Vitamin E, vitamin A, and zinc status are not related to serologic response to influenza vaccine in older adults: An observational prospective cohort study

Maria E. Sundaram, Simin Nikbin Meydani, Mary Vandermause, David K. Shay, Laura A. Coleman

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16 Scopus citations


It has been hypothesized that micronutrient levels play a role in the immune response to vaccination; however, population-level research on the association between micronutrient levels and immune response to influenza vaccination is needed. In this study, we hypothesized that decreasing levels of nutrients would be associated with decreased hemagglutination inhibition (HAI) responses to influenza vaccination. Therefore, the purpose of this study was to determine whether serum vitamin A, vitamin E, or zinc levels are associated with influenza vaccine response determined by HAI titer in adults 65 years or older. Participants in this study included 205 community-dwelling adults 65 years or older who resided in Marshfield, WI, USA, from fall 2008 through spring 2009. Participants received trivalent influenza vaccine and donated blood samples before and 21 to 28 days after vaccination. Prevaccination levels of serum retinol, α-tocopherol, and zinc as well as prevaccination and postvaccination HAI titer levels were measured. No participants were vitamin A or vitamin E deficient; 20% had low serum zinc levels (<70 μg/dL). Continuous variables and categorical quartiles coding for vitamin A, vitamin E, and zinc levels were not related to prevaccination or postvaccination seroprotection or seroconversion for any of the vaccine components (influenza A [H1N1], A [H3N2], or B), after adjusting for age, sex, body mass index, and prevaccination HAI geometric mean titer. In conclusion, our study population showed no association between variations in levels of serum vitamin A, vitamin E, or zinc and influenza vaccine response as measured by HAI in adults older than 65 years. Thus, associations between micronutrients and other measures of vaccine response, such as cell-mediated immune parameters, should also be explored.

Original languageEnglish (US)
Pages (from-to)149-154
Number of pages6
JournalNutrition Research
Issue number2
StatePublished - Feb 2014
Externally publishedYes

Bibliographical note

Funding Information:
The authors gratefully acknowledge the work of research coordinators, interviewers, and study managers at Marshfield Clinic as well as reviewers at the Centers for Disease Control and Prevention, without whom this research would not have been possible. S. N. Meydani, M. Vandermause, and D. K. Shay have no conflicts of interest. L.A. Coleman is an employee of Abbott Nutrition; however, at the time this research was completed, L.A. Coleman was an employee of Marshfield Clinic Research Foundation. M.E. Sundaram receives research funding from MedImmune, LLC. This project was supported by Centers for Disease Control and Prevention Grant 5 U18 IP000183-02 .


  • Immune response
  • Influenza
  • Observational prospective cohort study
  • Vaccine
  • Vitamin A
  • Vitamin E
  • Zinc


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