May 11, 2023

expert reaction to study looking at obesity and COVID vaccine immune response

A study published in Nature Medicine looks at immune response to COVID-19 vaccines in obesity.

Prof Peter Openshaw, Professor of Experimental Medicine, Imperial College London, said:

“This new study is very interesting, but it’s important to point out that although obesity is associated with more rapid waning of antibody and higher risk of severe disease, we don’t know that obesity itself is causing this.  It could be that obesity is a marker for something else, for example.  Losing weight won’t necessarily bring your risk to baseline or enhance antibody longevity.

“A second point is that it’s the extremes of weight that put people at risk of severe disease, not just obesity.  Being too thin isn’t good for you either although, again, it may be the reasons that underlie being unusually thin that cause the enhanced risk rather than thinness itself.

“As the authors mention, needle length can affect the immune response to vaccines.  In a study of hepatitis vaccine it was shown that using a standard short (one inch) needle in those who are obese means that the injection may not reach the muscle and that immune responses are better if a longer (1.5 inch) needle is used.  (See for example https://doi.org/10.1016/j.vaccine.2023.03.018).  The US Centers for Disease Control and Prevention recommends longer needles in obese patients.”

‘Accelerated waning of the humoral response to COVID-19 vaccines in obesity’ by Agatha A. van der Klaauw et al. was published in Nature Medicine at 16:00 UK time on Thursday 11 May 2023.

DOI: 10.1038/s41591-023-02343-2

Declared interests

Prof Peter Openshaw: “I have been on scientific advisory panels for GSK, Moderna, Janssen, Seqirus and Pfizer on vaccines against respiratory viral infections.”