When researchers started developing what they hoped would be an effective COVID-19 vaccine, they already knew that H1N1 influenza – a new virus, such as COVID-19 – more severely affected overweight or obese patientsPatients with a body mass index of 30 or higher had a higher risk of hospitalization and death from H1N1.
This is not the first time such a link has been found. A 2017 study from the University of North Carolina at Chapel Hill discovered the flu shot was less effective in overweight or obese patients. This study included only 1,022 participants, however other small studies show similar results.
Flash forward to today, when the COVID-19 vaccine was created, tested on more than 40,000 patients, and now distributed nationwide. The data is promising; the two approved vaccines provide more than 90% protection of the virus.
But doctors and researchers are aware of the H1N1 and UNC findings. Like a doctor specializing in obesity medicine, i am one of them. Now we all want to know this: Will the COVID-19 vaccines be equally effective in overweight or obese patients? Initial data suggests this to be the case, but additional 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 overweight or obese patients are among the most affected by COVID-19, and they make more than 70% of the US populationIndeed, I like through it Data from Pfizer vaccine research, I saw that very well-known group: 70% of the Pfizer COVID-19 trial participants, such as the American demographics, were overweight or obese. A collective cheer of obesity specialists was heard around the world for creating a group that best represented our current American population.
COVID-19 is devastating here in the US for overweight and obese people, especially younger patientsInitially, doctors thought that younger patients as a whole were less likely to have serious complications because of their age. But for overweight people under 50, obesity has negated the protective effect of age.
The COVID-19 vaccine shows promise because it is activated B and T immune cells, crucial for long-term protection against viruses. B cell activity and levels have been demonstrated lower in both mice and obese humans after infections.
These immune cells can quickly produce new antibodies, even if antibody levels drop over time and very little is left from previous vaccinations. Antibodies prevent the virus from entering and infecting a cell, but B and T cells destroy the virus-infected cells and prevent further replication of the virus and spread to other cells. But this may not be true for obese people. Researchers believe that obesity negatively affects the function of the immune system
While obese patients can produce enough antibodies, show multiple studies they have one lower level of those B and T cells after infection with the H1N1 influenza. This can change the typical immune response, leaving the body one step behind after the virus enters. An important question is whether this altered immune response is also present after a COVID-19 infection. And that's why we want to know if the vaccine will be as effective in obese patients as other patients who don't have this disease.
Vaccine is still a must
Even with this concern, overweight or obese patients should still receive the COVID-19 vaccine. Even for those obese patients who get the flu vaccine but still get the flu, there is almost one 40% reduction hospitalization and 82% reduction in IC admissions.
In summary, the data released by Pfizer and the FDA shows that the vaccine is effective not only in participants as a whole, but particularly in obese patients.
It's encouraging that Pfizer wanted to show the vaccine was just as effective in overweight or obese people. Researchers recognize that these patients are more at risk and are now designing studies to reflect that.
Behaviors that will help
Two things could encourage overweight or obese people to exercise and improve their diet: previous studies show a positive association between regular exercise before receiving a vaccine and your response to the vaccine, in which you have up to four times more antibodies after exposure to a virus or bacteria. This means that the antibodies are higher in those who trained before the vaccine was given than those who did not. It also appears type and amount of your gut bacteria can affect the vaccine response. Foods with prebiotics and probiotics can aid in this and other disease prevention and treatment. Prebiotics can be found in barley and garlic, while yogurt, sauerkraut and some cheeses contain probiotics.
More data is needed before we know exactly how overweight and obese patients respond to vaccines compared to the rest of the population. But that data comes quickly. Even in a year's time, we'll look back and be amazed at everything we've learned about COVID-19. That research will provide the knowledge we need to create a better way to deliver health care to all of us.
Cate Varney is a clinical physician and assistant professor at the University of Virginia. This article has been republished from The conversation under one Creative Commons LicenseRead the original article