{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:52:19Z","timestamp":1760230339766,"version":"build-2065373602"},"reference-count":60,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Overweight and obesity may cause a reduced response to vaccination. The purpose of the present research was to study the relationship between current body mass index (BMI) and antibody persistence after vaccination against measles, mumps, and rubella (MMR) and hepatitis B virus (HBV) given during childhood, as per the current vaccination schedule. The study was conducted on 2185 students at the School of Medicine, University of Padua, Italy. The mean age of the participants was 20.3 years. After adjusting for sex, age at first dose of vaccine administered, age at last dose, and age at study enrollment, no significant association was found between lack of serologic protection and BMI for either the HBV vaccine or each component of the MMR vaccine. For the first time, the absence of this relationship was demonstrated for the MMR vaccine. Given the evidence currently available, further research on BMI and vaccines in general remains desirable.<\/jats:p>","DOI":"10.3390\/vaccines10071152","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T22:38:50Z","timestamp":1658443130000},"page":"1152","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Body Mass Index and Antibody Persistence after Measles, Mumps, Rubella and Hepatitis B Vaccinations"],"prefix":"10.3390","volume":"10","author":[{"given":"Marco","family":"Fonzo","sequence":"first","affiliation":[{"name":"Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"Nicolli","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Maso","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Carrer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0764-1084","authenticated-orcid":false,"given":"Andrea","family":"Trevisan","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4040-8601","authenticated-orcid":false,"given":"Chiara","family":"Bertoncello","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"ref_1","unstructured":"WHO (2021, September 13). Obesity and Overweight. Gen\u00e8ve (CH), Available online: https:\/\/www.who.int\/news-room\/fact-sheets."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1210\/jc.2004-0535","article-title":"Medical Consequences of Obesity","volume":"89","author":"Bray","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_3","first-page":"e984","article-title":"Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association","volume":"143","author":"Poirier","year":"2021","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1111\/obr.12320","article-title":"Interaction of obesity and infections","volume":"16","author":"Dhurandhar","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Khafagy, A., AlJahdaly, I., and Goweda, R. (2020). Hepatitis B Vaccine: Assessment of Immunologic Response, Coverage Rate, and Factors Influencing Seroreactivity. Clin. Lab., 66.","DOI":"10.7754\/Clin.Lab.2019.191202"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4422","DOI":"10.1016\/j.vaccine.2015.06.101","article-title":"The weight of obesity on the human immune response to vaccination","volume":"33","author":"Painter","year":"2015","journal-title":"Vaccine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/oby.2007.541","article-title":"Burden of infection and fat mass in healthy middle-aged men","volume":"15","author":"Ferri","year":"2007","journal-title":"Obesity"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1038\/ijo.2017.263","article-title":"Body mass index and infectious disease mortality in midlife in a cohort of 2.3 million adolescents","volume":"42","author":"Twig","year":"2018","journal-title":"Int. J. Obes."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.annepidem.2013.04.002","article-title":"Hospitalized prenatal and childhood infections and obesity in Danish male conscripts","volume":"23","author":"Cocoros","year":"2013","journal-title":"Ann. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"333","DOI":"10.7326\/0003-4819-142-5-200503010-00008","article-title":"Antibody levels and protection after hepatitis B vaccination: Results of a 15-year follow-up","volume":"142","author":"McMahon","year":"2005","journal-title":"Ann. Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1097\/00006454-199403000-00022","article-title":"Hepatitis B vaccination in preterm infants","volume":"13","author":"Lau","year":"1994","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1086\/514575","article-title":"Prediction of response to hepatitis B vaccine in health care workers: Whose titers of antibody to hepatitis B surface antigen should be determined after a three-dose series, and what are the implications in terms of cost-effectiveness","volume":"26","author":"Alimonos","year":"1998","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/00004836-199906000-00007","article-title":"Hepatitis B vaccination in hospital personnel and medical students","volume":"28","author":"Marinho","year":"1999","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1016\/j.vaccine.2013.01.046","article-title":"Hepatitis B vaccination at three months of age: A successful strategy?","volume":"31","author":"Chiara","year":"2013","journal-title":"Vaccine"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Trevisan, A., Mason, P., Nicolli, A., Maso, S., Fonzo, M., Scarpa, B., and Bertoncello, C. (2021). Future Healthcare Workers and Hepatitis B Vaccination: A New Generation. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18157783"},{"key":"ref_16","unstructured":"Ministero della Salute (1999). Circolare n. 12. Controllo ed Eliminazione di Morbillo, Parotite e Rosolia per Mezzo Della Vaccinazione (Circular 12. Control and Elimination of Measles, Mumps and Rubella by Means of Vaccination)."},{"key":"ref_17","unstructured":"Decreto Presidente Consiglio dei Ministri (2001). Piano Nazionale per L\u2019eliminazione del Morbillo e Della Rosolia Congenita (Presidential Decree of the Council of Ministers. National Plan for the Elimination of Measles and Congenital Rubella)."},{"key":"ref_18","unstructured":"Centers for Disease Control and Prevention (1999). Prevention of varicella. Update recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 48, 1\u20135."},{"key":"ref_19","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_20","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_21","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1007\/BF00146405","article-title":"Immune response to anti-HBV vaccination: Study of conditioning factors","volume":"4","author":"Corrao","year":"1988","journal-title":"Eur. J. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2931","DOI":"10.1001\/jama.1993.03510240043029","article-title":"Hepatitis B vaccine responsiveness in Connecticut public safety personnel","volume":"270","author":"Roome","year":"1993","journal-title":"JAMA"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2935","DOI":"10.1001\/jama.1993.03510240047030","article-title":"Risk factors for lack of detectable antibody following hepatitis B vaccination of Minnesota health care workers","volume":"270","author":"Wood","year":"1993","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/0264-410X(95)00176-2","article-title":"Hepatitis B vaccine immunoresponsiveness in adolescents: A revaccination proposal after primary vaccination","volume":"14","year":"1996","journal-title":"Vaccine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0264-410X(96)00202-2","article-title":"Randomized, comparative trial of 20 micrograms vs 40 micrograms Engerix B vaccine in hepatitis B vaccine non-responders","volume":"15","author":"Goldwater","year":"1997","journal-title":"Vaccine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0749-3797(98)00003-8","article-title":"Immunogenicity of hepatitis B Vaccines. Implications for persons at occupational risk of hepatitis B virus infection","volume":"15","author":"Averhoff","year":"1998","journal-title":"Am. J. Prev. Med."},{"key":"ref_27","first-page":"983","article-title":"Hepatitis B vaccination in pregnancy: Factors influencing efficacy","volume":"93","author":"Ingardia","year":"1999","journal-title":"Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1016\/S0264-410X(03)00232-9","article-title":"Immunogenicity of 10 and 20 microgram hepatitis B vaccine in a two-dose schedule","volume":"21","author":"Hasnain","year":"2003","journal-title":"Vaccine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"c89","DOI":"10.1159\/000092016","article-title":"Antibody response to hepatitis B vaccine in end-stage renal disease patients","volume":"103","author":"Chow","year":"2006","journal-title":"Nephron Clin. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.biologicals.2006.06.001","article-title":"Immunogenicity and safety assessment of the Cuban recombinant hepatitis B vaccine in healthy adults","volume":"35","author":"Betancourt","year":"2007","journal-title":"Biologicals"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Young, K.M., Gray, C.M., and Bekker, L.G. (2013). Is obesity a risk factor for vaccine non-responsiveness?. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0082779"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"27251","DOI":"10.1038\/srep27251","article-title":"Factors influencing immunologic response to hepatitis B vaccine in adults","volume":"6","author":"Yang","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1080\/21645515.2016.1274475","article-title":"Influences of obesity on the immunogenicity of Hepatitis B vaccine","volume":"13","author":"Liu","year":"2017","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3345\/kjp.2019.00563","article-title":"Association between Body Mass Index and Hepatitis B antibody seropositivity in children","volume":"62","author":"Kwon","year":"2019","journal-title":"Korean J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ijid.2020.01.047","article-title":"Immune response to different types of hepatitis B vaccine booster doses 2\u201332 years after the primary immunization schedule and its influencing factors","volume":"93","author":"Zhao","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41541-020-00266-4","article-title":"Reduced immune responses to hepatitis B primary vaccination in obese individuals with nonalcoholic fatty liver disease (NAFLD)","volume":"6","author":"Joshi","year":"2021","journal-title":"NPJ Vaccines"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3457","DOI":"10.1016\/j.vaccine.2006.02.008","article-title":"Immunogenicity of a new, low-cost recombinant hepatitis B vaccine derived from Hansenula polymorpha in adults","volume":"24","author":"Kulkarni","year":"2006","journal-title":"Vaccine"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"102254","DOI":"10.1016\/j.dsx.2021.102254","article-title":"Impact of body mass index on immunogenicity of hepatitis B vaccine in bariatric surgery candidates: A retrospective study","volume":"15","author":"Kabir","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e508-12","DOI":"10.1542\/peds.2009-1592","article-title":"Effect of needle length when immunizing obese adolescents with hepatitis B vaccine","volume":"125","author":"Middleman","year":"2010","journal-title":"Pediatrics"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3155","DOI":"10.1016\/j.vaccine.2012.02.068","article-title":"Effect of needle length for response to hepatitis B vaccine in macrosomic neonates: A prospective randomized study","volume":"30","author":"Ozdemir","year":"2012","journal-title":"Vaccine"},{"key":"ref_41","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_42","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1097\/AOG.0b013e318244ed20","article-title":"Immunogenicity of trivalent inactivated influenza vaccination received during pregnancy or postpartum","volume":"119","author":"Sperling","year":"2012","journal-title":"Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.bbi.2011.10.009","article-title":"Vulnerability, distress, and immune response to vaccination in older adults","volume":"26","author":"Segerstrom","year":"2012","journal-title":"Brain Behav. Immun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1016\/j.vaccine.2021.02.047","article-title":"Sex-specific effects of age and body mass index on antibody responses to seasonal influenza vaccines in healthcare workers","volume":"40","author":"Kuo","year":"2021","journal-title":"Vaccine"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3937","DOI":"10.1016\/j.vaccine.2012.03.071","article-title":"Association between obesity and vulnerability and serologic response to influenza vaccination in older adults","volume":"30","author":"Talbot","year":"2012","journal-title":"Vaccine"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4864","DOI":"10.1016\/j.vaccine.2021.06.065","article-title":"Body mass index and vaccine responses following influenza vaccination during pregnancy","volume":"39","author":"Clarke","year":"2021","journal-title":"Vaccine"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/S0264-410X(96)00310-6","article-title":"The effect of age and weight on the response to formalin inactivated, alum-adjuvanted hepatitis A vaccine in healthy adults","volume":"15","author":"Reuman","year":"1997","journal-title":"Vaccine"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5509","DOI":"10.1016\/j.vaccine.2006.04.016","article-title":"Hepatitis A\/B vaccination of adults over 40 years old: Comparison of three vaccine regimens and effect of influencing factors","volume":"24","author":"Chlibek","year":"2006","journal-title":"Vaccine"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3349\/ymj.2014.55.1.126","article-title":"The immunogenicity of a single dose of hepatitis A virus vaccines (Havrix\u00ae and Epaxal\u00ae) in Korean young adults","volume":"55","author":"Lim","year":"2014","journal-title":"Yonsei Med. J."},{"key":"ref_50","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_51","doi-asserted-by":"crossref","first-page":"7203","DOI":"10.1016\/j.vaccine.2019.09.089","article-title":"The immune response to a two-dose schedule of quadrivalent HPV vaccine in 9\u201313 year-old girls: Is it influenced by age, menarche status or body mass index?","volume":"37","author":"Sauvageau","year":"2019","journal-title":"Vaccine"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/08916930600597326","article-title":"Reduced tetanus antibody titers in overweight children","volume":"39","author":"Eliakim","year":"2006","journal-title":"Autoimmunity"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Pellini, R., Venuti, A., Pimpinelli, F., Abril, E., Blandino, G., Campo, F., Conti, L., De Virgilio, A., De Marco, F., and Di Domenico, E.G. (2021). Early Onset of SARS-CoV-2 Antibodies after First Dose of BNT162b2: Correlation with Age, Gender and BMI. Vaccines, 9.","DOI":"10.3390\/vaccines9070685"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e3465","DOI":"10.1002\/dmrr.3465","article-title":"Central obesity, smoking habit, and hypertension are associated with lower antibody titres in response to COVID-19 mRNA vaccine","volume":"28","author":"Watanabe","year":"2022","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"100928","DOI":"10.1016\/j.eclinm.2021.100928","article-title":"Initial observations on age, gender, BMI and hypertension in antibody responses to SARS-CoV-2 BNT162b2 vaccine","volume":"36","author":"Pellini","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1093\/infdis\/jiab127","article-title":"Sex differences in the evolution of neutralizing antibodies to SARS-CoV-2","volume":"224","author":"Grzelak","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/obr.12334","article-title":"Predicting adult obesity from childhood obesity: A systematic review and meta-analysis","volume":"17","author":"Simmonds","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4103\/picr.PICR_119_19","article-title":"Immune response to hepatitis B vaccine: An evaluation","volume":"12","author":"Madhavan","year":"2021","journal-title":"Perspect. Clin. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.vaccine.2013.10.074","article-title":"Hepatitis B vaccination of adolescents: Significance of non-protective antibodies","volume":"32","author":"Chiara","year":"2013","journal-title":"Vaccine"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1080\/21645515.2019.1656483","article-title":"Significance of anti-HB levels below 10 IU\/L after vaccination against hepatitis B in infancy or adolescence: An update in relation to sex","volume":"16","author":"Trevisan","year":"2020","journal-title":"Hum. Vaccins Immunother."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/10\/7\/1152\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:54:25Z","timestamp":1760140465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/10\/7\/1152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,20]]},"references-count":60,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["vaccines10071152"],"URL":"https:\/\/doi.org\/10.3390\/vaccines10071152","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2022,7,20]]}}}