Nutritional adequacy may yet be able to increase vaccine effectiveness

Many silent factors, such as stress or lack of sleep, have a direct impact on our immune system. One such important factor is micronutrient deficiencies, a special focus area of ​​our work at the Site and Life (SAL) Foundation. The food we eat plays an important role in laying the foundation for our immune system. Our bodies require only small amounts of micronutrients, but maintaining an optimal level is essential for our immunity. Micronutrient deficiencies occur when either the food you eat doesn’t provide enough vitamins and minerals to the body, or demands similar growth during specific stages in life, such as pregnancy and breastfeeding.

In an ideal world, we could all adopt a healthy diet and correct deficiencies in specific nutrients to better protect ourselves. However, reaching 3 billion people quickly and immediately with an affordable healthy diet is not possible. In view of this, a comparatively fast, short-term solution may lie in multi-micronutrient supplements, which, on the back of good program implementation, can reach the final home. One micronutrient supplement a day can help correct this deficiency.

Hunger is increasing all over the world. The number of people who did not get adequate nutrition stood at 10 million from 2018 to 2019, and then rose sharply to 161 million in 2020, most certainly due to pandemic-related crises. According to the 2021 Global Nutrition Report, 149 million children under the age of 5 are stunted and 45 million are ‘wasted’, while 30% of women of child-bearing age suffer from anemia. The Standing Together for Nutrition Consortium estimated that over the next 3 years, the COVID crisis will cause an additional 3.5 million children to suffer stunting, 13.6 million children ‘wasted’ and an additional 283,000 malnutrition-related deaths among at least 5. – and middle-income countries.

Countries like India bear the huge burden of world hunger. Hidden hunger or micronutrient deficiency is an even greater disease, as it appears to lurk quietly among well-fed urban populations, who may consume nutrient-empty calories, thus Despite their lack of ‘appetite’, their immune system becomes weak.

Since the pandemic, optimal-micronutrient status of individuals has become even more important. Existing evidence (bit.ly/35uQaSe) indicates that supplementation with high-dose vitamins C, D and zinc may reduce health complications caused by covid, including inflammatory markers, oxygen dependence, increased risk of hospitalization. Duration and mortality are included.

However, achieving a good nutritional level goes beyond warding off infections.

While we wait for the protection of the COVID vaccine and ‘herd immunity’ to end this pandemic, what if we are overlooking an important factor?

There is strong scientific evidence that micronutrient deficiencies reduce vaccine effectiveness, as measured by a robust immune response and antibody levels. “When the immune system is not fueled properly and malfunctions, it can lead to poor vaccine responses,” said Margaret Rayman, professor of nutritional medicine, University of Surrey, and Philip Calder, chief of human development and health. The professor of nutrition concluded. Immunology, University of Southampton in their paper, ‘How to make COVID vaccines more effective: give people a vitamin and mineral supplement’.

A significant body of findings suggest that micronutrient supplementation is necessary, in addition to good nutritional knowledge and practice, to achieve the levels of micronutrients needed to support optimal functioning of the immune system. This is also one of the reasons why we launched IMPact4Nutrition along with UNICEF India and 13 other partners like Tata Trusts and CSR Box. The platform engages the private sector to work with government initiatives such as the POSHAN Abhiyaan to address malnutrition.

The effect of micronutrient adequacy on an effective vaccine response has been demonstrated previously. A clinical trial conducted in 2002 by Rajeev Behl et al studied the effect of vitamin A on the antibody response to oral polio vaccine (OPV). They noted that “vitamin A supplementation for mothers in the postpartum period and their infants with OPV at 6, 10, and 14 weeks improves antibody response to poliovirus type 1. Another recent study, in 2020, Stoffel and colleagues at ETH Zurich in Switzerland showed that iron deficiency in infants resulted in a reduced response to diphtheria, pertussis, and pneumococcal vaccines. Babies with iron deficiency anemia showed a better response to the measles vaccine when administered at the time of vaccination. Supplemental iron was given.

Current research addressing the effects of malnutrition and the effectiveness of the COVID vaccine is largely focused on elderly demographic groups in high-income countries. More clinical research is needed on the effects of supplementation to make vaccines more effective for different age groups in various other geographic areas.

SAL has proposed a call to action for clinical trials to determine whether micronutrient supplements before and after vaccination increase the effectiveness of the COVID vaccine.

We anticipate that such an approach will increase vaccine effectiveness and benefit most malnourished populations in low- and middle-income countries. The intervention may also encourage people to continue taking dietary supplements given its benefits. There is increasing evidence of how micronutrients help combat COVID. High priority should be given to the impact of good nutrition and adequate micronutrients on an effective vaccine response.

Klaus Kramer and Neha Bainsla are Managing Director, and India Country Manager, Sight & Life Foundation, respectively