資料來源：Br J Nutr. 2021 Jan 28
原文：Optimising COVID-19 vaccine efficacy by ensuring nutritional adequacy
Currently, there are many different brands of COVID-19 vaccines available to control the ongoing pandemic. Scientists are concerned that the vaccine’s effectiveness may be suboptimal for elderly individuals who are frail or malnourished, which could reduce the overall effectiveness of vaccination campaigns. Therefore, this study was published in 2021.
Poor Vaccine Response Related to Micronutrient Deficiency
Statistics indicate that elderly individuals have a weaker immune response and do not respond to many vaccines as effectively as younger adults (including seasonal flu vaccines). In the Oxford vaccine trial recruitment, it was found that elderly participants “had almost no comorbidities.” Compared to the 18-55 age group, the 56-69 and 70+ age groups had lower IgG responses and neutralizing antibody titers to a single dose of the Oxford vaccine. Therefore, in the real world, frail elderly individuals may not obtain the necessary clinical protection from the vaccine, leading to potential wastage of resources. Poor vaccination responses in the elderly are not only related to physical frailty but also to micronutrient deficiencies, which are addressable.
Adequate Nutrition Can Enhance Vaccine Efficiency
An effective immune response requires adequate nutritional status of the host. The European Food Safety Authority has authorized vitamins A (including β-carotene), B6, B9 (folate), B12, C, and D, as well as minerals Zn, Se, Fe, and Cu based on scientific assessments of their contributions to the normal functioning of the immune system. Each of these micronutrients, such as vitamin E, has been shown to play various critical roles in supporting the immune system and reducing the risk of infection.
Studies have demonstrated a causal relationship between micronutrient status and vaccination response. For example, a randomized controlled trial in individuals aged 65-85 reported that those consuming ≥ 5 servings of fruits and vegetables daily had a better response to the pneumococcal vaccine compared to those consuming ≤ 2 servings. Another study confirmed that individuals over 65 taking vitamin E (60 or 200 mg daily) showed improved responses to certain vaccines compared to a control group. In the UK, adults with low selenium status who supplemented with selenium (50 or 100 µg/day) showed improvements in some aspects of their immune response to the polio virus vaccine and a reduction in the occurrence of mutant viral strains.
Nutritional Supplementation Post-Vaccination Can Increase Vaccine Benefits
Margaret P. Rayman, a scientist at the University of Southampton, suggests that for individuals aged 70 and above, nutritional supplements (e.g., vitamins A, B6, B9, B12, C, D, and E, and minerals Zn, Cu, Se, and Fe) should be provided free of charge for several weeks before and after vaccination. The additional cost of supplementing these nutrients, which are crucial for immune function but may be insufficient or deficient in the elderly, would be a small investment to better ensure vaccine efficacy. Multivitamin and mineral supplements can be purchased at retail for around £1.50 ($2) for 45 tablets. A 45-day supplement, purchased wholesale, would offer significant potential benefits and only modestly increase the cost of any vaccination program: the U.S. government-negotiated price for the Pfizer vaccine is $20 per dose (i.e., $40 for a full treatment).
