Will Influenza Vaccination Protect Obese Adults? Public Deposited

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Last Modified
  • March 19, 2019
Creator
  • Neidich, Scott
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
Abstract
  • Obesity is a significant public health problem, affecting over one third of the United States, and more than one in ten worldwide. Obesity is associated with a number of comorbidities including cardiovascular disease, diabetes, and importantly, infection. Influenza has been recognized since the 2009 H1N1 influenza pandemic to cause increased severity in obesity, however use of influenza vaccine to reduce influenza-related risk has not been studied specifically in the context of obesity. In this dissertation, we report that obese adults are at an increased risk for influenza-like-illness despite vaccination. We further report that this deficiency is not due to impairments in response to influenza vaccination, as subjects with confirmed influenza and influenza-like illness produce vaccine-specific antibodies in comparable levels, as assessed by hemaglutination inhibition and microneutralization. Additionally, we report no apparent defects in influenza-vaccine specific immunoglobulin types, suggesting obesity causes no defects in antibody class switching during influenza vaccine response in a population of Caucasian female adults. Strain-specific response was also assessed, and obese Caucasian women were found to responds similarly to control populations. Finally, B-cell populations were not found to be altered in frequency by vaccination or obesity, however expression of the activation marker CD38 was found to be lower on CD38 expressing B-cells from obese participants. This dissertation calls into serious question the use of antibody measures as correlates of protection. If antibodies are indeed major drivers of immunity in influenza vaccination, then subjects who presented with clinical influenza or influenza-like-illness should have been protected against influenza. But as we report here, healthy weight and obese subjects with influenza-like-illness had similar levels of seroprotection assessed by hemaglutination inhibition. Taken in combination with elevated risk for influenza-like-illness in obesity, this suggests that hemaglutination inhibition antibody’s status as a correlate of protection against influenza should be reexamined, especially in context of obesity.
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Rights statement
  • In Copyright
Advisor
  • Beck, Melinda A.
  • Makowski, Liza
  • Hursting, Stephen
  • Whitmire, Jason
  • Jaspers, Ilona
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016
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