara, Kavita

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Michaela Brown

Sophie Carlisle

Robert Bennett

Jennifer Dumbleton

Christopher Hawkey

Katja Hoschler

Senior Research Fellow

Simon Royal

Clinical Associate Professor

Maria Zambon

Kavita Vedhara


Objective: This trial explored the psychological and immunological effects of two brief interventions, targeting improving positive mood, administered to older adults immediately prior to influenza vaccination. The primary aim was to examine whether the interventions resulted in greater positive mood compared to usual care, and if so, which was superior. Secondary outcomes included antibody responses to vaccination and feasibility of collecting clinical outcome data (e.g., respiratory infections). Method: Six hundred and fifty-four older adults (65–85 years) participated in a three-arm, parallel, randomized controlled trial between September 2019 and May 2020. Immediately prior to receiving an adjuvanted trivalent influenza vaccine (Fluad, Seqirus UK Ltd), participants viewed one of two brief (15-min) video-based positive mood interventions (one fixed content, one allowing participant choice) or received usual care. State affect was measured immediately prior to, and following, intervention exposure or usual care. Antibody responses were measured prevaccination and 4 weeks postvaccination. Clinical outcomes were extracted from primary care records for 6 months following vaccination. Results: Both interventions were equally effective at improving mood prior to vaccination compared to usual care. Antibody responses were highly robust with postvaccination seroprotection rates of >88% observed for all vaccine strains. Antibody responses did not significantly differ between groups. Clinical outcome data were feasible to collect. Conclusions: Brief psychological interventions can improve mood prior to vaccination. However, altering antibody responses to highly immunogenic adjuvanted vaccines may require more targeted or prolonged interventions. The provision of choice did not notably enhance the interventions impact on mood or antibody outcomes.

Journal Article Type Article
Acceptance Date Dec 5, 2022
Online Publication Date Dec 7, 2023
Publication Date Dec 7, 2023
Deposit Date Dec 7, 2022
Publicly Available Date Dec 7, 2023
Journal Health Psychology
Print ISSN 0278-6133
Electronic ISSN 1930-7810
Publisher American Psychological Association
Peer Reviewed Peer Reviewed
Volume 43
Issue 2
Pages 77-88
Public URL
Publisher URL


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