Infant cortisol stress-response is associated with thymic function and vaccine response

Stress. 2019 Jan;22(1):36-43. doi: 10.1080/10253890.2018.1484445. Epub 2018 Jun 22.


Stress can impair T cell-mediated immunity. To determine if infants with high stress responses had deficits in T-cell mediated immunity, we examined the association of pain-induced cortisol responsiveness with thymic function and vaccine responses in infants. This study was performed among 306 (male = 153 and female = 153) participants of a randomized, controlled trial examining the effect of neonatal vitamin A supplementation on immune function in Bangladesh (NCT01583972). Salivary cortisol was measured before and 20 min after a needle stick (vaccination) at 6 weeks of age. The thymic index (TI) was determined by ultrasonography at 1, 6, 10 and 15 weeks. T-cell receptor excision circle and blood T-cell concentrations were measured at 6 and 15 weeks. Responses to Bacillus Calmette-Guérin (BCG), tetanus toxoid, hepatitis B virus and oral poliovirus vaccination were assayed at 6 and 15 weeks. Cortisol responsiveness was negatively associated with TI at all ages (p < .01) in boys only, was negatively associated with naïve helper T-cell concentrations in both sexes at both 6 (p = .0035) and 15 weeks (p = .0083), and was negatively associated with the delayed-type hypersensitivity (DTH) skin test response to BCG vaccination at 15 weeks (p = .034) in both sexes. Infants with a higher cortisol response to pain have differences in the T-cell compartment and a lower DTH response to vaccination. Sex differences in the immune system were seen as early as 6 weeks of age in these healthy infants.

Keywords: Stress; T-cell; cortisol; thymus; vaccine; vitamin A.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • BCG Vaccine / administration & dosage*
  • Dietary Supplements
  • Double-Blind Method
  • Female
  • Humans
  • Hydrocortisone / immunology
  • Hydrocortisone / metabolism*
  • Infant
  • Infant, Newborn
  • Male
  • Poliovirus Vaccine, Oral / administration & dosage*
  • Stress, Psychological / immunology
  • Stress, Psychological / metabolism*
  • T-Lymphocytes / immunology
  • Tetanus Toxoid / administration & dosage*
  • Thymus Gland / immunology
  • Thymus Gland / metabolism*
  • Vitamin A / administration & dosage*
  • Vitamin A / immunology


  • BCG Vaccine
  • Poliovirus Vaccine, Oral
  • Tetanus Toxoid
  • Vitamin A
  • Hydrocortisone