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Comparison of Immune Response to the Influenza Vaccine in Obese and Nonobese Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Michael A. Sweet*
Affiliation:
Center for Quality Outcomes, West Virginia University Hospitals, Morgantown, West Virginia
Jonathan A. McCullers
Affiliation:
St. Jude Children’s Research Hospital, Memphis, Tennessee
Paul R. Lasala
Affiliation:
West Virginia University Pathology, West Virginia University Hospitals, Morgantown, West Virginia
Frank E. Briggs
Affiliation:
Center for Quality Outcomes, West Virginia University Hospitals, Morgantown, West Virginia
Anne Smithmyer
Affiliation:
Employee Health, West Virginia University Hospitals, Morgantown, West Virginia
Rashida A. Khakoo
Affiliation:
Department of Infectious Diseases, West Virginia University School of Medicine, Morgantown, West Virginia
*
Address correspondence to Michael A. Sweet, PharmD, Center for Quality Outcomes, West Virginia University Hospitals, PO Box 8242, Morgantown, WV 26506-8242 ([email protected]).

Abstract

OBJECTIVE

To determine whether there is a difference in antibody titers and functionality after receipt of the influenza vaccine for obese versus nonobese healthcare workers (HCW).

DESIGN

Prospective observational study.

SETTING

Tertiary medical center.

PARTICIPANTS

Healthcare workers.

METHODS

Baseline influenza antibody titers for obese and nonobese HCW were recorded during the hospital’s 2011 annual influenza vaccination day and follow-up antibody titers were measured 4 weeks later. Antibodies were measured using the hemagglutination inhibition assay and functionality was measured using the micro-neutralization method.

RESULTS

Of 200 initial HCWs, 190 completed the study (97 obese and 93 nonobese). Seroprotection after immunization was not significantly different for nonobese compared with obese HCW for each strain (influenza A [H1N1], 99% and 99%; influenza A [H3N2], 100% and 99%; and influenza B, 67% and 71%, respectively)

All geometric mean titers measured by micro-neutralization showed statistically significant increases in activity. In comparison, there was no difference in the 4-fold increase in H1N1 or B titers. There was a significant difference in the 4-fold increase of H3N2 titers between the nonobese and obese HCWs (82/93 [88%] vs 64/97 [66%], P=.003)

In an ad hoc analysis we found that obese HCWs had a statistically greater number of 4-fold decreases in titers with H1N1 and H3N2.

CONCLUSIONS

There was no significant difference in protection from influenza between obese and nonobese HCWs after immunization.

Infect Control Hosp Epidemiol 2014;00(0): 1–5

Type
Original Articles
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1.Thompson, WW, Shay, DK, Weintraub, E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003;289:179186.CrossRefGoogle ScholarPubMed
2.World Health Organization. WHO factsheet: influenza (seasonal). Available at: http://www.who.int/mediacentre/factsheets/fs211/en. Published April 2009. Accessed February 15, 2012.Google Scholar
3.Cox, NJ. Influenza. Lancet 1999;354:12771282.Google Scholar
4.Prevention and control of influenza with vaccines; recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Morb Mortal Wkly Rep 2010;59:147.Google Scholar
5.Diaz, E, Rodriguez, A, Martin-Loeche, I, et al. Impact of obesity in patients infected with 2009 A (H1N1). Chest 2011;139:382386.Google Scholar
6.Louie, JK, Acousta, M, Samuel, MC, et al. A novel risk factor for a novel virus: obesity and 2009 pandemic influenza A (H1N1). Clin Infect Dis 2011;52:301312.Google Scholar
7.Van Kerkhove, M, Vandemaele, KA, Shinde, V, et al. Risk factors for severe outcomes following 2009 Influenza A (H1N1) infection: a global pooled analysis. PLoS Med 2011;8:e1001053.Google Scholar
8.Kwong, JC, Campitelli, MA, Rosella, LC. Obesity and respiratory hospitalizations during influenza seasons in Ontario, Canada: a cohort study. Clin Infect Dis 2011;53:413421.Google Scholar
9. United States Obesity Statistics for 2010. Available at: http://www.cdc.gov/obesity/data/index.html. Accessed February 15, 2012.Google Scholar
10.Weber, DJ, Rutala, WA, Samsa, GP, et al. Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine. JAMA 1985;254:31873189.Google Scholar
11.Potter, CW, Oxford, JS. Determinants of immunity to influenza infection in man. Br Med Bull 1979;35:6975.Google Scholar
12.Carr, S, Allison, KJ, Van De Velde, L-A, et al. Safety and immunogenicity of live attenuated and inactivated influenza vaccines in children with cancer. J Infect Dis 2011;204:14751482.CrossRefGoogle ScholarPubMed
13.Goodwin, K, Vinoud, C, Simonsen, L. Antibody response to influenza vaccination in the elderly: a quantitative review. Vaccine 2006;24:11591169.Google Scholar
14.Coleman, LA, Talbot, HK, Crimin, K, et al. Effect of body mass index on serologic response to influenza vaccination in older adults. Presented at the Infectious Diseases Society of America 49th Annual Meeting; Boston, MA; October 21, 2011 (Abstract 538).Google Scholar
15.Sheridan, PA, Paich, HA, Handy, J, et al. Obesity is associated with impaired immune response to influenza vaccination in humans. Int J Obes (Lond) 2012;36:10721077.Google Scholar