Skip to main content Accessibility help

Probiotics and the immune response to vaccines

  • Thomas T. MacDonald (a1) and Iona Bell (a1)


Probiotics are bacteria, but sometimes fungi, which when taken by the oral route may give some health benefits. The most compelling evidence for beneficial effects of probiotics is in the prevention and reduction in the duration of symptoms related to gut infectious disease. There is also evidence to show that some specific probiotics are beneficial in Clostridium difficile diarrhoea in the elderly. As further and better controlled clinical studies have appeared, some specific probiotics also appear to have beneficial effects in perhaps preventing and reducing the duration of symptoms due to acquired upper respiratory tract infections. In an attempt to explain these effects, attention has turned to the effects of some specific probiotics on the immune system. There is evidence that some specific probiotics can alter monocyte and natural killer cell function in the blood. Evidence is also accumulating that taking some specific probiotics can boost antibody responses to oral and systemically administered vaccines. The effect when shown is modest and is not always seen in different studies to all vaccines, but there is enough of a trend to make the area worthy of further investigation, particularly to tease out the mechanisms involved.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Probiotics and the immune response to vaccines
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Probiotics and the immune response to vaccines
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Probiotics and the immune response to vaccines
      Available formats


Corresponding author

*Corresponding author: Thomas T. MacDonald, fax +44 207 8822185, email


Hide All
1.Solis, B, Samartin, S, Gómez, S et al. (2002) Probiotics as a help in children suffering from malnutrition and diarrhoea. Eur J Clin Nutr 56, Suppl. 3, S57S59.
2.Hatakka, K & Saxelin, M (2008) Probiotics in intestinal and non-intestinal infectious diseases – clinical evidence. Curr Pharm Des 14, 13511367.
3.Guandalini, S (2008) Probiotics for children with diarrhea: an update. J Clin Gastroenterol 42, Suppl. 2, S53S57.
4.Parkes, GC, Sanderson, JD & Whelan, K (2009) The mechanisms and efficacy of probiotics in the prevention of clostridium difficile-associated diarrhoea. Lancet Infect Dis 9, 237244.
5.Prantera, C & Scribano, ML (2009) Antibiotics and probiotics in inflammatory bowel disease: why, when, and how. Curr Opin Gastroenterol 25, 329333.
6.Hickson, M, D'Souza, AL, Muthu, N et al. (2007) Use of probiotic lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ 335, 80; Epublication 29 June 2007.
7.Vouloumanou, EK, Makris, GC, Karageorgopoulos, DE et al. (2009) Probiotics for the prevention of respiratory tract infections: a systematic review. Int J Antimicrob Agents 34, 197.E1–10.
8.Turchet, P, Laurenzano, M, Auboiron, S et al. (2003) Effects of fermented milk containing the probiotic Lactobacillus casei DN-114 001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study. J Nutr Health Aging 7, 7577.
9.De Vrese, M, Winkler, P, Rautenberg, P et al. (2006) Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial. Vaccine 24, 66706674.
10.Layer, JG, Li, S, Mubasher, EM et al. (2009) Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 124, E172E179.
11.Guillemard, E, Tondu, F, Lacoin, F et al. (2009) Consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 reduces the duration of respiratory infections in the elderly in a randomised controlled trial. Br J Nutr 103, 5868.
12.Schiffrin, EJ, Rochat, F, Link-Amster, H et al. (1995) Immunomodulation of human blood cells following the ingestion of lactic acid bacteria. J Dairy Sci 78, 491497.
13.Gill, HS, Rutherfurd, KJ, Cross, ML et al. (2001) Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019. Am J Clin Nutr 74, 833839.
14.Parra, D, Martinez de Morentin, B, Cobo, JM et al. (2004) Monocyte function in healthy middle-aged people receiving fermented milk containing Lactobacillus casei. J Nutr Health Aging 8, 208211.
15.Nagao, F, Nakayama, M, Muto, T et al. (2000) Effects of a fermented milk drink containing Lactobacillus casei strain Shirota on the immune system in healthy human subjects. Biosci Biotechnol Biochem 64, 27062708.
16.Morimoto, K, Takeshita, T, Nanno, M et al. (2005) Modulation of natural killer cell activity by supplementation of fermented milk containing Lactobacillus casei in habitual smokers. Prev Med 40, 589594.
17.Marschan, E, Kuitunen, M, Kukkonen, K et al. (2008) Probiotics in infancy induce protective immune profiles that are characteristic for chronic low-grade inflammation. Clin Exp Allergy 38, 611618.
18.Isolauri, E, Joensuu, J, Suomalainen, H et al. (1995) Improved immunogenicity of oral D x RRV reassortant rotavirus vaccine by Lactobacillus casei GG. Vaccine 13, 310312.
19.De Vrese, M, Rautenberg, P, Laue, C et al. (2005) Probiotic bacteria stimulate virus-specific neutralizing antibodies following a booster polio vaccination. Eur J Nutr 44, 406413.
20.Kukkonen, K, Nieminen, T, Poussa, T et al. (2006) Effect of probiotics on vaccine antibody responses in infancy – a randomized placebo-controlled double-blind trial. Pediatr Allergy Immunol 17, 416421.
21.West, CE, Gothefors, L, Granström, M et al. (2008) Effects of feeding probiotics during weaning on infections and antibody responses to diphtheria, tetanus and Hib vaccines. Pediatr Allergy Immunol 19, 5360.
22.Nauta, JJ, Beyer, WE & Osterhaus, AD (2009) On the relationship between mean antibody level, seroprotection and clinical protection from influenza. Biologicals 37, 216221.
23.Boge, T, Rémigy, M, Vaudaine, S et al. (2009) A probiotic fermented dairy drink improves antibody response to influenza vaccination in the elderly in two randomised controlled trials. Vaccine 27, 56775684.
24.Mortensen, RF (2001) C-reactive protein, inflammation, and innate immunity. Immunol Res 24, 163176.
25.Akira, S, Hirano, T, Taga, T et al. (1990) Biology of multifunctional cytokines:IL 6 and related molecules (IL1 and TNF). FASEB J 4, 28602867.
26.Karlsson, H, Larsson, P, Wold, AE et al. (2004) Pattern of cytokine responses to gram-positive and gram-negative commensal bacteria is profoundly changed when monocytes differentiate into dendritic cells. Infect Immun 72, 26712678.
27.Mohamadzadeh, M, Olson, S, Kalina, WV et al. (2005) Lactobacilli activate human dendritic cells that skew T cells toward T helper 1 polarization. Proc Natl Acad Sci USA 102, 28802885.
28.Hart, AL, Lammers, K, Brigidi, P et al. (2004) Modulation of human dendritric cell phenotype and function by probiotic bacteria. Gut 53, 16021609.
29.Van Baarlen, P, Troost, FJ, Van Hemert, S et al. (2009) Differential NF-kappaB pathways induction by Lactobacillus plantarum in the duodenum of healthy humans correlating with immune tolerance. Proc Natl Acad Sci USA 106, 23712376.
30.MacDonald, TT (2008) The gut is still the biggest lymphoid organ in the body. Mucosal Immunol 1, 246247.
31.Jameson, B, Baribaud, F, Pöhlmann, S et al. (2002) Expression of DC-SIGN by dendritic cells of intestinal and genital mucosae in human and rhesus macaques. J Virol 76, 18661875.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed