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When researchers started developing what they hoped would be an effective vaccine against COVID-19, they already knew that the H1N1 flu – a new virus, like COVID-19 – more seriously affects overweight or obese patients. Patients with a body mass index of 30 or more had a higher risk of hospitalization and death from H1N1.
This is not the first time that such a link has been found. A 2017 study from the University of North Carolina at Chapel Hill found that the flu shot was less effective in patients who were overweight or obese. This study only included 1,022 participants, but other small studies show similar results.
Proceed to today, when the COVID-19 vaccine was created, tested on over 40,000 patients, and is now being distributed across the country. The data is promising; the two licensed vaccines provide more than 90% protection against the virus.
But doctors and researchers are aware of the H1N1 and UNC findings. As a doctor specializing in obesity medicine, I am one of them. Now we all want to know this: Will COVID-19 vaccines also be effective in patients who are overweight or who are obese? Initial data shows this to be the case, but more data will need to be collected after many more patients have been vaccinated.
What the research says
The answer to this question is crucial. Adult patients who are overweight or obese are among the most affected by COVID-19 and represent more than 70% of the American population. Indeed, reading the data from the Pfizer vaccine trial, I saw this very familiar group: 70% of the participants in the Pfizer COVID-19 trial, like the demographic in the United States, were overweight or obese. . A collective acclaim from obesity specialists could be heard around the world for creating a group that best represented our current American population.
COVID-19 has been devastating here in the United States for overweight and obese people, especially younger patients. Initially, doctors believed that younger patients as a whole had a lower risk of serious complications due to their age. But for people under 50 who suffer from obesity, obesity cancels out the protective effect of age.
The COVID-19 vaccine shows promise because it activates immune B and T cells, essential for long-term protection against viruses. B-cell activity and levels have been shown to be lower in mice and human subjects who are obese as a result of infections.
These immune cells can quickly produce new antibodies even if antibody levels decline over time and little is left from previous vaccinations. Antibodies prevent the virus from entering and infecting a cell, but B and T cells destroy cells infected with the virus and prevent the virus from replicating further and spreading to other cells. But this may not be true for obese people. Researchers believe that obesity has a negative impact on the function of the immune system.
Although obese patients can produce adequate antibodies, several studies show that they have lower levels of these B and T cells after infection with the H1N1 influenza. This can alter the typical immune response, leaving the body a step back after the virus has invaded. An important question is whether this altered immune response is also present after infection with COVID-19. And for this reason, we want to know if the vaccine will be as effective in patients with obesity as long as other patients who do not have this disease.
The vaccine still essential
Even with this concern, patients who are overweight or obese should still receive the COVID-19 vaccine. Even for obese patients who receive the flu shot but still contract the flu, there is an almost 40% reduction in hospitalizations and 82% in ICU admissions.
In short, data released by Pfizer and the FDA shows that the vaccine is not only effective in participants as a whole, but particularly in obese patients.
It is encouraging that Pfizer wanted to show that the vaccine was just as effective in overweight or obese people. Researchers recognize that these patients are at higher risk and are now designing studies to reflect this.
Behaviors that will help
Two things can encourage overweight or obese people to exercise and improve their eating habits: Previous studies show a positive association between regular exercise before getting a vaccine and your response to the vaccine, producing up to four times more antibodies after being exposed to a virus or bacteria. This means that antibodies are higher in those who exercised before the vaccine was administered compared to those who did not exercise. Also, it appears that the type and amount of your gut bacteria may have an impact on the vaccine response. Foods containing prebiotics and probiotics can help prevent and treat disease. Prebiotics can be found in barley and garlic, while yogurt, sauerkraut, and some cheeses contain probiotics.
More data is needed before knowing precisely how overweight and obese patients respond to vaccines compared to the rest of the population. But this data arrives quickly. Even just a year from now, we will look back and be amazed at how much we have learned about COVID-19. From this research will emerge the knowledge we need to create a better way to deliver health care to all of us.
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This article is republished from The Conversation, a nonprofit news site dedicated to sharing ideas from academic experts. It was written by: Cate Varney, University of Virginia.
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Cate Varney does not work, consult, own stock, or receive funding from any company or organization that would benefit from this article, and has not disclosed any relevant affiliation beyond her academic appointment.
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