Many obese patients priority for vaccine

Even though most Virginia businesses reopened by July and grocery stores remained opened throughout the pandemic, 62-year-old Patty Nece hasn’t dared to step inside one since last March, as her obesity puts her at risk for severe COVID-19.

Because of her disease, she’s eligible to get a vaccine and has an appointment for her first dose on Wednesday. Al- though she’s looking forward to getting vaccinated, she’s also disappointed some Americans have criticized people with obesity who are prioritized to get the vaccine.

“It displays a misunderstanding ... weight isn’t always within your control,” said Nece, who is also the chairwoman of the Obesity Action Coalition. “Like many diseases, there’s personal responsibility involved but that’s not the end. The mantra of eat less and move more – which I’ve heard my entire life – isn’t the answer.”

Roughly 40% of adult Americans have obesity, according to Centers for Disease Control and Prevention data from 2018. Studies showed people with obesity are more likely to have worse outcomes from COVID-19 than others with a lower body mass index.

Researchers at the University of North Carolina at Chapel Hill found people with a BMI above 30 had a 113% higher risk for hospitalization, a 74% higher risk for ICU admission and a 48% higher risk of death, according to a study published in August 2020 in Obesity Reviews.

At first, health experts believed people with obesity were more at risk for severe COVID-19 because the disease also is associated with numerous underlying risk factors including hypertension, heart disease, Type 2 diabetes and chronic kidney and liver disease.

But after controlling for those factors, researchers found people with obesity were still at higher risk for COVID-19, said Dr. Rekha Kumar, medical director of the American Board of Obesity Medicine and associate professor of clinical medicine at Weill Cornell Medicine.

This might be partly the result of excess fat tissue producing more inflammation, she said.

“People’s bodies are mounting such a severe inflammatory response (to COVID-19), and that response is already existing at a baseline in obesity,” Kumar said. “So, when you add another stimulus, they’re getting even sicker.”

Obesity can change the metabolic state of immune cells and how they function, said Dr. Nancie MacIver, associate professor at Duke University School of Medicine. The excess inflammation may be an indication the immune system is dysfunctional.

Obesity patients’ altered immune system has led experts to worry about their response to the COVID-19 vaccine, especially as studies have suggested they might not respond as well to influenza vaccines.

Researchers at UNC Chapel Hill found that among vaccinated individuals, nearly 10% of patients with obesity were infected with the flu compared to about 5% of participants with a lower BMI, according to a 2017 study published in the International Journal of Obesity.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

GETTY IMAGES After controlling for factors such as blood pressure and diabetes, researchers find people with a body mass index above 30 are still at higher risk for COVID-19.