Association between obesity and vulnerability and serologic response to influenza vaccination in older adults

Abstract

Background Serologic response to influenza vaccination declines with age. Few other host factors are known to be associated with serologic response. Our objective was to determine whether obesity and vulnerability independently predicted serologic response to influenza vaccination. Methods Adults ≥ 50 yrs were recruited during the 2008-09 influenza season. Subjects provided pre- and post-vaccination sera for measuring antibody titers to 2008-09 vaccine components. Body mass index (BMI) was calculated as weight (kg) ÷ height (m)2. Data were collected on vulnerability using the Vulnerable Elders Survey (VES13). Logistic regression evaluated the associations between obesity and vulnerability and the serologic response to vaccination (both seroprotection andseroconversion), adjusting for gender, age, comorbidities, pre-vaccination titer, and site. Results Mean (± standard deviation) age of 415 study subjects was 65 ± 10 yrs; 40% were obese. Mean BMI was 29 ± 5.6 kg/m2; mean VES13 was 1.6 ± 1.8. The proportions of subjects who seroconverted and had seroprotective titers were 40% and 49%, respectively, for A/Brisbane/59 (H1N1); 73% and 80% for A/Brisbane/10 (H3N2); and 34% and 94% for B/Florida. Modified VES-13 (score 0 to 10, with 10 being most vulnerable) was not associated with seroprotection against H1N1 or H3N2, and VES-13 was directly associated with seroconversion to H1N1 but not H3N2 or B. Obesity (BMI ≥ 30 kg/m2 vs. BMI 18.5 – 30) was not associated with seroprotection for H1N1 or H3N2; obesity was directly associated with seroconversion to H3N2 but not H1N1 or B. Age was inversely associated with seroprotection and seroconversion against H1N1 and with seroconversion to influenza B. Conclusion Based on this sample of older healthy subjects, there were no consistent relationships between VES 13 or obesity and either seroprotection or seroconversion to three influenza vaccine antigens.

Are plasma mineral levels related to antibody response to influenza vaccination in older adults?

“…Day 0 magnesium and phosphorus levels were also significantly related to immune response to A/H1N1 levels when being overweight was included in the model. Other research has reported no relationship of obesity to immune response to influenza vaccine, 13 The major finding of the current study is the strong association between Day 21 phosphorus levels and both Day 21 seroprotection and seroconversion for both influenza A strains. The literature suggests a prominent role for phosphorus for lymphocyte and monocyte proliferation and activation.…”

Age and psychological influences on immune responses to trivalent inactivated influenza vaccine in the meditation or exercise for preventing acute respiratory infection (MEPARI) trial

“…49 But it should be noted that even in the published reports, BMI was not correlated with antibody levels at 3 mo post-immunization, only later at one year when a differential decline was detected by Sheridan et al 49 Our findings appear to concur with another study that also investigated the 2009-10 influenza vaccine, which failed to find a correlation between antibody responses and BMI. 50 Similarly, we were unable to detect a correlation between obesity and virus-specific cytokine production. 49 Most significantly, our study did not replicate the findings of Davidson and colleagues, who reported positive effects of MBSR on the incremental rise in IgG to influenza vaccination from month 1 to month 2.…”

Safety, immunogenicity, and tolerability of three influenza vaccines in older adults

“…13 This study benefitted from a high degree of similarity among the study groups, effectively controlling for a range of potential influences on responses to vaccination including age, 19 sex, prior influenza vaccination, 15,16 frailty, 20 chronic health conditions, obesity, 21 moderate exercise 22 and probiotic use. 23 Similarity of baseline antibody titers among the study groups avoided the need for adjustment of observed responses.…”