학술논문
Accelerated waning of the humoral response to COVID-19 vaccines in obesity
Document Type
Article
Author
van der Klaauw, Agatha A.; Horner, Emily C.; Pereyra-Gerber, Pehuén; Agrawal, Utkarsh; Foster, William S.; Spencer, Sarah; Vergese, Bensi; Smith, Miriam; Henning, Elana; Ramsay, Isobel D.; Smith, Jack A.; Guillaume, Stephane M.; Sharpe, Hayley J.; Hay, Iain M.; Thompson, Sam; Innocentin, Silvia; Booth, Lucy H.; Robertson, Chris; McCowan, Colin; Kerr, Steven; Mulroney, Thomas E.; O’Reilly, Martin J.; Gurugama, Thevinya P.; Gurugama, Lihinya P.; Rust, Maria A.; Ferreira, Alex; Ebrahimi, Soraya; Ceron-Gutierrez, Lourdes; Scotucci, Jacopo; Kronsteiner, Barbara; Dunachie, Susanna J.; Klenerman, Paul; Park, Adrian J.; Rubino, Francesco; Lamikanra, Abigail A.; Stark, Hannah; Kingston, Nathalie; Estcourt, Lise; Harvala, Heli; Roberts, David J.; Doffinger, Rainer; Linterman, Michelle A.; Matheson, Nicholas J.; Sheikh, Aziz; Farooqi, I. Sadaf; Thaventhiran, James E. D.
Source
Nature Medicine; May 2023, Vol. 29 Issue: 5 p1146-1154, 9p
Subject
Language
ISSN
10788956; 1546170X
Abstract
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.