Covid Vaccines, Special Considerations For The Obese Population; Few, No Side Effects of Vaccine?...

- NIH, April 8, 2021. - NCBI, NLM. Obes Surg. 2021 Apr 8

COVID-19 Vaccines: Special Considerations for the Obese Population, NIH, April 8, 2021

It has been demonstrated that obese individuals are at a greater risk for complications following SARS-CoV-2 infection [1]. Beyond COVID-19, obesity has been associated with severe complications from a variety of viral infections. Studies on both seasonal and highly pathogenic influenza show a relationship between complications (i.e., hospitalizations and ICU stays) and increased BMI [2, 3]. Numerous studies have demonstrated that obesity elicits a state of low-grade chronic inflammation, in part due to the circulation of mononuclear cells including leukocytes and lymphocytes [4, 5].

Many of the co-morbidities associated with obesity also have shown to alter the immune system, including types 1 and 2 diabetes. Yang and colleagues found that obesity may accelerate thymic involution and a depletion in T-cell repertoire diversity [6]. These effects are typically seen in elderly populations, leading to an increased risk in infection and weakened vaccine efficacy. High fat deposits decrease the level of adiponectin while increasing leptin levels. Adiponectin is an adipocyte hormone, which has shown to decrease macrophage activation and pro-inflammatory cytokine generation, including TNF, IL-6, and NFkB [7]. In contrast, leptin has shown to promote inflammatory reactions in the body as well as its direct action as a pro-inflammatory cytokine [8].

The effect of obesity on vaccine efficacy in humans is not well-studied. Weber and colleagues previously demonstrated the impaired immunogenicity of a now discontinued hepatitis B vaccine in obese patients [9, 10]. Sheridan and colleagues examined the effects of influenza vaccination in normal, overweight, and obese individuals. While BMI was correlated with a higher initial increase in IgG antibodies post-immunization, at 12 months post-vaccination, higher BMI was associated with a greater decline in antibody titers [11]. Another study demonstrated that BMI was independently associated with inadequate antibody titers 2 years post-rabies vaccination [12].

Current COVID-19 vaccine trials have shown no difference in the vaccine efficacy between normal and obese BMI groups. A pre-print study, however, has demonstrated an association between BMI classes and antibody titers. A stronger humoral response was observed in the groups with under-weight and normal-weight vs groups with pre-obesity and obesity participants (p < 0.0001). The obese group also demonstrated the widest range in titer levels after the second dose [13].. Therefore, more studies are needed to better understand the long-term efficacy of COVID-19 immunization on obese populations... In the midst of the COVID-19 pandemic, more aggressive facilitation of diet, exercise, and behavioral, pharmacologic, non-surgical, and surgical bariatric interventions may be warranted worldwide to [1] reduce complications in obese people exposed to SARS-CoV-2 virus and [2] to maintain efficacy of different COVID-19 vaccines...

Indeed previous studies show a positive association between regular exercise before receiving a flu vaccine and response to the vaccine, producing up to 4 times as more antibodies after being exposed to a virus or bacteria...

- Read More, National Center for Biotechnology Information, U.S. National Library of Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8029603/
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** Also:

- Few, No Vaccine Side Effects, Am I Still Protected? Don't Feel Bad, If You Don't Feel Bad: Experts. NPR, 'You Don't Have To Suffer To Benefit From Covid Vaccination- But Some Prefer It,' April 27, 2021.
https://www.democraticunderground.com/114225973
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- COVID-19 Vaccination and Obesity: Optimism and Challenges, NIH, April 29, 2021,

Abstract: Researchers have speculated that vaccines to prevent coronavirus disease 2019 (COVID-19) may be less effective for individuals with obesity, a major risk factor for mortality and morbidity from COVID-19. Initial results from the Pfizer-BioNTech and Moderna COVID-19 vaccine trials, though limited by inadequate power to compare subgroups and incomplete stratification of high-risk groups, appear to have similar efficacy among individuals with and without obesity. Careful follow-up in placebo-controlled studies is required to generate data on long-term vaccine immunogenicity, particularly in high-risk groups.

Subsequent analyses should stratify safety and efficacy results by each class of obesity. Speculation about variable effectiveness of COVID-19 vaccines in obesity likely increases vaccine hesitancy among individuals with obesity, who face not only a higher risk of severe outcomes from COVID-19 but also weight stigma, which reduces health care engagement at baseline. Clinical and public health messaging must be data driven, transparent, and sensitive to these biological and sociological vulnerabilities... https://pubmed.ncbi.nlm.nih.gov/33506642/
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- The Guardian, Feb. 28, 2021, Pfizer Vaccine May Be Less Effective In Obesity, STUDY. Healthcare workers with obesity found to produce only about half the antibodies healthy people do.
.. Italian researchers have discovered that healthcare workers with obesity produced only about half the amount of antibodies in response to a second dose of the jab compared with healthy people. Although it is too soon to know what this means for the efficacy of the vaccine, it might imply that people with obesity need an additional booster dose to ensure they are adequately protected against coronavirus...
https://www.theguardian.com/world/2021/feb/28/pfizer-vaccine-less-effective-obesity-study

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