title: Comparison of immune response to the influenza vaccine in obese and nonobese healthcare workers.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  Healthcare workers. METHODS 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  There was no significant difference in protection from influenza between obese and nonobese HCWs after immunization.
authors.affiliation: 1Center for Quality Outcomes,West Virginia University Hospitals,Morgantown,West Virginia.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Sweet
authors.affiliation: 4St. Jude Children's Research Hospital,Memphis,Tennessee.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: McCullers
authors.affiliation: 3West Virginia University Pathology,West Virginia University Hospitals,Morgantown,West Virginia.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Lasala
authors.affiliation: 1Center for Quality Outcomes,West Virginia University Hospitals,Morgantown,West Virginia.
authors.forename: Frank E
authors.initials: FE
authors.lastname: Briggs
authors.affiliation: 2Employee Health,West Virginia University Hospitals,Morgantown,West Virginia.
authors.forename: Anne
authors.initials: A
authors.lastname: Smithmyer
authors.affiliation: 5Department of Infectious Diseases,West Virginia University School of Medicine,Morgantown,West Virginia.
authors.forename: Rashida A
authors.initials: RA
authors.lastname: Khakoo
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006282:Health Personnel; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000276:immunology*; D011446:Prospective Studies
chemical_list: D000914:Antibodies, Viral; D015415:Biomarkers; D007252:Influenza Vaccines