tetano
Editor, Senior Moderator
Nat Med
. 2023 May 11.
doi: 10.1038/s41591-023-02343-2. Online ahead of print. Accelerated waning of the humoral response to COVID-19 vaccines in obesity
Agatha A van der Klaauw[SUP] 1 [/SUP], Emily C Horner[SUP] #[/SUP][SUP] 2 [/SUP], Pehuén Pereyra-Gerber[SUP] #[/SUP][SUP] 3 4 [/SUP], Utkarsh Agrawal[SUP] #[/SUP][SUP] 5 [/SUP], William S Foster[SUP] 6 [/SUP], Sarah Spencer[SUP] 2 [/SUP], Bensi Vergese[SUP] 1 7 [/SUP], Miriam Smith[SUP] 1 [/SUP], Elana Henning[SUP] 1 [/SUP], Isobel D Ramsay[SUP] 3 4 8 [/SUP], Jack A Smith[SUP] 3 4 [/SUP], Stephane M Guillaume[SUP] 6 [/SUP], Hayley J Sharpe[SUP] 6 [/SUP], Iain M Hay[SUP] 6 9 [/SUP], Sam Thompson[SUP] 6 [/SUP], Silvia Innocentin[SUP] 6 [/SUP], Lucy H Booth[SUP] 2 [/SUP], Chris Robertson[SUP] 10 [/SUP], Colin McCowan[SUP] 5 [/SUP], Steven Kerr[SUP] 11 [/SUP], Thomas E Mulroney[SUP] 2 [/SUP], Martin J O'Reilly[SUP] 2 [/SUP], Thevinya P Gurugama[SUP] 2 [/SUP], Lihinya P Gurugama[SUP] 2 [/SUP], Maria A Rust[SUP] 2 [/SUP], Alex Ferreira[SUP] 2 [/SUP], Soraya Ebrahimi[SUP] 12 13 [/SUP], Lourdes Ceron-Gutierrez[SUP] 12 13 [/SUP], Jacopo Scotucci[SUP] 1 [/SUP], Barbara Kronsteiner[SUP] 14 [/SUP], Susanna J Dunachie[SUP] 14 15 16 17 18 [/SUP], Paul Klenerman[SUP] 14 15 16 17 [/SUP]; PITCH Consortium; Adrian J Park[SUP] 13 [/SUP], Francesco Rubino[SUP] 19 [/SUP], Abigail A Lamikanra[SUP] 20 21 [/SUP], Hannah Stark[SUP] 22 [/SUP], Nathalie Kingston[SUP] 22 [/SUP], Lise Estcourt[SUP] 20 21 [/SUP], Heli Harvala[SUP] 23 [/SUP], David J Roberts[SUP] 20 21 [/SUP], Rainer Doffinger[SUP] 12 13 [/SUP], Michelle A Linterman[SUP] 6 [/SUP], Nicholas J Matheson[SUP] #[/SUP][SUP] 3 4 8 24 [/SUP], Aziz Sheikh[SUP] #[/SUP][SUP] 25 [/SUP], I Sadaf Farooqi[SUP] #[/SUP][SUP] 26 [/SUP], James E D Thaventhiran[SUP] #[/SUP][SUP] 27 [/SUP]
Affiliations
Obesity is associated with an increased risk of severe Coronavirus Disease 2019 (COVID-19) infection and mortality. COVID-19 vaccines reduce the risk of serious COVID-19 outcomes; however, their effectiveness in people with obesity is incompletely understood. We studied the relationship among body mass index (BMI), hospitalization and mortality due to COVID-19 among 3.6 million people in Scotland using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. We found that vaccinated individuals with severe obesity (BMI > 40 kg/m[SUP]2[/SUP]) were 76% more likely to experience hospitalization or death from COVID-19 (adjusted rate ratio of 1.76 (95% confidence interval (CI), 1.60-1.94). We also conducted a prospective longitudinal study of a cohort of 28 individuals with severe obesity compared to 41 control individuals with normal BMI (BMI 18.5-24.9 kg/m[SUP]2[/SUP]). We found that 55% of individuals with severe obesity had unquantifiable titers of neutralizing antibody against authentic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus compared to 12% of individuals with normal BMI (P = 0.0003) 6 months after their second vaccine dose. Furthermore, we observed that, for individuals with severe obesity, at any given anti-spike and anti-receptor-binding domain (RBD) antibody level, neutralizing capacity was lower than that of individuals with a normal BMI. Neutralizing capacity was restored by a third dose of vaccine but again declined more rapidly in people with severe obesity. We demonstrate that waning of COVID-19 vaccine-induced humoral immunity is accelerated in individuals with severe obesity. As obesity is associated with increased hospitalization and mortality from breakthrough infections, our findings have implications for vaccine prioritization policies.
. 2023 May 11.
doi: 10.1038/s41591-023-02343-2. Online ahead of print. Accelerated waning of the humoral response to COVID-19 vaccines in obesity
Agatha A van der Klaauw[SUP] 1 [/SUP], Emily C Horner[SUP] #[/SUP][SUP] 2 [/SUP], Pehuén Pereyra-Gerber[SUP] #[/SUP][SUP] 3 4 [/SUP], Utkarsh Agrawal[SUP] #[/SUP][SUP] 5 [/SUP], William S Foster[SUP] 6 [/SUP], Sarah Spencer[SUP] 2 [/SUP], Bensi Vergese[SUP] 1 7 [/SUP], Miriam Smith[SUP] 1 [/SUP], Elana Henning[SUP] 1 [/SUP], Isobel D Ramsay[SUP] 3 4 8 [/SUP], Jack A Smith[SUP] 3 4 [/SUP], Stephane M Guillaume[SUP] 6 [/SUP], Hayley J Sharpe[SUP] 6 [/SUP], Iain M Hay[SUP] 6 9 [/SUP], Sam Thompson[SUP] 6 [/SUP], Silvia Innocentin[SUP] 6 [/SUP], Lucy H Booth[SUP] 2 [/SUP], Chris Robertson[SUP] 10 [/SUP], Colin McCowan[SUP] 5 [/SUP], Steven Kerr[SUP] 11 [/SUP], Thomas E Mulroney[SUP] 2 [/SUP], Martin J O'Reilly[SUP] 2 [/SUP], Thevinya P Gurugama[SUP] 2 [/SUP], Lihinya P Gurugama[SUP] 2 [/SUP], Maria A Rust[SUP] 2 [/SUP], Alex Ferreira[SUP] 2 [/SUP], Soraya Ebrahimi[SUP] 12 13 [/SUP], Lourdes Ceron-Gutierrez[SUP] 12 13 [/SUP], Jacopo Scotucci[SUP] 1 [/SUP], Barbara Kronsteiner[SUP] 14 [/SUP], Susanna J Dunachie[SUP] 14 15 16 17 18 [/SUP], Paul Klenerman[SUP] 14 15 16 17 [/SUP]; PITCH Consortium; Adrian J Park[SUP] 13 [/SUP], Francesco Rubino[SUP] 19 [/SUP], Abigail A Lamikanra[SUP] 20 21 [/SUP], Hannah Stark[SUP] 22 [/SUP], Nathalie Kingston[SUP] 22 [/SUP], Lise Estcourt[SUP] 20 21 [/SUP], Heli Harvala[SUP] 23 [/SUP], David J Roberts[SUP] 20 21 [/SUP], Rainer Doffinger[SUP] 12 13 [/SUP], Michelle A Linterman[SUP] 6 [/SUP], Nicholas J Matheson[SUP] #[/SUP][SUP] 3 4 8 24 [/SUP], Aziz Sheikh[SUP] #[/SUP][SUP] 25 [/SUP], I Sadaf Farooqi[SUP] #[/SUP][SUP] 26 [/SUP], James E D Thaventhiran[SUP] #[/SUP][SUP] 27 [/SUP]
Affiliations
- PMID: 37169862
- DOI: 10.1038/s41591-023-02343-2
Obesity is associated with an increased risk of severe Coronavirus Disease 2019 (COVID-19) infection and mortality. COVID-19 vaccines reduce the risk of serious COVID-19 outcomes; however, their effectiveness in people with obesity is incompletely understood. We studied the relationship among body mass index (BMI), hospitalization and mortality due to COVID-19 among 3.6 million people in Scotland using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. We found that vaccinated individuals with severe obesity (BMI > 40 kg/m[SUP]2[/SUP]) were 76% more likely to experience hospitalization or death from COVID-19 (adjusted rate ratio of 1.76 (95% confidence interval (CI), 1.60-1.94). We also conducted a prospective longitudinal study of a cohort of 28 individuals with severe obesity compared to 41 control individuals with normal BMI (BMI 18.5-24.9 kg/m[SUP]2[/SUP]). We found that 55% of individuals with severe obesity had unquantifiable titers of neutralizing antibody against authentic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus compared to 12% of individuals with normal BMI (P = 0.0003) 6 months after their second vaccine dose. Furthermore, we observed that, for individuals with severe obesity, at any given anti-spike and anti-receptor-binding domain (RBD) antibody level, neutralizing capacity was lower than that of individuals with a normal BMI. Neutralizing capacity was restored by a third dose of vaccine but again declined more rapidly in people with severe obesity. We demonstrate that waning of COVID-19 vaccine-induced humoral immunity is accelerated in individuals with severe obesity. As obesity is associated with increased hospitalization and mortality from breakthrough infections, our findings have implications for vaccine prioritization policies.