The impact of obesity on influenza Vaccine immunogenicity: A systematic review

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-09-30 DOI:10.1016/j.vaccine.2025.127794

Michelle Clarke , Mark McMillan , Lynne C. Giles , Kathryn Riley , Prabha Andraweera , Peter C. Richmond , Suja M. Mathew , Helen S. Marshall

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引用次数: 0

Abstract

Background

Influenza vaccines are important for reducing the burden of influenza, particularly for populations at risk of more severe infections. Obesity is associated with increased influenza severity and therefore individuals with obesity are often specifically recommended for annual influenza vaccination. Obesity is also associated with an altered inflammatory profile, which may influence vaccine responses. This systematic review aimed to evaluate the evidence for any association between obesity and influenza vaccine immunogenicity.

Methods

Studies reporting seroprotection (SP) and/or seroconversion (SC) for obese vs non-obese recipients following licensed influenza vaccination were included. PubMed, Embase and Scopus were searched, with the final search completed on 21 Feb 2025. The protocol was registered in PROSPERO. Study selection, data extraction and critical appraisal were conducted by two reviewers in Covidence. Meta-analysis was performed in S tata 17 using a random-effects model.

Results

Of 2132 studies imported, 865 studies were screened and 140 underwent full-text review. Eleven studies reported outcomes for seroprotection and/or seroconversion for obese vs non-obese groups at 1-month following monovalent H1N1 (n = 1), trivalent (n = 6) or quadrivalent (n = 4) influenza vaccination. Studies included children (n = 5) and adults (n = 7) including pregnant women (n = 2). Study sample sizes varied from 44 to 1132 participants. Obesity was associated with a marginally higher likelihood of seroconversion or seroprotection for A/H1N1 (RR 1.04, 95 %CI 1.01–1.08; RR 1.08, 95 % CI 1.02–1.14) and marginally higher seroconversion for A/H3N2 strains (RR 1.11, 95 % CI 1.02–1.21). No significant differences were observed for Influenza B/Victoria and B/Yamagata strains.

Conclusions

Obesity does not impair influenza vaccine immunity at one-month post-vaccination, and may enhance antibody responses, potentially due to a proinflammatory immune profile.

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肥胖对流感疫苗免疫原性的影响：一项系统综述

背景：流感疫苗对于减轻流感负担非常重要，特别是对于面临更严重感染风险的人群。肥胖与流感严重程度增加有关，因此经常特别建议肥胖个体每年接种流感疫苗。肥胖还与炎症特征的改变有关，这可能会影响疫苗反应。本系统综述旨在评估肥胖与流感疫苗免疫原性之间的关联证据。方法：纳入报告肥胖与非肥胖接种流感疫苗后血清保护（SP）和/或血清转化（SC）的研究。检索PubMed、Embase和Scopus，最终检索于2025年2月21日完成。该议定书已在普洛斯彼罗登记。研究选择、数据提取和批判性评价由两名审稿人在covid - ence中进行。采用随机效应模型对S tata 17进行meta分析。结果：在导入的2132项研究中，筛选了865项研究，其中140项进行了全文综述。11项研究报告了单价H1N1 （n = 1）、三价（n = 6）或四价（n = 4）流感疫苗接种1个月后肥胖组与非肥胖组的血清保护和/或血清转化结果。研究对象包括儿童（n = 5）和成人（n = 7），其中包括孕妇（n = 2）。研究样本量从44人到1132人不等。肥胖与a /H1N1血清转化或血清保护的可能性较高相关（RR 1.04, 95% CI 1.01-1.08; RR 1.08, 95% CI 1.02-1.14），与a /H3N2血清转化的可能性较高相关（RR 1.11, 95% CI 1.02-1.21）。B型维多利亚流感和B型山形流感没有显著差异。结论：肥胖在接种流感疫苗一个月后不会损害流感疫苗的免疫力，并可能增强抗体反应，可能是由于促炎免疫特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.