Immunogenicity of Split Inactivated Quadrivalent Influenza Vaccine in Adults with Obesity in the 2017/2018 Season

Abstract

Background Obesity is associated with susceptibility to severe influenza infection and several disturbances of the immune response to the influenza vaccine. However, the effect of obesity on the immunogenicity of the influenza vaccine is not fully understood. Our objective here was to assess the immunogenicity of the split, inactivated quadrivalent influenza vaccine (QIV) in Polish adults with obesity. Material/Methods Fifty-three subjects with obesity aged 2169 years were vaccinated with the QIV in 2017/2018 season. Antibody titers against the 4 vaccine strains were measured using the hemagglutination inhibition (HI) assay. The mean fold antibody increase (MFI), seroprotection rate (protection rate, PR), and seroconversion rate (response rate, RR) were calculated to assess vaccine immunogenicity. Results The vaccine elicited a significant increase in the anti-HI titers against the QIV antigens. The MFI, PR, and RR for the QIV antigens also reached the required age-specific values, indicating the QIV meets current immunogenicity criteria. Individuals with class I and class II/III obesity had similar anti-HI titers, MFI, PR, and RR to each of the vaccine strains. Adults aged <60 years had similar anti-HI titers, MFI, PR, and RR to the QIV strains to those aged 60 years. Conclusions Our results indicate that the split virion, inactivated QIV is immunogenic in adults with obesity regardless of their degree of obesity and age (ie, <60 and 60 years).

Antibody responses to COVID‐19 vaccination in people with obesity: A systematic review and meta‐analysis

“…In addition, obesity is associated with reduced immunogenicity after hepatitis B, 49 tetanus, 50 and influenza 51 , 52 , 53 vaccination. A recent study demonstrated that higher BMI is associated with lower Ab titers in response to the COVID‐19 vaccine in Italian healthcare workers.…”

SARS-CoV-2 and Influenza Vaccines in People with Excessive Body Mass—A Narrative Review

“…Similarly to Sheridan et al, other studies found no interrelation between seroconversion, seroprotection, and elevated BMI level to different influenza H1N1 vaccine components in adults and children after two doses [ 47 ] and for H1N1, H3N2, and influenza B lineages in children [ 44 ]. Furthermore, adults aged <60 years with first-class obesity had a higher rise of HAI titres for H3N2 vaccine strain in comparison with obesity in classes two and three ( p < 0.001) [ 48 ]. Pregnant and postpartum obese women showed lower seroconversion rate than non-obese women (51.5% and 64.4%, respectively [ 49 ]).…”

“…Annual vaccination is an advised approach to avoid the disease. In presented studies, the most frequently administered vaccine was inactivated trivalent influenza vaccine (TIV) [ 42 , 43 , 46 , 48 , 50 ] which protects from an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one of the influenza B viruses, i.e., B/Yamagata or B/Victoria. Nowadays, the quadrivalent vaccine is the most recommended vaccine, containing, in addition, one more influenza B lineage virus according to the Advisory Committee on Immunisation Practices (ACIP).…”

“…It was also hypothesised that inferior protection of obese people after influenza vaccination may be due to lower seroconversion and seroprotection rates. Nevertheless, some studies indicate that people with elevated BMI have higher rates of seroconversion [ 47 ], while other trials have indicated that there is no significant difference between the obese and non-obese groups in seroprotection and seroconversion rates [ 44 , 46 , 48 ]. One month after vaccination, HAI titres were higher in the group of obese people [ 41 ].…”

A Prospective Study Investigating the Impact of Obesity on the Immune Response to the Quadrivalent Influenza Vaccine in Children and Adolescents

“…There are an increasing number of recent studies assessing the association between obesity and influenza vaccine responses in adults with conflicting findings [ 25 , 26 , 27 ]. In contrast, there are only a few small studies describing influenza vaccine responses in obese children and adolescents [ 17 , 18 , 19 ], and none of these studies characterizes the immune responses through to 6-months post-vaccination.…”