Covid Antibody Test

[Reinhard]

I am on IgG substitution and get the infusion 4-weekly. I got vaccinated with Pfizer and got my second jab 4 weeks ago.

I read that in the meantime Covid antibodies are included in the IgG infusions from infected or vaccinated donors.

How can I find out if I by myself have produced antibodies?

My plan would be to wait some 3 - 4 weeks longer with the next IgG infusion and then do the test...hoping all foreign antibodies are gone at this time.

My doc told me that I will most probably have Covid antibodies from the vaccination because after the second jab I got flue like symptoms for two days. But this is way too easy and even dangerous for such an important question.

Has somebody similar situation with IgG substitution and vaccination?

Best regards

Reinhard from Austria

Dx Jan. 2000,Tx Venetoclax Obinutuzumab Jun 2015 - Sep 2018 (CR, mrd- in blood and bone marrow)

[Vizilo]

I have had both Pfizer shots (no side effects other than a sore arm for one day) and also have been on immunoglobulin infusions for more than one year. I get it at home weekly through subcutaneous infusions (SCIG)

I recently asked my CLL specialist whether IVIG or SCIG helps boost your COVID immunity. He felt that it is likely too early to get much benefit from such infusions. The blood product used in such infusions is derived from blood donations from thousands of people around the world. There is more than a one year lag between time of donation and when you infuse it.

I just checked the manufacture date of my current immunoglobulin supply: May, 2020. This means that the blood used to manufacture it would have been donated earlier than May, 2020 when few people had developed anti-COVID antibodies and there were no COVID vaccines. My oncologist believes that in a year or two, when the majority of blood donors will have acquired anti-COVID antibodies from having COVID and/or the vaccines, IVIG/SCIG may provide a much greater benefit.

So, it’s a little too early to hope such infusions will help with managing the higher risk of COVID to CLL patients. My oncologist suggests that I continue following the same safety steps as we did before vaccination i.e. masks, social distancing, hand-washing and avoiding indoor contacts.

[MsLockYourPosts Passed Volunteer]

I also get IVIG and have had both vaccines. I've stopped reading about the antibody tests. It seems to me that they are still figuring out how to test and what the tests tell us about the long range effects of the vaccine. I plan to also carry on with the masks and all. And I expect that we will be hearing about boosters down the road, at least for those of us less likely to mount a response.

[Myfavoritecat]

I’m surprised your doctor said that you probably have antibodies because of your flu-like symptoms after your shot. I asked my sister-in-law, who is a retired GP, about that, thinking I might have good antibodies because I had some vaccine side effects. She said such a theory is naive because that would imply that people who had no side effects had low antibodies, which isn’t true. She thought I should ask one of my docs to order the quantitative antibody test which seems to offer information about the level of antibodies one has. I am currently at stage 0 CLL with no treatment.

[KatieBlue in reply to Myfavoritecat]

Yes, what your siste-in-law said regarding side effects meshes with (and has been my take away from) local doctors on the news, Med Twitter, and so on. My understanding is no correlation between having or not having a reaction to the vaccine and vaccination efficacy /lack of efficacy.

However, the semi-qualitative and quantitative antibody tests aren’t providing clear indications of what is considered protective. Currently no one knows how to interpret the test results for immunity/level of protection.

The tests have disclaimers about the results. (“It is yet undetermined what level of antibodies to SARS-CoV-2 spike protein correlates to immunity against developing symptomatic SARS-CoV-2 disease.”)

From the CLL Society: “there are no data in CLL patients to suggest that presence of antibodies confers protection, or even lack of antibodies means no immunity.”

[SERVrider]

Reinhard, I am on SCIG weekly with 16g/80ml of Hizentra. As others have said, the pool of plasma from which manufacturers like CSL Behring purify the IgG has not yet absorbed any significant number of donors with Covid antibodies so we are unlikely to derive any immunity from our supplemental IgG yet and probably not for a couple of years. The immunity we get from the vaccine is going to be the much greater contribution than anything else. I've had 2 doses of the O-AZ vaccine with no ill-effects. I have sent blood samples off the the University of Birmingham who are doing a study of post-vaccine immune response in CLL patients but the results will, of course, be anonymised so I won't know my personal response level.