Real world SARS-COV-2 vaccine effectiveness in a Miami academic institution

Mallow, Christopher; Ferreira, Tanira; Shukla, Bhavarth; Warde, Prem R.; Sosa, Marie Anne; Parekh, Dipen J.; Gershengorn, Hayley B.

doi:10.1016/j.ajem.2022.01.066

Cited by 8 publications

(15 citation statements)

References 8 publications

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“…Our findings in people with severe obesity are consistent with previous studies showing that the acute immune response to SARS-CoV-2 vaccines is comparable in people with obesity and normal weight people 15–20 . Some of these studies suggested that the duration of vaccine-induced immunity may be reduced in people with obesity 16–18 .…”

Section: Discussionsupporting

confidence: 92%

“…These studies all relied on measurements of immunity at a single time-point and used different assays/endpoints (e.g. self-reported home antibody tests 19 or an assumption of effectiveness in those who tested negative for Covid-19 by RT-PCR 20 ). Here, by prospectively measuring B cell and T cell responses as well as neutralizing capacity of antibodies to authentic virus in vaccinated people with severe obesity and normal weight controls over time, we demonstrate that the waning of humoral immunity associated with SARS-CoV-2 vaccines 29 is accelerated in people with severe obesity.…”

Section: Discussionmentioning

confidence: 99%

“…People with obesity have impaired immune responses to conventional influenza, rabies and hepatitis vaccines [11][12][13][14] , however, the impact of obesity on their responses to mRNA and adenoviral vectored vaccines is not known. Some studies have suggested that following SARS-CoV-2 vaccination, antibody titres may be lower in people with obesity [15][16][17][18][19][20] . One possible explanation is the impact of needle length on vaccine dosing in people with obesity 21 .…”

Section: Mainmentioning

confidence: 99%

See 2 more Smart Citations

Accelerated waning of the humoral response to SARS-CoV-2 vaccines in obesity

Klaauw

Horner

Pereyra-Gerber

et al. 2022

Preprint

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Obesity is associated with an increased risk of severe Covid-19. However, the effectiveness of SARS-CoV-2 vaccines in people with obesity is unknown. Here we studied the relationship between body mass index (BMI), hospitalization and mortality due to Covid-19 amongst 3.5 million people in Scotland. Vaccinated people with severe obesity (BMI>40 kg/m2) were significantly more likely to experience hospitalization or death from Covid-19. Excess risk increased with time since vaccination. To investigate the underlying mechanisms, we conducted a prospective longitudinal study of the immune response in a clinical cohort of vaccinated people with severe obesity. Compared with normal weight controls, six months after their second vaccine dose, significantly more people with severe obesity had unquantifiable titres of neutralizing antibody against authentic SARS-CoV-2 virus, reduced frequencies of antigen-experienced SARS-CoV-2 Spike-binding B cells, and a dissociation between anti-Spike antibody levels and neutralizing capacity. Neutralizing capacity was restored by a third dose of vaccine, but again declined more rapidly in people with severe obesity. We demonstrate that waning of SARS-CoV-2 vaccine-induced humoral immunity is accelerated in people with severe obesity and associated with increased hospitalization and mortality from breakthrough infections. Given the prevalence of obesity, our findings have significant implications for global public health.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Mainmentioning

confidence: 99%

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Accelerated waning of the humoral response to SARS-CoV-2 vaccines in obesity

Klaauw

Horner

Pereyra-Gerber

et al. 2022

Preprint

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show abstract

“…Similarly to The Obesity Society’s study [ 34 ], a study analysing the University of Miami Hospital’s Emergency Department patients showed that increased BMI is not negatively affecting immune response to mRNA vaccines: BMI < 25 kg/m²: 66.3% vaccine effectiveness calculated from the formula: 1 − [(a/b)/(c/d)] ((a) vaccinated patients who were tested positive for COVID-19, (b) vaccinated patients who were tested negative for COVID-19, (c) unvaccinated patients who were tested positive for COVID-19, (d) unvaccinated patients who were tested negative for COVID-19); BMI 25–29 kg/m 2 : 71.3%; BMI 30–34 kg/m 2 : 84.5% and BMI ≥ 35 kg/m 2 : 72.7%, p < 0.001. The study suggested that increased BMI can lead to an even greater response to vaccination.…”

Section: Resultsmentioning

confidence: 99%

“…The study suggested that increased BMI can lead to an even greater response to vaccination. However, the scientists admit that the data could be influenced by the low number of vaccinated patients (108 patients) [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

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

Drożdżyńska

Jakubowska

Kemuś

et al. 2022

Life

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In the face of a growing number of overweight people and two widely known viral diseases, SARS-CoV-2 and influenza, it is crucial to be aware of the impact of excess body weight on immunisation against these diseases. The aim of this review is to show the effectiveness of SARS-CoV-2 and influenza vaccines in overweight and obese patients. Excessive adipose tissue releases cytokines and maintains local hypoxia, which causes persistent low-grade inflammation. These factors make excess body mass patients’ immune systems weaker. Under such conditions, the humoral response becomes less efficient, leading to a weakened ability to fight against infection and an increased risk of developing lower antibody titres. Vaccines help to reduce morbidity both in normal-weight and excess body mass people, although most studies show that patients with higher BMI tend to lose the antibodies produced more quickly. It is shown that the most effective vaccines (in terms of preventing the infection and potential post-illness complications) are the BNT162b2 vaccine against SARS-CoV-2 and the inactivated influenza vaccine against influenza among both obese and non-obese subjects.

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Accelerated waning of the humoral response to COVID-19 vaccines in obesity

van der Klaauw,

Horner,

Pereyra-Gerber

et al. 2023

Nat Med

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Obesity is associated with an increased risk of severe Coronavirus Disease 2019 (COVID-19) infection and mortality. COVID-19 vaccines reduce the risk of serious COVID-19 outcomes; however, their effectiveness in people with obesity is incompletely understood. We studied the relationship among body mass index (BMI), hospitalization and mortality due to COVID-19 among 3.6 million people in Scotland using the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) surveillance platform. We found that vaccinated individuals with severe obesity (BMI > 40 kg/m2) were 76% more likely to experience hospitalization or death from COVID-19 (adjusted rate ratio of 1.76 (95% confidence interval (CI), 1.60–1.94). We also conducted a prospective longitudinal study of a cohort of 28 individuals with severe obesity compared to 41 control individuals with normal BMI (BMI 18.5–24.9 kg/m2). We found that 55% of individuals with severe obesity had unquantifiable titers of neutralizing antibody against authentic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus compared to 12% of individuals with normal BMI (P = 0.0003) 6 months after their second vaccine dose. Furthermore, we observed that, for individuals with severe obesity, at any given anti-spike and anti-receptor-binding domain (RBD) antibody level, neutralizing capacity was lower than that of individuals with a normal BMI. Neutralizing capacity was restored by a third dose of vaccine but again declined more rapidly in people with severe obesity. We demonstrate that waning of COVID-19 vaccine-induced humoral immunity is accelerated in individuals with severe obesity. As obesity is associated with increased hospitalization and mortality from breakthrough infections, our findings have implications for vaccine prioritization policies.

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Real world SARS-COV-2 vaccine effectiveness in a Miami academic institution

Cited by 8 publications

References 8 publications

Accelerated waning of the humoral response to SARS-CoV-2 vaccines in obesity

Accelerated waning of the humoral response to SARS-CoV-2 vaccines in obesity

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

Accelerated waning of the humoral response to COVID-19 vaccines in obesity

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