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Comparison of Immune Response to the Influenza Vaccine in Obese and Nonobese Healthcare Workers

  • Michael A. Sweet (a1), Jonathan A. McCullers (a2), Paul R. Lasala (a3), Frank E. Briggs (a1), Anne Smithmyer (a4) and Rashida A. Khakoo (a5)...



To determine whether there is a difference in antibody titers and functionality after receipt of the influenza vaccine for obese versus nonobese healthcare workers (HCW).


Prospective observational study.


Tertiary medical center.


Healthcare workers.


Baseline influenza antibody titers for obese and nonobese HCW were recorded during the hospital’s 2011 annual influenza vaccination day and follow-up antibody titers were measured 4 weeks later. Antibodies were measured using the hemagglutination inhibition assay and functionality was measured using the micro-neutralization method.


Of 200 initial HCWs, 190 completed the study (97 obese and 93 nonobese). Seroprotection after immunization was not significantly different for nonobese compared with obese HCW for each strain (influenza A [H1N1], 99% and 99%; influenza A [H3N2], 100% and 99%; and influenza B, 67% and 71%, respectively)

All geometric mean titers measured by micro-neutralization showed statistically significant increases in activity. In comparison, there was no difference in the 4-fold increase in H1N1 or B titers. There was a significant difference in the 4-fold increase of H3N2 titers between the nonobese and obese HCWs (82/93 [88%] vs 64/97 [66%], P=.003)

In an ad hoc analysis we found that obese HCWs had a statistically greater number of 4-fold decreases in titers with H1N1 and H3N2.


There was no significant difference in protection from influenza between obese and nonobese HCWs after immunization.

Infect Control Hosp Epidemiol 2014;00(0): 1–5


Corresponding author

Address correspondence to Michael A. Sweet, PharmD, Center for Quality Outcomes, West Virginia University Hospitals, PO Box 8242, Morgantown, WV 26506-8242 (


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