COVID‐19 Vaccination and Obesity: Optimism and Challenges

Researchers have speculated that vaccines to prevent coronavirus disease 2019 (COVID‐19) may be less effective for individuals with obesity, a major risk factor for mortality and morbidity from COVID‐19. Initial results from the Pfizer‐BioNTech and Moderna COVID‐19 vaccine trials, though limited by inadequate power to compare subgroups and incomplete stratification of high‐risk groups, appear to have similar efficacy among individuals with and without obesity. Careful follow‐up in placebo‐controlled studies is required to generate data on long‐term vaccine immunogenicity, particularly in high‐risk groups. Subsequent analyses should stratify safety and efficacy results by each class of obesity. Speculation about variable effectiveness of COVID‐19 vaccines in obesity likely increases vaccine hesitancy among individuals with obesity, who face not only a higher risk of severe outcomes from COVID‐19 but also weight stigma, which reduces health care engagement at baseline. Clinical and public health messaging must be data driven, transparent, and sensitive to these biological and sociological vulnerabilities.