Sorry this is another covid post but this might be important when we all have our booster jabs in the autumn. The issue of our vulnerability despite vaccination still persists of course and that is no different to any other vaccination or infection we have. However, anything that improves herd immunity is also good for us and this sounds like good news in boosting that immunity.
"Mixed schedules involving Pfizer-BioNTech and Oxford-AstraZeneca generate strong immune response against SARS-CoV2 spike IgG protein
Doses administered four weeks apart; data for 12-week dose interval due soon.
Immune responses differed according to order of immunisation, with Oxford-AstraZeneca followed by Pfizer-BioNTech generating the better immune response out of the two mixed schedules."
Thank you Jackie very interesting. The subject of our immunity despite vaccination is becoming more of an issue since they are considering lifting restrictions again. Personally I do not understand why they are not prepared to support the immunocompromised with monoclonal antibody infusions as the are in the USA. I don’t know if you can throw any light on this?I have done all I can by drawing this matter to the attention of my local MP.
I have been extremely upbeat and positive throughout lockdown and remain upbeat despite having a broken leg. However, it is beginning to feel as if we are being ignored and forgotten by the government right now. I do hope this changes in the near future.
Sorry to rant but it is discriminating to say the least.
Hi Ann, I feel exactly like you do about the monoclonal antibodies too. I'm in Canada and we are in the same situation, I've made phone calls to Health Canada and my local MP and of course nothings come of it. Very frustrating.
I never thought about the monoclonals not being tested in immunocompromised. I just assumed they would work just like IVIG infusions that some patients require. Thanks for pointing that out.
There are still many unknowns about the antibody treatment (see Jackie's post on the topic, and also in Neil's response above).Is it a treatment pre hospitalization? Prophylaxis prior to infection? Effective for sero+ or -? Effective for those immune-compromised?
All are still under study.
I guess things will be clearer in 2-3 years, and till then I personally feel that a 3rd shot (if and when approved) and/or boosters are our best safeguard...
To put a finer point on this - “Personally I do not understand why they are not prepared to support the immunocompromised with monoclonal antibody infusions as the are in the USA.”
To my knowledge they are not reserved for immuno compromised, but anyone at higher risk for severe Covid. It seems that one must be aware of them to request at a point early on after testing positive.
I thought at first that when you wrote “The subject of our immunity despite vaccination is becoming more of an issue” was going a different direction as several are making a points that those with low/no immunity despite vaccination, become a reservoir for the virus snd a further way for it to escape the vaccine.
Additionally, last week’s CDC panel mentioned the possibility that boosters will not be given to those who aren’t likely to mount an immune response.
Even though I’m in the US, I’m not convinced monoclonal antibodies will be an option for me, so I am continuing as many mitigation measures as possible. Especially concerning is not just the delta variant, which can spread in a matter of seconds, but there is now a delta plus variant.
Add in that a local doctor yesterday mentioned it still may be possible for someone who is vaccinated and gets mild Covid symptoms to still spread Covid. I’ve believed that to be the case, but others on social media like to say that if you’re vaccinated you can’t spread it.
Just a number of random thoughts upon reading your post. I empathize with your frustration. Stay well. 💜
Hi KatieBlue thank you for your response. I agree with everything you have said and appreciate your thoughts on the matter.I can’t understand why the immunocompromised are being left behind either. Without immunity we are at greater risk of spreading covid if we get it and are asymptotic. I can only assume it is down to money, which is discriminating in my opinion.
I am fully aware that we are at risk from other viruses like the flu, which can kill us and have always been careful because of this. However, covid is a much greater risk. We can only hope herd immunity helps.
It does feel a bit like we’ve been thrown under the bus.
Hard to know the whys of it — many and varied complexities. Information is in higher demand than supply, resource allocation, time factors, money, and so forth.
I think as people became vaccinated, the belief was life would return to normal. Most aren’t thinking of people for whom the vaccines aren’t effective most want no reminders of Covid. I feel this only intensified in the US when the CDC removed masking requirements for vaccinated (but gave no consequences if unvaccinated went unmasked).
I have explained to different people about being fully vaccinated but not fully protected and I’ve gotten sympathy, but I’m also realizing that if they stop to think about it, I’m technically a risk to them. I’ve become more hesitant in some forums to discuss potential virus reservoirs for variants for this reason.
I just listened to one of Dr. Campbell’s YouTube’s and he mentioned that because if the delta variant being so much more contagious, a higher level of vaccination is needed to attain herd immunity. 😞
Hi Katie I agree with all you say. It is important to remember we can be a risk to others too without alarming them unnecessarily. We are facing the end of restrictions in the U.K. and I am sure there will be a surge in cases thereafter.🥲All we can do is continue keeping up to date with new information and continue with restrictions ourselves.Take care and stay safe.
I am sure UK and EU too are conducting trials to find out ways to boost immunity for those with compromised systems.
I personally am seriously thinking about getting the 3rd shot (I had 2 shots of AZ, and am thinking about taking a 3rd shot of Pfizer), but I am waiting for some more results from studies on the efficacy of the 3rd shot for immune compromised patients.
The fact that we have effective vaccines within one year, and that within 4-6 months, many of the developed nations have 70% of the population fully vaccinated are amazing achievements. So yes, we all have reasons to be extremely upbeat and positive. And the safety and efficacy trials are ongoing...
I won't be surprised if within another 2-3 months, a 3rd shot will be recommended for those with immune issues. So I feel there is reason to remain positive and upbeat.
The concerns of course are the 30% who stubbornly refuse to get vaccinated, and the big question mark about vaccinations for those 12 and under, and the dismally low rate of vaccination in many parts of the world. These are the populations with the potential for large outbreaks and the consequent high probability of breakthrough mutations (new variants that might evade antibodies from vaccinations or previous infections).
The Delta variant seems to be such a breakthrough mutation, and it seems like the first generation antibody treatment, previous infection, or a single shot vaccine is not very effective against this mutation.
However, the second generation of antibody treatments seem to be effective:
Hopefully the rest of the world and children below 12 will get vaccinated within the next 2-3 years (the large scale vaccine production and the ongoing trials for 12 and below age groups point towards it). And with the 3rd shot for us and/or (annual?) booster shot for everyone, we will all stay one step ahead of the mutations.
Now if only someone influential can figure out a way to convince the anti-vaxxers to rethink their ideological stand...
While watching part of the CDC panel last week, they mentioned concern about boosters for those who were not able to mount an immune response. Got the impression they would look to “other prevention measures.”
Of course, this isn’t set in stone, but it is something being bandied about by CDC.
I agree KatieBlue,There still seems to be lots of unknowns and confusion about how to cater for the immune compromised...
My way of making sense of it all is to follow the science and the results of the studies as these are 'forward looking', while the directives from the government and agencies are ' backward looking'.
The forward looking results point to what might be coming down the pipeline in the near future (after further large population studies confirm to the safety and efficacy), while the directives reflect what is known based on past studies.
I know they did discuss needing to wait on study results, though those seemed to be more in the context of those on immuno suppressive/anti rejection meds related to transplants.
Their comments about not giving boosters seemingly weren’t directed toward all immuno compromised, but rather those who didn’t mount an immune response.
I haven’t checked to see if the panel was recorded and available to view again. There were nuances in what was being said, that I don’t trust to my memory enough to post beyond this as I want to this time be as accurate a representation as possible of what was said.
But I find it very frustrating to hear from influential UK scientists (who advise decision makers) that booster shots won't be needed because two shots have proved so effective at giving people strong immunity. HELLO....??
Perplexing too that the UK trials investigating blending shots (COM-COV) and booster shots (COV-BOOST) excluded cancer patients, amongst whom are CLL patients and large numbers of other immunocompromised individuals needing all the help they can get to boost their weaker immune response.
If the above-mentioned influential scientists are right, these studies will have provided ample data for the people who wouldn't benefit, and no data for the people who would.
Your second sentence says a lot B, could’nt agree more! Why is it taking so long to finally start trials like this?
Interesting articles, hope more on this topic gets looked into Cus I have a feeling this type of out of box thinking (multiple vaccines) will be progress in helping at least some build up a-bodies.
Today, 30th June 2021, the government have issued a press release saying
"Boosters aim to ensure protection from COVID-19 is maintained ahead of winter and against new variants."
The JCVI’s interim advice is to plan to offer COVID-19 booster vaccines from September 2021, in order to prolong the protection that vaccines provide in those who are most vulnerable to serious COVID-19 ahead of the winter months. The 2-stage programme would take place alongside the annual flu vaccination programme.
The following people should be offered a third dose COVID-19 booster vaccine and the annual influenza vaccine as soon as possible from September 2021:
- adults aged 16 years and over who are immunosuppressed
- those living in residential care homes for older adults
- all adults aged 70 years or over
- adults aged 16 years and over who are considered clinically extremely vulnerable
This is to be applauded but it's of limited help to blood cancer patients who almost certainly won't produce any antibodies. It should however, help with herd immunity to the new variants and 'every little helps' to protect us.
It’s almost certainly unethical to start a trial of an optional medication on the population that is already ill and compromised. Once you had demonstrated safety and efficacy in the healthy population then you can move into other specific and more vulnerable groups.
Yes, I understand the basics of phasing of trials, but I think the current circumstances make ethical distinctions more complicated. After all, it was considered ethical to mass-jab immunocompromised people with vaccines approved on the basis of phase 3 trials which specifically excluded immunocompromised people. I don't see the problem with giving an extra shot of one of these approved drugs, or indeed a modified AZ vaccine, to immunocompromised people in current trials. I do see a problem if those trials only demonstrate safety and efficacy in immunocompetent people and then we are told "This is as far as we go to keep you immunocompromised folk safe".
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