Central obesity, smoking habit, and hypertension are associated with lower antibody titres in response to COVID‐19 mRNA vaccine

Abstract

Aims To explore variables associated with the serological response following COVID‐19 mRNA vaccine. Methods Eighty‐six healthcare workers adhering to the vaccination campaign against COVID‐19 were enrolled in January–February 2021. All subjects underwent two COVID‐19 mRNA vaccine inoculations (Pfizer/BioNTech) separated by 3 weeks. Blood samples were collected before the 1st and 1–4 weeks after the second inoculation. Clinical history, demographics, and vaccine side effects were recorded. Baseline anthropometric parameters were measured, and body composition was performed through dual‐energy‐X‐ray absorptiometry. Results Higher waist circumference was associated with lower antibody (Ab) titres ( R = −0.324, p = 0.004); smokers had lower levels compared to non‐smokers [1099 (1350) vs. 1921 (1375), p = 0.007], as well as hypertensive versus normotensive [650 ± 1192 vs. 1911 (1364), p = 0.001] and dyslipideamic compared to those with normal serum lipids [534 (972) vs 1872 (1406), p = 0.005]. Multivariate analysis showed that higher waist circumference, smoking, hypertension, and longer time elapsed since second vaccine inoculation were associated with lower Ab titres, independent of BMI, age. and gender. Conclusions Central obesity, hypertension, and smoking are associated with lower Ab titres following COVID‐19 vaccination. Although it is currently impossible to determine whether lower SARS‐CoV‐2 Abs lead to higher likelihood of developing COVID‐19, it is well‐established that neutralizing antibodies correlate with protection against several viruses including SARS‐CoV‐2. Our findings, therefore, call for a vigilant approach, as subjects with central obesity, hypertension, and smoking could benefit from earlier vaccine boosters or different vaccine schedules.

Kinetics of Anti-SARS-CoV-2 Antibody Responses 3 Months Post Complete Vaccination with BNT162b2; A Prospective Study in 283 Health Workers

“…The presence of comorbidities may impair the anticipated immunogenicity following COVID-19 vaccination [30][31][32][33]. Relatively lower NAbs titers were observed among individuals with diabetes at D22.…”

Does abdominal obesity influence immunological response to SARS-CoV-2 infection?

“…These increased risks have been found after adjusting for age, ethnicity, income, and other demographic and socio-economic factors [ 6 ]. Notably, individuals with central obesity had lower antibody titers than those without, after two COVID-19 mRNA vaccine inoculations (Pfizer/BioNTech) separated by 3 weeks, which would unfavorably affect their prognosis in the case of vaccine breakthrough [ 7 ].…”

ENE-COVID nationwide serosurvey served to characterize asymptomatic infections and to develop a symptom-based risk score to predict COVID-19

“…A certain underdetection of cases among smokers could not be ruled out, since they may develop lower antibody levels. 31 However, a recent review concluded that smokers have lower risk of infection, 32 although the mechanisms are not well understood. 33 A lower probability of participation of infected smokers in our study due to their higher risk of hospitalization is unlikely, as we contacted each person up to 3 times -one per round-, so they had several chances to participate.…”