Impact of Obesity and Being Overweight on the Immunogenicity to Live Attenuated Hepatitis A Vaccine in Children and Young Adults

Abstract

Prior results investigating a correlation between obesity and hepatitis A virus (HAV) vaccine response have been inconclusive, with limited data involving live attenuated HAV vaccines. The aim of this study is to evaluate the effect of overweight and obesity on the response to live attenuated HAV vaccine in children and young adults. This prospective cohort study was conducted in Thailand with subjects ranging in age from seven to twenty-five years. The subjects were administered 0.5 mL of MEVAC™-A and tested for anti-HAV antibodies before and at 8–9 weeks after vaccination. Baseline seronegative subjects (anti-HAV antibodies < 20 mIU/mL) were divided into non-obese (underweight/normal weight) and obese (overweight/obesity/severe obesity) groups. A total of 212 (117 non-obese and 95 obese) subjects completed the study (mean age (SD) = 13.95 (3.90) years). The seroprotection rates were 100%. Postvaccination geometric mean titers (95% CI) were 429.51 (401.97, 458.94) and 467.45 (424.47, 514.79) mIU/mL in the non-obese and obese groups, respectively. Females (p = 0.013) and subjects with truncal obesity (p = 0.002) had significantly higher titers than other participants. Live attenuated HAV vaccine is safe and has comparably high immunogenicity in both underweight/normal weight and overweight/obese persons.

Seroprevalence of hepatitis A virus antibodies among children and adolescents living in Northern Thailand: an implication for hepatitis A immunization

“…Frequent eating habits might be one possible factor that increased their exposure to natural HAV infections. A previous study conducted in Thailand also reported that truncal obesity was a strong associated factor of a better immune response to single-dose live-attenuated HAV vaccine 27 . To date, the plausible mechanisms of the association between overweight/obesity and strong immune response to HAV infection or vaccination are not clearly understood 28 .…”

Systemic immunometabolism and responses to vaccines: insights from T and B cell perspectives

“…Specifically, poor antibody responses have been reported in obese individuals upon tetanus ( 70 ), influenza ( 66 , 71 ) or inactivated SARS-CoV-2 ( 72 ) vaccinations. In contrast, other vaccination regimes, such as live-attenuated hepatitis A, have been shown to be equally effective in both obese and lean individuals, suggesting that other factors may be at play ( 73 ). Furthermore, several studies have observed lower antibody titres upon influenza vaccination in obese individuals, and this defect is typically mirrored by decreased protection from influenza-related complications compared with non-obese individuals ( 74 , 75 ).…”