Obesity can strongly reduce antibody response to COVID-19 vaccines

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Scientists from Istanbul University found that adults (aged 18 or older) with severe obesity generate a much weaker immune response to COVID-19 vaccination compared to those with normal weight.

The study also found that people with severe obesity (BMI of more than 40kg/m2) vaccinated with Pfizer/BioNTech BNT162b2 mRNA vaccine generated significantly more antibodies than those vaccinated with CoronaVac (inactivated SARS-CoV-2) vaccine.

This suggests that the Pfizer/BioNTech vaccine might be a better choice for this vulnerable population.

The research was presented at European Congress on Obesity and was conducted by Professor Volkan Demirhan Yumuk et al.

Obesity is a disease complicating the course of COVID-19, and SARS-CoV-2 vaccine antibody response in adults with obesity may be compromised.

Vaccines against influenza, hepatitis B and rabies, have shown reduced responses in people with obesity.

In the study, the team examined antibody responses following Pfizer/BioNTech and CoronaVac vaccination in 124 adults (average age 42-63 years) with severe obesity.

Researchers measured antibody levels in blood samples taken from patients and normal-weight controls who had received two doses of either the Pfizer/BioNTech or CoronaVac vaccine and had their second dose four weeks earlier.

The participants were classified by infection history as either previously having COVID-19 or not (confirmed by their antibody profile).

Overall, 130 participants received two doses of Pfizer/BioNTech and 160 participants two doses of CoronaVac, of whom 70 had previous SARS-CoV-2 infection.

The team found that in those without previous COVID infection and vaccinated with Pfizer/BioNTech, patients with severe obesity had antibody levels more than three times lower than normal-weight people.

Similarly, in participants with no prior COVID infection and vaccinated with CoronaVac, patients with severe obesity had antibody levels 27 times lower than normal-weight people.

However, in those with previous COVID infection, antibody levels in patients with severe obesity and vaccinated with Pfizer/BioNTech or CoronaVac were not different from normal-weight people.

Interestingly, the team also found that in patients with severe obesity, with and without prior COVID infection, antibody levels in those vaccinated with Pfizer/BioNTech were much higher than those vaccinated with CoronaVac.

These results provide new information on the antibody response to SARS-CoV-2 vaccines in people with severe obesity and reinforce the importance of prioritizing and increasing vaccine uptake in this vulnerable group.

The study confirms that immune memory induced by prior infection alters the way in which people respond to vaccination and indicates that two doses of Pfizer/BioNTech vaccine may generate significantly more antibodies than CoronaVac in people with severe obesity, regardless of infection history.

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