Immunocompromised ? Why the COVID-19 vaccine could still protect you

News photo: Immunodéprimé?  Why the COVID-19 vaccine could still protect youBy Denise Mann Health Day Journalist

WEDNESDAY July 7, 2021 (HealthDay News)

COVID-19 vaccinations may not offer as much protection for people with weakened immune systems, but how much that seems to depend on the type of underlying disease, new research suggests.

“People with conditions that compromise their immune system have a wide range of antibody responses to COVID-19 vaccination, ranging from just 1 in 5 lung transplant patients having an antibody response to an almost identical to that in healthy individuals in patients with controlled HIV, ”said study author Dr. Ghady Haidar, an infectious disease transplant physician at the University of Pittsburgh Medical Center.

“This highlights the urgent need to optimize and individualize the prevention of COVID-19 in patients with immunocompromised conditions and to have other treatments, such as monoclonal antibodies, in the event of failure of the vaccination, ”he said.

To see how well, or even if, the COVID-19 vaccine worked in people with weakened immune systems, the researchers compared the levels of anti-COVID antibodies in the blood of 107 healthy health workers. to those of 489 people whose immune systems are weakened due to a variety of causes. The study included people who had solid organ transplants, autoimmune disorders, blood cancers, solid tumors and HIV.

While just over 98% of health workers produced antibodies after vaccination, responses were lower in immunocompromised people. About 37% of people who have had solid organ transplants have made antibodies. Responses in people with blood cancers were also low, with only about half making antibodies. In contrast, about 80% of people with solid tumors and / or autoimmune diseases have produced antibodies after vaccination.

The drugs also affect the likelihood of developing an immune response to vaccination, which makes perfect sense, Haidar said.

“Immunosuppressive drugs given to prevent organ rejection after transplantation also hamper the body’s ability to produce antibodies that fight infections,” he explained.

Radiation therapy for cancer also predicts poor responses to the vaccine. “Radiation therapy is very toxic to cells of the immune system that make antibodies,” Haidar added.

Yet there is more to the story. “The immune system is extremely complex, with different interconnected compartments all talking to each other,” Haidar said. “So just because someone hasn’t made antibodies, it doesn’t necessarily mean the vaccines haven’t ‘taken’ – other parts of the immune system, such as T cells, may have been activated. “

Giving these people a booster or a third dose of the COVID-19 vaccine may help boost their immune system response, but it is too early to say for sure. “We expect to have data in the near future that could modify the recommendations for people with immunosuppression here in the United States,” Haidar said.

The results, which are part of an interim analysis of a larger study, were recently published on the preprint server. medRxiv and have not yet been peer reviewed.

The findings follow another study which showed that people with blood cancer known as multiple myeloma also have variable responses to the COVID-19 vaccine.

“The study reiterates the unfortunate fact that people on immunosuppressants and those with autoimmune diseases or who are being treated for cancer will not respond to the COVID-19 vaccine the same way a healthy person does.” said Dr. Len Horovitz, a pulmonologist at Lenox Hill Hospital in New York City.

“Get the vaccine and encourage everyone around you to do the same,” said Horovitz, who has nothing to do with the new research. “If you have a weakened immune system, continue to wear masks in public and practice social distancing. “

More information

Get the facts on COVID-19 vaccination at U.S. Centers for Disease Control and Prevention.

SOURCES: Ghady Haidar, MD, infectious disease transplant physician, University of Pittsburgh Medical Center and assistant professor, division of infectious diseases, University of Pittsburgh; Len Horovitz, MD, pulmonologist, Lenox Hill Hospital, New York City; medRxiv, June 30, 2021

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