{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T07:04:44Z","timestamp":1777100684855,"version":"3.51.4"},"reference-count":81,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Opole, Poland","award":["INM-2021-P-2021-014"],"award-info":[{"award-number":["INM-2021-P-2021-014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: This study aimed to investigate the early and longitudinal humoral response in Healthcare Workers (HCWs) after two doses of the BNT162b2 vaccine and to assess the association between metabolic and anthropometric parameters and the humoral response after vaccination. Methods: The study included 243 fully vaccinated HCWs: 25.50% previously infected with SARS-CoV-2 (with prior history of COVID-19\u2014PH) and 74.40%\u2014uninfected, seronegative before the first vaccination (with no prior history of COVID-19\u2014NPH). IgG antibodies were measured, and sera were collected: prior to the vaccination, 21 days after the first dose, and 14 days and 8 months after the second dose. Results: 21 days after the first dose, 90.95% of individuals were seropositive; 14 days after the second dose, persistent immunity was observed in 99.18% HCWs, 8 months after complete vaccination\u2014in 61.73%. Statistical analysis revealed that HCWs with PH had a greater chance of maintaining a humoral response beyond eight months after vaccination. Increased muscle mass, decreased fat mass, and younger age may positively affect long-term immunity. Smokers have a reduced chance of developing immunity compared to non-smokers. Conclusions: Fully vaccinated HCWs with PH are more likely to be seropositive than fully inoculated volunteers with NPH.<\/jats:p>","DOI":"10.3390\/v14050868","type":"journal-article","created":{"date-parts":[[2022,4,24]],"date-time":"2022-04-24T02:22:02Z","timestamp":1650766922000},"page":"868","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Early and Longitudinal Humoral Response to the SARS-CoV-2 mRNA BNT162b2 Vaccine in Healthcare Workers: Significance of BMI, Adipose Tissue and Muscle Mass on Long-Lasting Post-Vaccinal Immunity"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1698-5257","authenticated-orcid":false,"given":"Marlena","family":"Golec","sequence":"first","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3669-1416","authenticated-orcid":false,"given":"Martyna","family":"Fronczek","sequence":"additional","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"},{"name":"Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 38, 41-808 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Zembala-John","sequence":"additional","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"},{"name":"Department of Medicine and Environmental Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 19, 41-808 Zabrze, Poland"},{"name":"Silesian Center for Heart Diseases in Zabrze, M. Curie-Sk\u0142odowskiej 9, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1008-3730","authenticated-orcid":false,"given":"Martyna","family":"Chrapiec","sequence":"additional","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5568-222X","authenticated-orcid":false,"given":"Adam","family":"Konka","sequence":"additional","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Wystyrk","sequence":"additional","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Botor","sequence":"additional","affiliation":[{"name":"Acellmed Ltd., M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-7013","authenticated-orcid":false,"given":"Zenon","family":"Brzoza","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases, Allergology, Endocrinology and Gastroenterology, Institute of Medical Sciences, University of Opole, Al. W. Witosa 26, 40-451 Opole, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u0142awomir","family":"Kasperczyk","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, H. Jordana 19, 41-808 Zabrze, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0405-0596","authenticated-orcid":false,"given":"Rafa\u0142 Jakub","family":"Bu\u0142dak","sequence":"additional","affiliation":[{"name":"Silesian Park of Medical Technology Kardio-Med Silesia, M. Curie-Sk\u0142odowskiej 10C, 41-800 Zabrze, Poland"},{"name":"Department of Clinical Biochemistry and Laboratory Diagnostics, Institute of Medical Sciences, University of Opole, Oleska 48, 45-052 Opole, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1186\/s12931-020-01479-w","article-title":"From SARS and MERS to COVID-19: A brief summary and comparison of severe acute respiratory infections caused by three highly pathogenic human coronaviruses","volume":"21","author":"Zhu","year":"2020","journal-title":"Respir. Res."},{"key":"ref_2","unstructured":"(2021, December 19). WHO Website: WHO COVID-19 Dashboard. Available online: https:\/\/covid19.who.int."},{"key":"ref_3","unstructured":"Ritchie, H., Mathieu, E., Rod\u00e9s-Guirao, L., Appel, C., Giattino, C., Ortiz-Ospina, E., Hasell, J., Macdonald, B., Beltekian, D., and Roser, M. (2021, October 20). Coronavirus Pandemic (COVID-19). Available online: https:\/\/ourworldindata.org\/covid-cases#licence."},{"key":"ref_4","unstructured":"(2021, June 20). European Centre for Disease Prevention and Control Website: COVID-19\u2014Latest evidence\u2014Risk factors and risk groups. Available online: https:\/\/www.ecdc.europa.eu\/en\/covid-19\/latest-evidence\/risk-factors-risk-groups."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1002\/oby.23096","article-title":"Visceral Adiposity Elevates the Risk of Critical Condition in COVID-19: A Systematic Review and Meta-Analysis","volume":"29","author":"Farkas","year":"2021","journal-title":"Obesity"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.cmi.2020.10.020","article-title":"Nourollahpour Shiadeh, M.; Esfandyari, S.; Mokdad, A.H.; Hotez, P.J.; Gasser, R.B. SARS-CoV-2 seroprevalence worldwide: A systematic review and meta-analysis","volume":"27","author":"Rostami","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"115140","DOI":"10.1016\/j.diagmicrobio.2020.115140","article-title":"Monitoring antibody response following SARS-CoV-2 infection: Diagnostic efficiency of 4 automated immunoassays","volume":"98","author":"Wolff","year":"2020","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4704","DOI":"10.1038\/s41467-020-18450-4","article-title":"A systematic review of antibody mediated immunity to coronaviruses: Kinetics, correlates of protection, and association with severity","volume":"11","author":"Huang","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S0140-6736(20)31483-5","article-title":"Prevalence of SARS-CoV-2 in Spain (ENE-COVID): A nationwide, population-based seroepidemiological study","volume":"396","author":"Oteo","year":"2020","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1038\/s41591-020-0949-6","article-title":"Seroprevalence of immunoglobulin M and G antibodies against SARS-CoV-2 in China","volume":"26","author":"Xu","year":"2020","journal-title":"Nat. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.clinbiochem.2021.01.010","article-title":"Initial determination of COVID-19 seroprevalence among outpatients and healthcare workers in Minnesota using a novel SARS-CoV-2 total antibody ELISA","volume":"90","author":"Thomas","year":"2021","journal-title":"Clin. Biochem."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e475","DOI":"10.1016\/S2468-2667(20)30164-X","article-title":"Risk of COVID-19 among frontline healthcare workers and the general community: A prospective cohort study","volume":"5","author":"Nguyen","year":"2020","journal-title":"Lancet Public Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"362","DOI":"10.7326\/M20-3012","article-title":"Prevalence of Asymptomatic SARS-CoV-2 Infection","volume":"173","author":"Oran","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"17513","DOI":"10.1073\/pnas.2008373117","article-title":"The implications of silent transmission for the control of COVID-19 outbreaks","volume":"117","author":"Moghadas","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_16","unstructured":"World Health Organization (2022, March 02). Protocol for Assessment of Potential Risk Factors for 2019-Novel Coronavirus (COVID-19) Infection among Health Care Workers in a Health Care Setting. Available online: https:\/\/www.who.int\/publications\/i\/item\/protocol-for-assessment-of-potential-risk-factors-for-2019-novel-coronavirus-(2019-ncov)-infection-among-health-care-workers-in-a-health-care-setting."},{"key":"ref_17","unstructured":"(2022, March 12). European Centre for Disease Prevention and Control Website: SARS-CoV-2 Variants Dashboard. Available online: https:\/\/www.ecdc.europa.eu\/en\/covid-19\/situation-updates\/variants-dashboard."},{"key":"ref_18","unstructured":"(2022, March 12). SARS-CoV-2 w Polsce. Available online: https:\/\/sarswpolsce.pl."},{"key":"ref_19","unstructured":"(2022, January 20). ACCESS SARS-CoV-2 IgG\u2014Instructions for Use, Available online: https:\/\/www.fda.gov\/media\/139627\/download."},{"key":"ref_20","unstructured":"(2020, October 20). WHO Website: Body Mass Index\u2014BMI. Available online: https:\/\/www.euro.who.int\/en\/health-topics\/disease-prevention\/nutrition\/a-healthy-lifestyle\/body-mass-index-bmi."},{"key":"ref_21","unstructured":"RStudio Team (2021, December 20). RStudio: Integrated Development for R. RStudio, PBC, Boston, 2020. Available online: http:\/\/www.rstudio.com\/."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wickham, H. (2016). Ggplot2: Elegant Graphics for Data Analysis, Springer.","DOI":"10.1007\/978-3-319-24277-4_9"},{"key":"ref_23","unstructured":"(2021, August 10). Healthcare in Europe. Available online: https:\/\/healthcare-in-europe.com\/en\/news\/should-covid-19-vaccination-be-mandatory-for-health-care-staff.html."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"9","DOI":"10.3390\/tropicalmed7010009","article-title":"SARS-CoV-2 mRNA Vaccine Breakthrough Infections in Fully Vaccinated Healthcare Personnel: A Systematic Review","volume":"7","author":"Leggat","year":"2022","journal-title":"Trop. Med. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1002\/jmv.27457","article-title":"Postvaccination SARS-CoV-2 infection among healthcare workers\u2014A Systematic Review and meta-analysis","volume":"94","author":"Chandan","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1017\/ash.2021.195","article-title":"The short-term effectiveness of coronavirus disease 2019 (COVID-19) vaccines among healthcare workers: A systematic literature review and meta-analysis","volume":"1","author":"Marra","year":"2021","journal-title":"ASHE"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100770","DOI":"10.1016\/j.eclinm.2021.100770","article-title":"Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis","volume":"33","author":"Hossain","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s40249-021-00915-3","article-title":"Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: A systematic review and meta-analysis","volume":"10","author":"Liu","year":"2021","journal-title":"Infect. Dis. Poverty"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1056\/NEJMoa2114583","article-title":"Waning Immune Humoral Response to BNT162b2 COVID-19 Vaccine over 6 Months","volume":"385","author":"Levin","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"24503","DOI":"10.1038\/s41598-021-04279-4","article-title":"Humoral immune response to SARS-CoV-2 in five different groups of individuals at different environmental and professional risk of infection","volume":"11","author":"Novello","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1093\/cid\/ciaa219","article-title":"2019 Novel Coronavirus Is Undergoing Active Recombination","volume":"71","author":"Yi","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"602108","DOI":"10.3389\/fragi.2020.602108","article-title":"Aging of the Immune System: Research Challenges to Enhance the Health Span of Older Adults","volume":"1","author":"Haynes","year":"2020","journal-title":"Front. Aging"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.3389\/fimmu.2019.01076","article-title":"Editorial: Sex Hormones and Gender Differences in Immune Responses","volume":"10","author":"Ortona","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_34","unstructured":"Shreeves, R. (2021, February 08). COVID-19: The Need for a Gendered Response. European Parliamentary Research Service\u2014Briefing. Brussels: PE 68348. Available online: https:\/\/www.europarl.europa.eu\/RegData\/etudes\/BRIE\/2021\/689348\/EPRS_BRI(2021)689348_EN.pdf."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1038\/nri.2016.90","article-title":"Sex differences in immune responses","volume":"16","author":"Klein","year":"2016","journal-title":"Nat. Rev. Immunol."},{"key":"ref_36","unstructured":"Center for Disease Control and Prevention Website (2021, June 15). Evidence Used to Update the List of Underlying Medical Conditions That Increase a Person\u2019s Risk of Severe Illness from COVID-19, Available online: https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extraprecautions\/evidence-table.html."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e13362","DOI":"10.1111\/eci.13362","article-title":"Predictors of adverse prognosis in COVID-19: A systematic review and meta-analysis","volume":"50","author":"Figliozzi","year":"2020","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/hast.1136","article-title":"Older Adults and COVID-19: The Most Vulnerable, the Hardest Hit","volume":"50","author":"Powell","year":"2020","journal-title":"Hastings Cent. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Amodio, E., Capra, G., Casuccio, A., Grazia, S., Genovese, D., Pizzo, S., Calamusa, G., Ferraro, D., Giammanco, G.M., and Vitale, F. (2021). Antibodies Responses to SARS-CoV-2 in a Large Cohort of Vaccinated Subjects and Seropositive Patients. Vaccines, 9.","DOI":"10.2139\/ssrn.3831846"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"100208","DOI":"10.1016\/j.lanepe.2021.100208","article-title":"Dynamics of antibody response to BNT162b2 vaccine after six months: A longitudinal prospective study","volume":"10","author":"Naaber","year":"2021","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1093\/cid\/ciab381","article-title":"Age-dependent Immune Response to the BioNTech\/Pfizer BNT162b2 Coronavirus Disease 2019 Vaccination","volume":"73","author":"Moskorz","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/jmv.26232","article-title":"The cytokine storm and COVID-19","volume":"93","author":"Hu","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ebiom.2019.10.034","article-title":"Skeletal muscle as a potential central link between sarcopenia and immune senescence","volume":"49","author":"Nelke","year":"2019","journal-title":"EBioMedicine"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"631179","DOI":"10.3389\/fpsyg.2021.631179","article-title":"Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review","volume":"12","author":"Piqueras","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/sj.ejcn.1601484","article-title":"Obesity and immunocompetence","volume":"56","author":"Lamas","year":"2002","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/NT.0000000000000092","article-title":"Body Mass Index: Obesity, BMI, and Health: A Critical Review","volume":"50","author":"Nuttall","year":"2015","journal-title":"Nutr. Today"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Karchynskaya, V., Kopcakova, J., Klein, D., G\u00e1ba, A., Madarasova-Geckova, A., van Dijk, J.P., de Winter, A.F., and Reijneveld, S.A. (2020). Is BMI a Valid Indicator of Overweight and Obesity for Adolescents?. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17134815"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S0899-9007(00)00471-8","article-title":"Limits of body mass index to detect obesity and predict body composition","volume":"17","author":"Frankenfield","year":"2001","journal-title":"Nutrition"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/s13679-021-00448-8","article-title":"Obesity as a Risk Factor for Severe COVID-19: Summary of the Best Evidence and Implications for Health Care","volume":"10","author":"Sattar","year":"2021","journal-title":"Curr. Obes. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"355","DOI":"10.15585\/mmwr.mm7010e4","article-title":"Body Mass Index and Risk for COVID-19\u2013Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death\u2014United States, March\u2013December 2020","volume":"70","author":"Kompaniyets","year":"2021","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0271-5317(00)00255-4","article-title":"Obesity, overnutrition and the immune system","volume":"21","author":"Chandra","year":"2001","journal-title":"Nutr. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1016\/S0271-5317(96)00204-7","article-title":"Body size and immune responses","volume":"16","author":"Chandra","year":"1996","journal-title":"Nutr. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1017\/S0029665112000092","article-title":"Obesity, inflammation and the immune system","volume":"71","author":"Marcos","year":"2012","journal-title":"Proc. Nutr. Soc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e13216","DOI":"10.1111\/obr.13216","article-title":"The impact of obesity on immune response to infection: Plausible mechanisms and outcomes","volume":"22","author":"Muscogiuri","year":"2021","journal-title":"Obes. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Zorita, S., Milton-Laskibar, I., Garc\u00eda-Arellano, L., Gonz\u00e1lez, M., and Portillo, M.P. (2021). An Overview of Adipose Tissue ACE2 Modulation by Diet and Obesity. Potential Implications in COVID-19 Infection and Severity. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22157975"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/dom.12154","article-title":"The immune cells in adipose tissue","volume":"15","author":"Ferrante","year":"2013","journal-title":"Diabetes Obes. Metab."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1146\/annurev-immunol-020711-074934","article-title":"Immune regulatory function of B cells","volume":"30","author":"Mauri","year":"2012","journal-title":"Annu. Rev. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e695","DOI":"10.1093\/cid\/ciaa1419","article-title":"Risk factors for coronavirus disease 2019 (COVID-19)\u2013associated hospitalization: COVID-19\u2014Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System","volume":"72","author":"Ko","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1038\/d41586-020-02946-6","article-title":"Could obesity could create problems for a COVID vaccine?","volume":"586","author":"Ledford","year":"2020","journal-title":"Nature"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1002\/oby.21383","article-title":"Obesity decreases B cell responses in young and elderly individuals","volume":"24","author":"Frasca","year":"2016","journal-title":"Obesity"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3187","DOI":"10.1001\/jama.1985.03360220053027","article-title":"Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine","volume":"254","author":"Weber","year":"1985","journal-title":"JAMA"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1056\/NEJM198605223142119","article-title":"Impaired immunogenicity of hepatitis B vaccine in obese persons","volume":"314","author":"Weber","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1038\/ijo.2011.208","article-title":"Obesity is associated with impaired immune response to influenza vaccination in humans","volume":"36","author":"Sheridan","year":"2012","journal-title":"Int. J. Obes."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.vaccine.2013.12.019","article-title":"Incidence and variables associated with inadequate antibody titers after pre-exposure rabies vaccination among veterinary medical students","volume":"32","author":"Banga","year":"2014","journal-title":"Vaccine"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S406","DOI":"10.1513\/AnnalsATS.201706-447AW","article-title":"Obesity impairs the adaptive immune response to influenza virus","volume":"14","author":"Green","year":"2017","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1002\/oby.23251","article-title":"COVID-19 vaccines are effective in people with obesity: A position statement from the Obesity Society","volume":"29","author":"Butsch","year":"2021","journal-title":"Obesity"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1006\/cyto.2001.0860","article-title":"Cigarette smoking depletes cells spontaneously secreting Th (1) cytokines in the human airway","volume":"14","author":"Hagiwara","year":"2001","journal-title":"Cytokine"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"268","DOI":"10.18632\/oncotarget.13613","article-title":"Impacts of cigarette smoking on immune responsiveness: Up and down or upside down?","volume":"8","author":"Qiu","year":"2017","journal-title":"Oncotarget"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"20","DOI":"10.18332\/tid\/119324","article-title":"COVID-19 and smoking: A systematic review of the evidence","volume":"18","author":"Vardavas","year":"2020","journal-title":"Tob. Induc. Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"200","DOI":"10.3892\/ijmm.2021.5033","article-title":"Immune response (IgG) following full inoculation with BNT162b2 COVID-19 mRNA among healthcare professionals","volume":"48","author":"Tsatsakis","year":"2021","journal-title":"Int. J. Mol. Med."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Parthymou, A., Habeos, E.E., Habepr, G.I., Deligakis, A., Livieratos, E., Marangos, M., and Chartoumpekis, D.V. (2021). SARS-CoV-2 antibody titer 3 months post-vaccination is affected by age, gender, smoking and vitamin D. MedRxiv, 21262913.","DOI":"10.1101\/2021.09.01.21262913"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Nomura, Y., Sawahata, M., Nakamura, Y., Kurihara, M., Koike, R., Katsube, O., Hagiwara, K., Niho, S., Masuda, N., and Tanaka, T. (2021). Age and Smoking Predict Antibody Titres at 3 Months after the Second Dose of the BNT162b2 COVID-19 Vaccine. Vaccines, 9.","DOI":"10.1101\/2021.08.06.21261590"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1017\/S0022172400055790","article-title":"The effect of cigarette smoking on susceptibility to epidemic influenza and on serological responses to live attenuated and killed subunit influenza vaccines","volume":"77","author":"MacKenzie","year":"1976","journal-title":"J. Hyg."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"497","DOI":"10.21037\/atm.2020.03.157","article-title":"Coronavirus disease 2019 (COVID-19): The portrait of a perfect storm","volume":"8","author":"Lippi","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_75","unstructured":"WHO Website (2021). Weekly Epidemiological Update on COVID-19, WHO. Available online: https:\/\/www.who.int\/publications\/m\/item\/weekly-epidemiological-update-on-covid-19---8-june-2021."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/S0140-6736(21)02844-0","article-title":"Reduced neutralization of SARS-CoV-2 Omicron-B.1.1.529 variant by post-immunisation serum","volume":"399","author":"Dejnirattisai","year":"2022","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1038\/s41586-021-03398-2","article-title":"Antibody Resistance of SARS-CoV-2 Variants B.1.351 and B.1.1.7","volume":"593","author":"Wang","year":"2021","journal-title":"Nature"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1038\/s41564-021-01053-0","article-title":"Canadian Immunization Research Network (CIRN) Provincial Collaborative Network (PCN) Investigators. Effectiveness of COVID-19 vaccines against symptomatic SARS-CoV-2 infection and severe outcomes with variants of concern in Ontario","volume":"7","author":"Nasreen","year":"2022","journal-title":"Nat. Micr-obiol."},{"key":"ref_79","first-page":"100171","article-title":"Impact of original, B.1.1.7, and B.1.351\/P.1 SARS-CoV-2 lineages on vaccine effectiveness of two doses of COVID-19 mRNA vaccines: Results from a nationwide case-control study in France","volume":"8","author":"Charmet","year":"2021","journal-title":"Lancet Reg. Health"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1056\/NEJMoa2108891","article-title":"Effectiveness of COVID-19 Vaccines against the B.1.617.2 (Delta) Variant","volume":"385","author":"Bernal","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1056\/NEJMc2119358","article-title":"Third BNT162b2 Vaccination Neutralization of SARS-CoV-2 Omicron Infection","volume":"386","author":"Nemet","year":"2022","journal-title":"N. Engl. J. Med."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/5\/868\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:58:38Z","timestamp":1760137118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/5\/868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,22]]},"references-count":81,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["v14050868"],"URL":"https:\/\/doi.org\/10.3390\/v14050868","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,22]]}}}