Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 11;14(1):124.
doi: 10.3390/v14010124.

Obesity and Metabolic Dysregulation in Children Provide Protective Influenza Vaccine Responses

Mundeep K Kainth  1   2   3 , Joanna S Fishbein  3 , Teresa Aydillo  4   5 , Alba Escalera  4   5   6 , Rachael Odusanya  7 , Kalliopi Grammatikopoulos  1 , Tiffany Scotto  1   8 , Christine B Sethna  1   2   3 , Adolfo García-Sastre  4   5   6   9   10   11 , Clifford S Deutschman  1   2   3
Affiliations

Obesity and Metabolic Dysregulation in Children Provide Protective Influenza Vaccine Responses

Mundeep K Kainth et al. Viruses. .

Abstract

The most effective intervention for influenza prevention is vaccination. However, there are conflicting data on influenza vaccine antibody responses in obese children. Cardio-metabolic parameters such as waist circumference, cholesterol, insulin sensitivity, and blood pressure are used to subdivide individuals with overweight or obese BMI into 'healthy' (MHOO) or 'unhealthy' (MUOO) metabolic phenotypes. The ever-evolving metabolic phenotypes in children may be elucidated by using vaccine stimulation to characterize cytokine responses. We conducted a prospective cohort study evaluating influenza vaccine responses in children. Participants were identified as either normal-weight children (NWC) or overweight/obese using BMI. Children with obesity were then characterized using metabolic health metrics. These metrics consisted of changes in serum cytokine and chemokine concentrations measured via multiplex assay at baseline and repeated at one month following vaccination. Changes in NWC, MHOO and MUOO were compared using Chi-square/Fisher's exact test for antibody responses and Kruskal-Wallis test for cytokines. Differences in influenza antibody responses in normal, MHOO and MUOO children were statistically indistinguishable. IL-13 was decreased in MUOO children compared to NWC and MHOO children (p = 0.04). IL-10 approached a statistically significant decrease in MUOO compared to MHOO and NWC (p = 0.07). Influenza vaccination does not provoke different responses in NCW, MHOO, or MUOO children, suggesting that obesity, whether metabolically healthy or unhealthy, does not alter the efficacy of vaccination. IL-13 levels in MUO children were significantly different from levels in normal and MHOO children, indicating that the metabolically unhealthy phenotypes may be associated with an altered inflammatory response. A larger sample size with greater numbers of metabolically unhealthy children may lend more insight into the relationship of chronic inflammation secondary to obesity with vaccine immunity.

Keywords: influenza vaccine; metabolic health; pediatric obesity.

PubMed Disclaimer

Conflict of interest statement

The A.G.-S. laboratory has received research support from Pfizer, Senhwa Biosciences, Kenall Manufacturing, Avimex, Johnson & Johnson, Dynavax, 7Hills Pharma, Pharmamar, ImmunityBio, Accurius, Nanocomposix, Hexamer, N-fold LLC, Model Medicines, Atea Pharma and Merck outside of the reported work. A.G.-S. has consulting agreements for the following companies involving cash and/or stock: Vivaldi Biosciences, Contrafect, 7Hills Pharma, Avimex, Vaxalto, Pagoda, Accurius, Esperovax, Farmak, Applied Biological Laboratories, Pharmamar and Pfizer outside of the reported work. A.G.-S. is an inventor on patents and patent applications on the use of antivirals and vaccines for the treatment and prevention of virus infections and cancer, owned by the Icahn School of Medicine at Mount Sinai, New York, outside of the reported work. CSD is supported in part by the National Institute of General Medical Science and BARDA, receives a stipend from the Society of Critical Care Medicine as Scientific Editor of the journal Critical Care Medicine, has received support in kind (free study drug) from La Jolla Pharmaceuticals, has consulted for ICON Data Management and Pfizer and holds stock options in Enlivex Inc. The remaining authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
Characterization of influenza responses in the entire cohort of children measured by hemagglutination inhibition (HI) assays. HI titers before vaccination (at baseline), ~1 month, and 6 months after vaccination are shown for each of the vaccine strains contained in the quadrivalent influenza vaccine (Fluzone) for three consecutive seasons (2017–2018, 2018–2019, 2019–2020). **** p < 0.0001; *** p < 0.001, * p < 0.05. ns: indicated Not Significant.
Figure 2
Figure 2
IL-13 percent change in concentration from baseline to 1-month post-influenza vaccination (p < 0.04).
Figure 3
Figure 3
IL-10 percent change in concentration from baseline to 1 month post-influenza vaccination.
Figure 4
Figure 4
(A–C) Adiponectin, GM-CSF, and IFN-g percent change from baseline to 1 month post-influenza vaccination.
Figure 4
Figure 4
(A–C) Adiponectin, GM-CSF, and IFN-g percent change from baseline to 1 month post-influenza vaccination.
See this image and copyright information in PMC

References

    1. Coleman L.A., Waring S.C., Irving S.A., Vandermause M., Shay D.K., Belongia E.A. Evaluation of obesity as an independent risk factor for medically attended laboratory-confirmed influenza. Influenza Other Respir. Viruses. 2013;7:160–167. doi: 10.1111/j.1750-2659.2012.00377.x. - DOI - PMC - PubMed
    1. Cocoros N.M., Lash T.L., DeMaria A., Klompas M. Obesity as a risk factor for severe influenza-like illness. Influenza Other Respir. Viruses. 2014;8:25–32. doi: 10.1111/irv.12156. - DOI - PMC - PubMed
    1. Martín V., Castilla J., Godoy P., Delgado-Rodríguez M., Soldevila N., Fernández-Villa T., Molina A.J., Astray J., Castro A., González-Candelas F., et al. High Body Mass Index as a Risk Factor for Hospitalization Due to Influenza: A Case-Control Study. Arch. Bronconeumol. 2016;52:299–307. doi: 10.1016/j.arbres.2015.11.006. - DOI - PubMed
    1. Morgan O.W., Bramley A., Fowlkes A., Freedman D.S., Taylor T.H., Gargiullo P., Belay B., Jain S., Cox C., Kamimoto L., et al. Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1) disease. PLoS ONE. 2010;5:e9694. doi: 10.1371/journal.pone.0009694. - DOI - PMC - PubMed
    1. Louie J.K., Acosta M., Samuel M.C., Schechter R., Vugia D.J., Harriman K., Matyas B.T. California Pandemic (H1N1) Working Group A novel risk factor for a novel virus: Obesity and 2009 pandemic influenza A (H1N1) Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am. 2011;52:301–312. doi: 10.1093/cid/ciq152. - DOI - PubMed

Publication types