From this list, I learned that PV patients on hydroxyurea should consider themselves as immune compromised and should have a third and possibly a fourth Covid shot. My hematologist included in latest bloodwork an antibody test that showed me as negative for immune response to Covid - and that's after three shots. On the other hand, the CDC advises against taking action based on antibody tests, which seems to indicate that they are saying that antibody tests cannot be relied on.
My question is, will a fourth shot make a difference if the first three did not? Is there any research on this? And what is the most accurate way to test for Covid antibodies?
Thanks for your help!
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souplover
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I took the worst two medications That inhibit ability to produce antibodies. Years of Rituxan followed by a clinical trial that included Gazyva. Both of these medications target CD20 markers on B cells. I have a B cell lymphoma along with P. Vera. After year of Phlebotomies I opted to start taking hydrea about 3 months ago. My wife and daughter both exposed me to Covid and I had zero symptoms other than a terrible upset stomach for a few weeks. I’ve had multiple COVID tests and had the blood test to test for antibodies. Have zero. Just some background on my current condition. If I had three shots and didn’t produce antibodies I most definitely wound not have a 4th. J&J vax was just black boxed with clotting issues and multiple reports last week of children with heart inflammation. Just based on science it wouldn’t make sense to continue to risk side effects with little hope of immunity.
I called the Blood Cancer help/support line yesterday and was told that the antibody test (bought on line home test) doesn't show all the different antibody responses and that there may be antibodies present but they do not show up on the standard test.
I asked my GP for an antibody test a couple of months after my 2nd vaccine and it came back with no detectable antibodies. 10 days after my 3rd vaccine I took part in the survey with Blood Cancer Uk and did my own test which gets sent back to the test and trace. This came back saying I did have antibodies. Obviously I have no idea how many or what quality and whether over the past two months they have now disappeared. However, they are very clear that they only show the initial antibody response and there are other parts of the immune system that the vaccines also boost which are much harder to detect - such as T cells. I will be knocking the door down on the day my 4th vaccine is due to get it. There is probably little research on how effective the 4th dose will be but if you read the information on Blood Cancer Uk, they are hopeful that each time we are given another vaccine it primes our immune system a little more, even if we have no detectable antibodies. Have a look over on the site as there is quite a lot of useful information, even if it doesn;'t answer your specific question directly. Good luck.
This is a grey area that causes a lot of confusion, and for good reason.
You might ask your Hem for more details about which type of test you got. Some are yes/no, some are how much, and to add confusion, the rapid home test common in USA looks for Antigens,(if you've got virus in you right now) which are not directly relevant to Antibodies (if you had vax or virus before.
Right on the point is the CDC report you probably are referring to:
<<Antibody testing is not currently recommended to determine if you are immune to COVID-19 following COVID-19 vaccination.>>
<<Some antibody tests will only detect antibodies from infection, not from vaccination with the virus that causes COVID-19.>>
It seems, in spite of their use of "some", there is no antibody test I can find, at least in the US, that is qualified for vax testing. If so your negative result by itself may not be a problem. And of course after 3-6 months the antibodies are well reduced in any case. I have seen a proposal for medical workers to get vaxed every three months. Nothing actionable yet for anybody, but interesting.
Another question is your dose of HU. It's reasonable that a lower dose would have less bad vax effect. The MPN drug that usually has more negative vax effect than HU is Rux. Rituxan that Golfer64 is using has an especially strong effect on the vax.
As MW says here, the T-cell part of our response is important but less well understood, partly bec it's currently expensive and complex to test. Current info from S Africa points to this response being important- lots of new infections (low antibody benefit) but relatively low severity (possibly t-cell and other cellular response from prior infection and/or vax) But S Africa has very high prior infections. The next good info on Omicron should be from UK.
Thank you, this was the clearest explanation I've read so far. What I'm understanding is that there is no single accurate way to test the antibodies from the vaccines in order to assess whether they are still providing immunity months later.
Can I ask two other questions: it seems that both the NHS and the CDC are recommending fourth shots now for immune compromised. Am I correct in thinking that both the NHS and the CDC are advising booster shots for the fourth shot, not full vaccines?
And it seems that the CDC is advising that the fourth shot is not needed until six months after the third shot, while the NHS is advising three months?
I will definitely try to reach my hematologist this week with these questions, but unfortunately, much as I like her, she doesn't seem very on top of all of the Covid related issues.
Actually I read the info as the antibody test is not approved to look for vax effects even soon after the vax happens since it may not be looking for the correct antibodies. It only is approved to look for *infection* effects for an unspecified time afterwards. Of course all do decline over time so at 6 months it's unlikely to find anything in any case.
<<A booster dose of COVID-19 vaccine is recommended for all persons aged 18 and older, at least 6 months after completion of an mRNA vaccine (Pfizer-BioNTech or Moderna) primary series, or at least 2 months after completion of a Janssen vaccine primary dose.>> Our primary series reasonably included the three shots for the RNA vaxes, so that's the 4th they are talking about here for us.
<<Moderately or severely immunocompromised people aged 16 or 17 years who received the Pfizer-BioNTech COVID-19 Vaccine primary series and an additional primary Pfizer-BioNTech Vaccine dose may receive a single Pfizer-BioNTech COVID-19 Vaccine booster dose at least 6 months after completing their additional primary dose.>>
For most of us in US that means it's in the future. My 3rd was late Sept, so that would be March 2022. That would be why we have not heard more about it. But in UK that's right now in this example, hence the active posts on it from our UK mates.
Being called a Booster, it means half dose for Mod, 50mcg, Pf is always the same and less, at 30mcg for adults. I could not get Mod last Sept, but we can now mix (although the above states only Pf, more confusion) , so I'll go for the 50mcg Mod in March vs the 30mcg Pf if it's allowed.
I'm actually already "quad" vaxed, (hybrid immunity) having had the infection Mar 2020. But I'll gladly take more vax as it becomes allowed.
Hi souplover. I have ET and take hydrea 5x500mg a week.
I live in the UK and took a private antibody test with ‘Testing for All’ (recommended by Paul123456) after my second Vaccine shot. The test was specific, in that it looked for antibodies to the spike protein created from the ‘vaccine’. Anything over 0.8 was a positive response, my level was 2239. So, for me at least hydrea did not affect my response.
I would clarify with your haematologist which type of antibody test was undertaken - antibodies to past Covid infection or antibodies to the Vaccine.
As others have noted T Cell response is important too!
The test is manufactured by Roche and uses UK accredited labs. I think they do a lot more tests now.
At the time I took my test you could either take a test to see if you had antibodies to previous Covid infection or antibodies specific to the vaccine. I took the latter test which had to be done so many weeks after the second shot. Quite a few on the forum took the test with varying results.
I’ve posted the link for you to peruse, hopefully you’ll be able to access it.
Thanks. Nothing smart and simple like this is in USA.
I see the HOME TOTAL ANTIBODY TEST covers natural infection while the IMMUNITY TRACKER is less specific for either.
The US CDC provides this table in the image, but no way I know for us to do anything about it.
The whole lot is plenty confusing but I'm learning here from the UK and US sites that N-protein is uniquely associated with infection while S is triggered by either type of exposure.
I had infection near two years ago, I wonder whether any of the N would show up. They talk about "Hybrid immunity" from vax + infection, this might be the anti-N in action.
Pleased you’ve found it helpful in gaining further knowledge.
At the time I took the test the ‘immunity tracker’ was more specific to vaccine or previous infection, in that you had a choice of which test.
Having the test was helpful to me at the time, but I never interpreted it as conclusive evidence that I would fare well if I got Covid, just an indicator that I may.
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