The Health Effects of Loneliness

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Loneliness has been commonplace in analyses of the effects of the pandemic and the public health restrictions implemented to address it. The single-minded focus on mitigating the spread of the coronavirus pandemic and the related illness and mortality has led to months of isolation. The resulting loneliness has taken a toll on the mental health of both adults and children. Social support has long been known to be a significant factor in health and well-being, reducing the likelihood, severity, and duration of various illnesses.

The negative outcomes of isolation
Therefore, it is not surprising that the isolation associated with the response to the pandemic has resulted in increased negative outcomes that are mitigated by social support. These range from overall well-being and satisfaction with life (DeYoung & Mangum, 2021) to rates of psychiatric hospitalizations (Parmar et al., 2021) and suicidality, especially among adolescents (Santini et al., 2021). Suicidality has been directly related to COVID-19-related stress symptoms, loneliness, and financial strain (Elbogen, Lanier, Blakey, Wagner, & Tsai, 2021).

The effects of psychological factors on response to infections have been one of the driving forces in the development of the field of psychoneuroimmunology. Stress and social support, for example, have long been known to impact both susceptibility to the common cold virus and severity of symptoms (Cohen, Tyrrell, & Smith, 1991). More recently, loneliness specifically has been shown to predict symptoms of the common cold (LeRoy, Murdock, Jaremka, Loya, & Fagundes, 2017).

Loneliness can impair the immune system’s response to vaccines
Widespread vaccination to create “herd immunity” is seen as an important component of stopping the spread of the virus. However, there is evidence that stress, depression, and loneliness can impair the immune system’s response to vaccines, particularly in the elderly (Madison, Shrout, Renna, & Kiecolt-Glaser, 2021). The first phase of an immune response to challenge is called “innate immunity” and is the immediate and non-specific response, which includes the inflammatory response. The second phase is referred to as “adaptive immunity,” which is slower but involves the development of lasting memory to specific pathogens (e.g., viruses and bacteria) that allows the immune system to respond more quickly to future exposures.

This response, which is what the vaccine is aimed at, includes the development of T-cells that recognize and kill pathogens, and B-cells that produce specific antibodies that neutralize pathogens. Reported stress both before and after receiving vaccines has been related to reductions in the antibody response. The interference of stress on the immune response is particularly noticeable in older adults, both initially and in terms of maintaining antibodies.

Consideration of the relationship between psychological health and immunity highlights the importance of considering the impact of public health interventions such as lockdowns and isolation on our ability to develop immunity as well as to the mental health consequences of these interventions. A holistic approach to dealing with the pandemic would include such considerations.