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Evidence-Based Study
Augmenting Immune Responses to Varicella Zoster Virus in Older Adults: A Randomized, Controlled Trial of Tai Chi
  • Michael R. Irwin, MD*
  • ,
  • Richard Olmstead, PhD*
  • Michael N. Oxman, MD \
    • Cousins Center for Psycho-neuroimmunology, Semel Institute for Neuroscience, University of California at Los Angeles, Los Angeles, California; Department of Medicine, Division of Infectious Diseases, University of California at San Diego, San Diego, California; and San Diego Veterans Affairs Healthcare System, San Diego, California.
Address correspondence to Michael R. Irwin, MD, Cousins Center for Psycho-neuroimmunology, UCLA Neuropsychiatric Institute, 300 UCLA Medical Plaza, Room 3130, Los Angeles, CA 90095. E-mail:


OBJECTIVES: To evaluate the effects of a behavioral intervention, Tai Chi, on resting and vaccine-stimulated levels of cell-mediated immunity (CMI) to varicella zoster virus (VZV) and on health functioning in older adults.

DESIGN: A prospective, randomized, controlled trial with allocation to two arms (Tai Chi and health education) for 25 weeks. After 16 weeks of intervention, subjects were vaccinated with VARIVAX, the live attenuated Oka/Merck VZV vaccine licensed to prevent varicella.

SETTING: Two urban U.S. communities between 2001 and 2005.

PARTICIPANTS: A total of 112 healthy older adults aged 59 to 86.

MEASUREMENTS: The primary endpoint was a quantitative measure of VZV-CMI. Secondary outcomes were scores on the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36).

RESULTS: The Tai Chi group showed higher levels of VZV-CMI than the health education group (P<.05), with a significant rate of increase (P<.001) that was nearly twice that found in the health education group. Tai Chi alone induced an increase in VZV-CMI that was comparable in magnitude with that induced by varicella vaccine, and the two were additive; Tai Chi, together with vaccine, produced a substantially higher level of VZV-CMI than vaccine alone. The Tai Chi group also showed significant improvements in SF-36 scores for physical functioning, bodily pain, vitality, and mental health (P<.05).

CONCLUSION: Tai Chi augments resting levels of VZV-specific CMI and boosts VZV-CMI of the varicella vaccine.

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