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Background <p>Obesity significantly increases the risk of severe COVID-19 and mortality. Concerns have emerged regarding the efficacy of COVID-19 vaccines in obese populations due to potential alterations in immune responses.</p> Methods <p>Between March 2021 and March 2022, 5,071 participants with comorbidities received CoronaVac administered in two doses 28 days (± 7 days) apart and a single subsequent booster dose of ChAdOx1 with an interval of 180 days (± 30 days). Body composition was analyzed using a tetrapolar bioimpedance measurement scale. Anti-RBD IgG was dosed at baseline (D0) and on days 28, 90, 180, 270, and 360.</p> Results <p>1,181 participants with obesity (body fat percentage &gt; P50), non-immune at baseline, showed significantly lower antibody titers (IgG anti-RBD) until D180 than 576 non-obese individuals. However, there was no difference in the frequency of COVID-19, COVID-19-related hospitalization or death. After the booster, no significant changes were seen. Patients with very excessive body fat (body fat percentage &gt; P90) showed even slower seroconversion, with increased COVID-19 after D180. Similar results were observed using the routine body mass index (BMI); however, waning immunity (serology) was observed in individuals classified as having very excessive body fat only when bioimpedance was used.</p> Conclusion <p>Participants with obesity demonstrated weaker and slower seroconversion, which worsened in higher body fat mass. Bioimpedance revealed quicker waning immunity, emphasizing its importance over BMI in assessing vaccine response.</p>

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Impact of obesity on COVID-19 CoronaVac and ChAdOx1-S vaccine efficacy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月9日

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  • Márcio Valle Cortez,
  • Alex Martins,
  • Joabi Nascimento,
  • Fabíola Mendonça da Silva Chui,
  • Maria Gabriela Almeida Rodrigues,
  • Talita Bastos,
  • Sonia Maria Lemos,
  • Eduardo Honorato,
  • Erika Gomes,
  • Rebeca Linhares Abreu-Netto,
  • Salete Fernandes,
  • Alexandre Vilhena Silva-Neto,
  • André Sachett,
  • Bernardo Maia Silva,
  • Gabriel Santos Mouta,
  • Jady Shayenne Mota Cordeiro,
  • Djane Clarys Baía-da-Silva,
  • Jose Diego Brito-Sousa,
  • Karina Pinheiro Pessoa,
  • Wuelton Monteiro,
  • Felipe Naveca,
  • Vanderson Sampaio,
  • Fernando Almeida-Val,
  • Gisely Melo,
  • Maria Paula Mourão,
  • Marcus Lacerda

摘要

Background

Obesity significantly increases the risk of severe COVID-19 and mortality. Concerns have emerged regarding the efficacy of COVID-19 vaccines in obese populations due to potential alterations in immune responses.

Methods

Between March 2021 and March 2022, 5,071 participants with comorbidities received CoronaVac administered in two doses 28 days (± 7 days) apart and a single subsequent booster dose of ChAdOx1 with an interval of 180 days (± 30 days). Body composition was analyzed using a tetrapolar bioimpedance measurement scale. Anti-RBD IgG was dosed at baseline (D0) and on days 28, 90, 180, 270, and 360.

Results

1,181 participants with obesity (body fat percentage > P50), non-immune at baseline, showed significantly lower antibody titers (IgG anti-RBD) until D180 than 576 non-obese individuals. However, there was no difference in the frequency of COVID-19, COVID-19-related hospitalization or death. After the booster, no significant changes were seen. Patients with very excessive body fat (body fat percentage > P90) showed even slower seroconversion, with increased COVID-19 after D180. Similar results were observed using the routine body mass index (BMI); however, waning immunity (serology) was observed in individuals classified as having very excessive body fat only when bioimpedance was used.

Conclusion

Participants with obesity demonstrated weaker and slower seroconversion, which worsened in higher body fat mass. Bioimpedance revealed quicker waning immunity, emphasizing its importance over BMI in assessing vaccine response.