Association of Fat-Soluble Vitamins (A, D, and E) Status with Humoral Immune Response to COVID-19 Inactivated Vaccination. A Prospective Cohort Study

Background: Fat-soluble vitamins’ (A, D, and E) effects on the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination remain unknown. This study aimed to explore the associations of vitamin A, D, and E status with the humoral immune response to BBIBP-CorV/CoronaVac boosting vaccination in Chinese adults.Methods: In this prospective observational study involving 141 participants, neutralizing titers against wild type and Omicron were evaluated at the baseline (immediately before the booster), and day 14 and 98 post the 3rd booster, respectively. Plasma vitamins A, D, and E concentrations at the baseline were determined through high-performance liquid chromatography-tandem mass spectroscopy.Findings: Neutralizing titers against wild type and Omicron were highest at day 14 post the 3rd booster and slowly decreased over time. 25(OH)D3 was significantly negatively related to the neutralizing titers against wild type at the baseline and day 98 post the 3rd booster (Beta: -0.331 and -0.317, respectively). Similarly, 25(OH)D3 was negatively associated with the seropositivity of anti-Omicron antibody at day 98 post the 3rd booster (OR, 0.94; 95% CI, 0.883 to 0.996). However, the humoral immune response was not related to vitamin A and E status biomarkers.Interpretation:This study demonstrated that vitamin D, but not A and E was negatively associated with the humoral immune response to BBIBP-CorV/CoronaVac boosting vaccination in people with relatively great nutritional status.Funding: This work was supported by the National Natural Science Foundation of China (81903312), the Xiangshan Talented Scientific Research Project of Zhuhai People’s Hospital (2021XSYC-03)Declaration of Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paperEthics Approval: The study informed consent and protocol were reviewed and approved by the Ethics Committee of Zhuhai People's Hospital.