Tags

Type your tag names separated by a space and hit enter

Increased risk of influenza among vaccinated adults who are obese.
Int J Obes (Lond). 2017 09; 41(9):1324-1330.IJ

Abstract

BACKGROUND

Influenza infects 5-15% of the global population each year, and obesity has been shown to be an independent risk factor for increased influenza-related complications including hospitalization and death. However, the risk of developing influenza or influenza-like illness (ILI) in a vaccinated obese adult population has not been addressed.

OBJECTIVE

This study evaluated whether obesity was associated with increased risk of influenza and ILI among vaccinated adults.

SUBJECTS AND METHODS

During the 2013-2014 and 2014-2015 influenza seasons, we recruited 1042 subjects to a prospective observational study of trivalent inactivated influenza vaccine (IIV3) in adults. A total of 1022 subjects completed the study. Assessments of relative risk for laboratory confirmed influenza and ILI were determined based on body mass index. Seroconversion and seroprotection rates were determined using prevaccination and 26-35 days post vaccination serum samples. Recruitment criteria for this study were adults 18 years of age and older receiving the seasonal trivalent inactivated influenza vaccine (IIV3) for the years 2013-2014 and 2014-2015. Exclusion criteria were immunosuppressive diseases, use of immunomodulatory or immunosuppressive drugs, acute febrile illness, history of Guillain-Barre syndrome, use of theophylline preparations or use of warfarin.

RESULTS

Among obese, 9.8% had either confirmed influenza or influenza-like-illness compared with 5.1% of healthy weight participants. Compared with vaccinated healthy weight, obese participants had double the risk of developing influenza or ILI (relative risk=2.01, 95% CI 1.12, 3.60, P=0.020). Seroconversion or seroprotection rates were not different between healthy weight and obese adults with influenza or ILI.

CONCLUSIONS

Despite robust serological responses, vaccinated obese adults are twice as likely to develop influenza and ILI compared with healthy weight adults. This finding challenges the current standard for correlates of protection, suggesting use of antibody titers to determine vaccine effectiveness in an obese population may provide misleading information.

Authors+Show Affiliations

Human Vaccine Institute, Duke University, Durham, NC, USA.Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

28584297

Citation

Neidich, S D., et al. "Increased Risk of Influenza Among Vaccinated Adults Who Are Obese." International Journal of Obesity (2005), vol. 41, no. 9, 2017, pp. 1324-1330.
Neidich SD, Green WD, Rebeles J, et al. Increased risk of influenza among vaccinated adults who are obese. Int J Obes (Lond). 2017;41(9):1324-1330.
Neidich, S. D., Green, W. D., Rebeles, J., Karlsson, E. A., Schultz-Cherry, S., Noah, T. L., Chakladar, S., Hudgens, M. G., Weir, S. S., & Beck, M. A. (2017). Increased risk of influenza among vaccinated adults who are obese. International Journal of Obesity (2005), 41(9), 1324-1330. https://doi.org/10.1038/ijo.2017.131
Neidich SD, et al. Increased Risk of Influenza Among Vaccinated Adults Who Are Obese. Int J Obes (Lond). 2017;41(9):1324-1330. PubMed PMID: 28584297.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased risk of influenza among vaccinated adults who are obese. AU - Neidich,S D, AU - Green,W D, AU - Rebeles,J, AU - Karlsson,E A, AU - Schultz-Cherry,S, AU - Noah,T L, AU - Chakladar,S, AU - Hudgens,M G, AU - Weir,S S, AU - Beck,M A, Y1 - 2017/06/06/ PY - 2017/01/12/received PY - 2017/03/16/revised PY - 2017/04/16/accepted PY - 2017/6/7/pubmed PY - 2018/7/3/medline PY - 2017/6/7/entrez SP - 1324 EP - 1330 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 41 IS - 9 N2 - BACKGROUND: Influenza infects 5-15% of the global population each year, and obesity has been shown to be an independent risk factor for increased influenza-related complications including hospitalization and death. However, the risk of developing influenza or influenza-like illness (ILI) in a vaccinated obese adult population has not been addressed. OBJECTIVE: This study evaluated whether obesity was associated with increased risk of influenza and ILI among vaccinated adults. SUBJECTS AND METHODS: During the 2013-2014 and 2014-2015 influenza seasons, we recruited 1042 subjects to a prospective observational study of trivalent inactivated influenza vaccine (IIV3) in adults. A total of 1022 subjects completed the study. Assessments of relative risk for laboratory confirmed influenza and ILI were determined based on body mass index. Seroconversion and seroprotection rates were determined using prevaccination and 26-35 days post vaccination serum samples. Recruitment criteria for this study were adults 18 years of age and older receiving the seasonal trivalent inactivated influenza vaccine (IIV3) for the years 2013-2014 and 2014-2015. Exclusion criteria were immunosuppressive diseases, use of immunomodulatory or immunosuppressive drugs, acute febrile illness, history of Guillain-Barre syndrome, use of theophylline preparations or use of warfarin. RESULTS: Among obese, 9.8% had either confirmed influenza or influenza-like-illness compared with 5.1% of healthy weight participants. Compared with vaccinated healthy weight, obese participants had double the risk of developing influenza or ILI (relative risk=2.01, 95% CI 1.12, 3.60, P=0.020). Seroconversion or seroprotection rates were not different between healthy weight and obese adults with influenza or ILI. CONCLUSIONS: Despite robust serological responses, vaccinated obese adults are twice as likely to develop influenza and ILI compared with healthy weight adults. This finding challenges the current standard for correlates of protection, suggesting use of antibody titers to determine vaccine effectiveness in an obese population may provide misleading information. SN - 1476-5497 UR - https://www.unboundmedicine.com/medline/citation/28584297/Increased_risk_of_influenza_among_vaccinated_adults_who_are_obese_ L2 - https://doi.org/10.1038/ijo.2017.131 DB - PRIME DP - Unbound Medicine ER -