肥胖与COVID-19疫苗（新冠疫苗）的有效性？

Obesity & COVID-19 Vaccine Effectiveness

Sep. 29, 2020

Rajat Madan, MD, UC Health infectious diseases specialist and assistant professor of Internal Medicine in the Department of Internal Medicine shares insight into the effectiveness of vaccines in obese adults.

肥胖与COVID-19疫苗（新冠疫苗）的有效性？

2020年9月29日

拉贾特马丹，医学博士，美国辛辛那提大学医学中心健康传染病专家和内科学助理教授分享了疫苗对肥胖成年人有效性的见解。

Will obesity block the effectiveness of a COVID-19 vaccine in the U.S.?

It has long been known by experts that those who have obesity are often unable to benefit from common vaccines, including influenza, hepatitis B and tetanus. When a COVID-19 vaccine is discovered, how will the obese population be impacted? Will they benefit from a vaccine or will they be vulnerable to infection and illness?

With a vaccine trial now underway at the University of Cincinnati and UC Health, and knowing that more than 107 million adults in the U.S. are obese, can our nation beat this virus despite the availability of a vaccine?

Rajat Madan, MD, UC Health infectious diseases specialist and assistant professor in the Department of Internal Medicine at the UC College of Medicine, is available to discuss and clarify information about this topic, which includes addressing the questions listed below.

1、肥胖是否会阻碍COVID-19疫苗在美国的有效性？

专家们早就知道，肥胖者往往无法从普通疫苗中获益，包括流感、乙肝和破伤风。当COVID-19疫苗被发现时，肥胖人群将受到怎样的影响？他们会从疫苗中受益，还是容易受到感染和因此生病？

美国辛辛那提大学和大学的健康部正在进行疫苗试验，美国有1.07亿多成年人肥胖，尽管有疫苗，我们的国家能战胜这种病毒吗？

Rajat Madan，医学博士，美国辛辛那提大学健康传染病专家，辛辛那提大学医学院内科助理教授，认为可以讨论和澄清关于这个主题的信息，包括回答下面列出的问题。

What is a simple explanation about how vaccines work and why obesity often interferes with the body’s immune response?

Vaccines are made up of small parts of a virus (e.g. viral proteins) or dead virus particles. Our body’s immune system recognizes these as foreign materials and generates a protective immune response against them. When a vaccinated person’s immune system then sees the whole virus, it generates the same immune response, which results in killing the virus. Obesity affects many facets of our immune system and results in dysregulated immune responses. Therefore, the effects of vaccination in an obese person can be very different, compared to a non-obese person.

2、关于疫苗是如何工作的，为什么肥胖常常干扰人体的免疫反应，有什么简单易懂的解释吗？

疫苗只是由病毒的一小部分（如病毒蛋白）或死亡病毒颗粒组成的。我们身体的免疫系统识别这些外来物质，并对它们产生保护性免疫反应。当接种疫苗的人的免疫系统遇到整个病毒时，它会产生相同的免疫反应，从而杀死病毒。肥胖影响我们免疫系统的许多方面，导致免疫反应失调。因此，与非肥胖者相比，肥胖者接种疫苗的效果可能大不相同。

If obesity impacts the effectiveness of a vaccine, such as the flu shot, will a COVID-19 vaccine be any different?

Typically, obese individuals have a poor response to the flu vaccine. However, at this time, we do not know if the effectiveness of a COVID-19 vaccine will be different in obese individuals or not. This is because some of the vaccines that are currently being developed for COVID-19 use a new technology – “mRNA” vaccines – and therefore, the responses could be different.

3、如果肥胖影响疫苗的有效性，比如流感疫苗，那么COVID-19疫苗会有什么不同吗？

通常，肥胖者对流感疫苗的反应很差。然而，目前我们还不知道COVID-19疫苗在肥胖人群中的效果是否会有所不同。为什么会有这样的问题吗？这是因为目前为COVID-19开发的一些疫苗使用了一种新技术——“mRNA”疫苗，因此，反应可能不同。

With our nation’s high level of obesity, how is bariatric surgery helpful in the battle against this epidemic?

Bariatric surgery is a very effective option for the treatment of obesity. However, it takes weeks to see maximal weight loss. While it likely does not have a direct role in battling the epidemic, in the long run, reducing the overall burden of obesity in our society could have an impact on decreasing the severity of the epidemic.

4、我们国家的肥胖率很高，减重手术对抗击这一流行病有什么帮助？

减重手术是治疗肥胖的一个非常有效的选择。然而，它需要数周才能看到最大的体重减轻。虽然它可能对抗击这一流行病没有直接作用，但从长远来看，减轻我们社会中肥胖的总体负担可能会对降低这一流行病的严重性产生影响。

When is surgery safer than remaining obese? Why?

In cases of morbid obesity (i.e. people with a BMI > 40) and in patients with conditions that are associated with worse obesity-associated outcomes, such as high blood pressure or uncontrolled diabetes, getting surgery is better than remaining obese. Surgical weight loss in these patients has been shown to reverse these other chronic conditions and therefore, giving patients better outcomes.

5、什么时候手术比仍然肥胖更安全？为什么？

在病态肥胖症患者（即体重指数>40kg/m2的人）和患有与肥胖症相关结果更差的疾病的患者（如高血压或未控制的糖尿病）中，接受手术比保持肥胖状态要好。手术减重在这些患者中已经被证明可以逆转这些其他慢性疾病，因此，给患者更好的结果。

What is the most important message that those with obesity should hear in today’s COVID-19 world?

Obesity is an independent risk factor for having worse outcomes after COVID-19. Therefore, prevention is imperative in obese individuals and they should be especially careful about social distancing and trying to maintain a healthy lifestyle.

6、在当今COVID-19流行的世界中，肥胖患者应该听到的最重要的信息是什么？

肥胖是COVID-19治疗时预后较差的独立危险因素。因此，预防肥胖是必要的，肥胖患者更应该特别注意社会距离，并且要保持健康的生活方式。