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COVID, influenza, hepatitis B, measles, etc. vaccine responses vary with Vitamin D and its receptor


Vaccine antibody response to SARS- COVID-19 Vaccine - Aug 2021 preprint

Age and vitamin D affect the magnitude of the antibody response to the first dose of the SARS-CoV-2 BNT162b2 vaccine
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Note by VitaminDWiki: A "good" level is vitamin D is at least 100 nmol (40 ng/mL)

Background: Most approved vaccines utilise a two-dose strategy. To enable larger groups of patients to receive the first dose, the UK government increased the gap between the two doses from three to 12 weeks. Here we report on the immunogenicity of the first dose, including effect of age and vitamin D status on these levels over an 8 week-period.

Methods: Blood was collected from healthcare workers (HCW) receiving their first BNT162b2 vaccine dose between January and February 2021. Antibody production was measured, prior to and weekly for 4 weeks post immunization, and a final measurement was performed at 8 weeks. Vitamin D were also measured at baseline.

Findings: Immunization of 97 HCW induced an Ab response that peaked 3·2 weeks post immunization to decrease thereafter. Ab levels remained positive at 8 weeks. The response was significantly modified by age (p<0·001) and greater in younger adults. Response to immunization was significantly affected by vitamin D status (p=0·035), on average 29·3% greater peak value in individuals with 25(OH)D>50nmol/L. No other variable showed significant effect.

Interpretation: The first dose of BNT162b2 produced Ab levels that remained positive after 8 weeks. Peak was greater in younger subjects and 25(OH)D>50nmol/L was beneficial. Booster campaigns should take into consideration vitamin D status which is at its highest following a period of sunshine exposure or following oral supplementation (400-1000IU daily).

Funding: Abbott Diagnostics Ltd supplied the kits used to quantify the anti-SARS -CoV-2 Spike IgG and technical support as well as provided financial support for sample collections.

Declaration of Interest: Two of the authors (SR and MB) are employees of Abbott Diagnostics Ltd who supplied the kits used to quantify the anti-SARS -CoV-2 Spike IgG and technical support as well as provided financial support for sample collections. All other authors have no conflict of interest.

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influenza, hepatitis B, measles, rubella, BCG vaccine, pneumococcal, meningococcal, etc. - 2015

“Let There Be Light”: The Role of Vitamin D in the Immune Response to Vaccines
Expert Rev Vaccines. 2015 ; 14(11): 1427-1440. doi:10.1586/14760584.2015.1082426.
Sapna Sadarangania,b, Jennifer A. Whitakera,b,c, and Gregory A. Polanda,c poland.gregory at mayo.edu.
a Mayo Vaccine Research Group
b Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota
c Mayo Clinic Division of General Internal Medicine

Key Issues

  • Vitamin D has various immunomodulatory actions, including potent actions on the innate immune system, enhancing production of antimicrobial peptide, and biasing toward a Th2 skewed phenotype
  • The vitamin D level/threshold that is relevant to immune actions has not been defined, as current definitions of deficiency are based on effects on bone health.
  • Vitamin D’s role has been examined in the immune response to vaccines in studies looking at vitamin D levels as well as vitamin D signaling pathway polymorphisms (
    • influenza,
    • hepatitis B,
    • measles,
    • rubella,
    • BCG vaccine,
    • pneumococcal,
    • meningococcal, etc.
    • but the results have been variable, and such studies remain un-replicated to date.
  • Higher HAI response to influenza vaccine was seen in vitamin D replete patients in a small study involving prostate cancer patients. There was suggestion of dose-response relationship of improved HAI response in HD patients who were receiving calcitriol in a separate study. Similarly, vitamin D deficiency was an independent negative predictor of seroconversion to hepatitis B vaccine in patients with CKD stages 3-5. Anti-tetanus specific IgG responses were noted to be higher in patients who received vitamin D supplementation compared to placebo, and this group had higher 25-(OH) D levels.
  • Certain VDR and RXRA gene polymorphisms were associated with measles and rubella vaccine induced adaptive immune responses in two separate studies. A single study found an association with a particular VDR gene polymorphism with higher odds of non-response to hepatitis B vaccine.
  • Animal studies have shown superior immunogenicity with vitamin D coadministered with inactivated polio vaccine, hepatitis B, and Hemophilus iniluenzae vaccines
  • Elderly, obese and CKD patients have a higher incidence of vitamin D deficiency, and often have suboptimal vaccine responses, hence they remain important patient populations to study
  • Future studies need to include patients with a wide range of vitamin D levels and vitamin D gene polymorphisms
  • Mechanistic and systems biology-level studies are also needed, examining strategies of either boosting homeostatic levels, or co-administering vitamin D with vaccine.

Abstract

Vitamin D’s non-skeletal actions, including immunomodulatory role, have been increasingly recognized. Of significance, many immune cells are able to synthesize a biologically active form of vitamin D from circulating 25-(OH) D with subsequent intracrine actions, and the vitamin D receptor (VDR) is broadly distributed. In this review, we discuss vitamin D’s potent role in innate and adaptive immune responses and published studies evaluating the impact of serum vitamin D, vitamin D gene pathway polymorphisms or empiric vitamin D supplementation on vaccine immunogenicity. We highlight existing knowledge gaps and propose the steps needed to advance the science and answer the question of whether vitamin D may prove valuable as a vaccine adjuvant for certain vaccines against infectious diseases.
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28 citations of this study (Nov 2021)

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