Obesity speeds up loss of immunity from COVID vaccines – new research

By Agatha A. van der Klaauw, I. Sadaf Farooqi, James E. D. Thaventhiran, University of Cambridge

COVID vaccines are very effective, but for some groups they don’t generate as strong an immune response. These groups include older adults and people with weakened immune systems, for example due to cancer or other medical conditions. They tend to already be at heightened risk from COVID.

Likewise, obesity – and its association with several other conditions such as type 2 diabetes, high blood pressure and chronic kidney disease – leads to an increased risk of severe COVID.

The effect of obesity on COVID vaccine effectiveness, however, has not been well understood. But our new study in Nature Medicine finds obesity is linked to faster loss of immunity from COVID vaccines.

We know people with obesity have an impaired immune response to other vaccines including those for influenza, rabies and hepatitis.

COVID vaccines generate antibodies which recognise the spike protein, a protein on the surface of SARS-CoV-2 (the virus that causes COVID) that allows it to attach to and infect our cells. The vaccines also prime immune cells called T cells to protect against severe COVID if we do contract the virus.

Because immunity acquired after two doses wanes in the months afterwards, many countries have elected to administer booster vaccines to maintain immune protection, particularly in vulnerable groups.

Several studies have suggested that following COVID vaccination, antibody levels may be lower in people with obesity than in the general population.

Earlier in the pandemic, we assembled a team of researchers from the University of Cambridge and the University of Edinburgh to investigate the effect of obesity on vaccine effectiveness over time.

Using a data platform called EAVE II, the University of Edinburgh team, led by Aziz Sheikh, examined real-time healthcare data for 5.4 million people across Scotland. In particular, they looked at hospitalisations and deaths from COVID among 3.5 million adults who had received two vaccine doses (either Pfizer or AstraZeneca).

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