Covid-19 vaccine challenge for immunosuppressed patients


In addition, antibodies are not the only defense that the body deploys to produce immunity: we also make T cell, Memory B cells, etc. Vaccine clinical trials have not attempted to measure the number of cells needed to effectively fight the virus.They only report clinical End point, such as whether someone is seriously ill or died of disease. Therefore, focusing only on antibodies may miss an important part of the immune response.

“When someone does not produce antibodies, I try not to use words such as’you don’t respond to the vaccine’,” said Heydar, the lead researcher of a study. Larger research People with a range of immunodeficiencies, including HIV, are being recruited to study the Covid vaccine response. “I worry that if the message is that the vaccine does not work for you, it may cause the vaccine to hesitate. I think we must explain in more detail the complexity of other elements of the immune system that may be accelerated by the vaccine.”

Even in the few studies conducted so far, it is clear that the immune response to the vaccine varies, depending on the age of the patient, the type of immunodeficiency they have experienced, the type of transplant they have received, the specific drugs they have taken, and their The length of time since the transplant or last dose, and many other factors. For example, in patients taking immunosuppressive drugs to treat chronic inflammatory diseases, the likelihood of producing large amounts of antibodies appears to be higher than in transplantation and cancer patients. Research done by Segev and his team shows that these patients have a higher rate of antibody production One with two dose. But a separate preprint completed by the Washington University School of Medicine in St. Louis and the University of California, San Francisco, display The broad response depends on the medication regimen the patient is taking.

This may provide clues for managing the vulnerability of patients so that they can get closer to the kind of immune protection that healthy people get from the Covid vaccine. Alfred HJ Kim, senior author of the study and assistant professor of rheumatology and immunology at the University of Washington, said: “One thing we want to tell patients in a suppressed state who have not been vaccinated is to consider keeping the medication.” “Obviously, if you hold With drugs, you are at risk of an outbreak. If you are going to have an outbreak, this may make your vaccine side effects worse, or it may make the vaccine itself less effective. This is a very difficult situation.”

Moreover, legally speaking, doctors cannot currently advise patients to seek additional doses of the Covid vaccine. The U.S. Food and Drug Administration authorizes only one or two doses of all vaccines it allows to enter the U.S. market. For the Segev team’s research, the doctor did not prescribe a third dose—the patient found the third dose himself, but the research did not specify it. The team at Hopkins University tracked the results.

Nevertheless, there is some evidence in the medical literature to support the utility of additional doses.For example, the French government Recommended The third dose for people with weakened immune system.In the U.S., people have thought Second dose Seasonal flu vaccine and Larger dose The hepatitis B vaccine needs to generate immunity in them.

But it is necessary to collect more data to be sure. The team at Hopkins University is considering a larger trial in which immunosuppressed patients seeking a third dose will be formally registered and tracked. Despite the temptation of higher protection, they did not urge immunocompromised patients to start freelancing their own third shot. “Taking the third dose is risky,” Segev said. “The third dose may activate your immune system, leading to obvious rejection or some kind of subclinical phenomenon. You start to produce more antibodies against the transplanted organ. The important thing is that the people who go out to receive the third dose are either from the research protocol Part of it is either done in collaboration with doctors who assess the risks and benefits.”

If such a test can produce data-anotherIt was recently announced by the National Institutes of Health-they can do more than just let people with weakened immune functions resume their daily lives. They can also shed light on various aspects of the immune system and its interaction with vaccines, which are still not very clear. This is not only good during this pandemic, but also good for our next need to protect ourselves from harm.


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