Antibody responses to BNT162b2 mRNA vaccine: infection-naïve individuals with abdominal obesity warrant attention

Abstract

Objective. The excess of visceral adipose tissue might hinder and delay the immune response. How people with abdominal obesity will respond to mRNA vaccines against SARS-CoV-2 is yet to be established. We evaluated SARS-CoV-2-specific antibody responses after the first and second dose of the BNT162b2 mRNA vaccine comparing the response of individuals affected by abdominal obesity (AO) to those without, discerning between individuals with or without prior infection. Methods. IgG neutralizing antibodies against the Trimeric complex (IgG-TrimericS) were measured at four time points: at baseline, at day 21 after vaccine dose-1, at one month and three months after dose-2. Nucleocapsid antibodies were assessed to detect prior SARS-CoV-2 infection. Waist circumference was measured to determine abdominal obesity. Results. Between the first and third month after vaccine dose-2, the drop in IgG-TrimericS levels was more remarkable in individuals with AO compared to those without AO (2.44 fold [95%CI: 2.22-2.63] vs 1.82 fold [95%CI: 1.69-1.92], respectively, p<0.001). Multiple linear regression confirmed this result even when adjusting for possible confounders (p<0.001). Conclusions. Our findings highlight the need to extend the duration of serological monitoring of antibody levels in infection-naive individuals with abdominal obesity, a higher-risk population category in terms of possible weaker antibody response.

Risk Factors Influencing Seroconversion after Inactive SARS-CoV-2 Vaccination in People Living with Obesity

“…In our study, the seroconversion rate of patients in the non-prior SARS-CoV-2 infection arm was 83.5% in the obese group and 99.4% in the nonobese group. In a recent study with BNT162b2 mRNA vaccine, the antibody titer in individuals with abdominal obesity was found to be 2.4 times lower than those without [32]. In our study, antibody levels of nonobese subjects were found to be approximately 10 times higher than those of PwO.…”

Antibody responses to COVID‐19 vaccination in people with obesity: A systematic review and meta‐analysis

“…Of these individuals, 1869 were obese. Out of 12 articles, four [25][26][27]34 articles reported the mRNA vaccines (BNT162b2): two 28,35 that of adenovirus-vector vaccines (ChAdOx1 nCoV-19) and two 29,31 that of inactivated virus vaccines (Sinovac, Sinopharm). The remaining four [31][32][33] articles do not exclusively contain one type of vaccine.…”

“…Among the five included articles, three [25][26][27] reported BNT162b2 mRNA vaccination, and two 28,35 were vaccinated with ChAdOx1 nCoV-19 vaccine. As the results show, both vaccinations were significantly associated with obesity (Figure 3A).…”

The effect of needle length and skin to deltoid muscle distance in adults receiving an mRNA COVID-19 vaccine

“… [21] In contrast, a study that categorised by abdominal obesity rather than BMI found those with abdominal obesity had both lower spike antibodies and faster antibody waning in the months following vaccination. [22] It is possible that the distribution of body fat, rather than BMI, may be a stronger predicter of vaccine response. Data on whether obese people in clinical trials or observational studies were vaccinated with needles sufficiently long to ensure intra-muscular deposition are lacking.…”