Association between Overweight/Obesity and the Safety and Efficacy of COVID-19 Vaccination: A Systematic Review

Abstract

Objective: The objective of this study was to appraise the interrelation between overweight/obesity and the safety and efficacy of COVID-19 vaccination by synthesizing the currently available evidence. Methods: A systematic review of published studies on the safety and efficacy of the COVID-19 vaccine in people who were overweight or obese was conducted. Databases including Embase, Medline Epub (Ovid), PsychInfo (Ovid), Web of Science, PubMed, CINAHL, and Google Scholar were searched to identify relevant studies. The databases of the Centers for Disease Control (CDC) and World Health Organization (WHO) were also searched for relevant unpublished and gray literature. Results: Fifteen studies were included in the review. All the included studies used observational study designs; there were ten cohort studies and five cross-sectional studies. The sample size of these studies ranged from 21 to 9,171,524. Thirteen studies reported using BNT162b2 (Pfizer-BioNTech, USA), four reported using ChAdOx-nCov19 (AstraZeneca, U.K), two were reported using CoronaVac (Sinovac, China), and two were reported using mRNA1273 (Moderna, USA). The efficacy and safety of COVID-19 vaccines have been extensively studied in individuals with overweight/obesity. Most studies have shown that the humoral response decreases with increasing BMI. The available evidence does not conclusively indicate that these vaccines are generally safe in this population. Conclusion: While the efficacy of the COVID-19 vaccine may be less than ideal in people who are overweight or obese, it does not mean that obese people should not be vaccinated, as the vaccine can still provide some protection. There is a lack of evidence for conclusions to be drawn about the safety of the vaccine in the population. This study calls on health professionals, policymakers, caregivers, and all other stakeholders to focus on monitoring the possible adverse effects of injections in overweight/obese people.

Immediate and Long-Term Adverse Events of COVID-19 Vaccines: A One-Year Follow-Up Study From the Kurdistan Region of Iraq

“…However, more than half of the overweight (55.17%, n = 240) and 75% (n = 6) of the severely obese vaccinated individuals reported one to three AEs after the second dose (p = 0.03). Our finding is parallel to the controversy observed in the literature, as indicated in a very recent systematic review published in May 2023, which aimed to assess the safety and efficacy of COVID-19 vaccines specifically in individuals who were overweight or obese [28]. Among the included studies, 13 reported the use of BNT162b2 (Pfizer-BioNTech, USA), while four studies reported the use of ChAdOx-nCov19 (AstraZeneca, UK).…”

Safety and efficiency of COVID-19 vaccine in North Africa

“… 74 , 79 Encouraging healthy eating habits, physical activity, and weight reduction should be emphasized. 80 The low rate of reinfection among vaccinated individuals in our study indicates that immunity produced by vaccination remains effective despite the ongoing mutation of the COVID-19 virus and the emergence of new VOCs. While there is controversy, one meta-analysis reported that certain variants (Beta, Gamma and Delta) may have the ability to evade immunity induced by vaccination.…”

Short-term side effects of BNT162b2 vaccine in primary care settings in Qatar: a retrospective study

“…However, this supports findings from other studies suggesting a potential association ( 67 , 68 ). The literature emphasizes the current lack of conclusive evidence regarding vaccine safety in the obese population ( 69 ). Further research is necessary to delve into the mechanisms underlying this potential association.…”