Effectiveness of two jabs for immune sup... - Kidney Transplant

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Effectiveness of two jabs for immune suppressed patients

Westbourne profile image
13 Replies

From information I have about kidney transplant patients in France, and from the USA, it looks like there is evidence that the suppressed immune systems of organ transplants, IBD conditions, some cancer treatments, and any other conditions that require immune suppressants, might not responding to the two jabs we all have now. That is, not ALL patients, but a considerable number, have NOT responded to the vaccinations as do normal people. The solution proposed in a letter I mistakenly got at my old French address, and the treatment of one friend in the USA with a transplant (in both places), is to have one jab of another pharmaceutical company in the hope that it "wakes up" the immune system and we transplant patients can have the same antibody reaction as normal people.

My question is whether anyone, in England, with ANY consultant, or reading or hearing ANY information, has heard about this. I have never heard it mentioned on TV or radio or in my casual reading of newspapers. I am getting a test which will maybe shed light on my own case, although there is some doubt that an "antibody test" is really useful in that regard.

So how is anyone being sure they are protected with two jabs? Any consultants know about this?

Thanks.

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Westbourne
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13 Replies
PostivelyJo profile image
PostivelyJo

I’ll ask my team at Guy’s London. Speaking to them today hopefully Nothing has been mentioned by them in advice to transplant patients so it will be interesting to hear their answer .Jo

Mgt8 profile image
Mgt8 in reply toPostivelyJo

Hi, I'm with Guys too. It would be great to hear what they say.....Mgt

Frida2013 profile image
Frida2013

I have had both vaccines ( Pfizer)and I spoke to a renal consultant last week about the efficacy and he said he has not been given any information at all and I should continue as I am ( shielding) as much as possible and to continue to be extra careful, so really no further forward which is so frustrating for all us transplant/ immune suppressed patients, keep safe everyone.

Mgt8 profile image
Mgt8

Hi, I've had 2 Pfizer vaccines, waited 3 weeks then had antibody test. Result: no antibodies, or so little that it did not show in test.

Have found this article online which may be of interest:

blogs.bmj.com/bmj/2021/03/3...

Am also part of the Oxford research study for this. At least it is being looked into....

Would like to hear what consultants say about this too....

Let's take care and watch this space...

Best wishes,

Mgt

pepeagamez profile image
pepeagamez

May 7, 2021

Transplant Recipients

May Be at Risk for

COVID-19 Even After 2

Vaccine Doses

Natasha Persaud

Investigators recently reported that only 17% of

solid organ transplant (SOT) recipients mount ar

antibody response to the first dose of the SARS-

CoV-2 messenger RNA (mRNA) vaccines

produced by Moderna and Pfizer-BioNTech.

Now, in an updated analysis published in JANA,

the same research team has found low antibody

response after the second dose, especially

among patients receiving anti-metabolite

maintenance immunosuppression.

Of 658 participants, 301 (46%) had no antibody

response after dose I or dose 2, including 168

kidney transplant recipients, Brian J. Boyarsky,

MD, PhD, ofJohns Hopkins University School of

Medicine in Baltimore, Maryland, and colleagues

reported. Another 259 patients (39%), including

118 kidney transplant recipients, had no

antibody response after dose I but responded to

dose 2. Only 98 patients (15%), including 36

kidney transplant recipients, had an antibody

response after both dose I and dose 2.

An antibody response was detectable at a

median 21 days after the first dose and a median

29 days after the second dose. The investigators

employed 2 immunoassays: the Roche Elecsys

anti-SARS-CoV-2 S enzyme immunoassayassay,

which measures total antibodies to the receptor-

binding domain of the SARS-CoV-2 spike protein

(threshold at least 0.8 U/ml), and EUROIMMUN,

which tests for immunoglobulin G to the SI

domain of SARS-CoV-2 spike protein (threshold

at least 1.1 arbitrary units). Among the 259

patients with no antibody response after first

dose, antibody response after the second dose

was 34.7 U/ml using the Roche immunoassay.

immunoassay

and 5.05 arbitrary units using the EUROIMMUN

immunoassay. In the 98 patients with an

antibody response after the first dose, the

antibody response after the second dose was

more than 250 U/ml using the Roche assay and

9.23 arbitrary units using the EUROIMMUN

Essay.

Among 473 SOT recipients receiving

antimetabolites, 268 (57%) had no antibody

response after dose I or dose 2, 167 (35%) had

no antibody response after dose I but had a

subsequent antibody response after dose 2, and

38 (8%) had antibody response after dose I and

dose 2. Among 185 SOT recipients who did not receive antimetabolites, only 33 (18%) had no

antibody response after dose I or dose 2, 92

(50%) had no antibody response after dose I but

did so after dose 2, and 60 (32%) had antibody

response after dose I and dose 2.

"Although this study demonstrates an

improvement in antispike antibody responses in

transplant recipients after dose 2 compared with

dose 1, these data suggest that a substantial

proportion of transplant recipients likely remain

at risk for COVID-19 after 2 doses of mRNA

vaccine," Dr Boyarsky's team stated. "Future

studies should address interventions to improve

vaccine responses in this population, including population, including

additional booster doses or immunosup12rlgSSjgD

mod ulation .

In an online presentation mentioning this study,

Liise-anne Pirofski, MD, chief of infectious

diseases at Albert Einstein College of Medicine -

Monteflore Medical Center in the Bronx, New

York, emphasized that for SOT recipients

COVID-19 prevention is crucial.

Disclosure: Some for ones study author(s) declared

afhliations with biotech, pharmaceutical, and/or

device companies. Please see the original reference

for a full list of authors' disclosures.

Reference

Boyarsky BJ, Werbel WA, Avery RK, et al.

A!)!!body:.response to 2-dose SARS-CoV-2 m RNA

vaccine series in solid orgs!!!Ea115121a1l

ceciiaie111s. JANA. Pu bi ished on I i ne May 5, 2021.

doi: IO.1001/jama .2021.7489 .

Sorry for the copy paste.......

WYOAnne profile image
WYOAnneNKF Ambassador

I am in the US, 21 + years post transplant and had both shots of the Moderna vaccine. About 2-3 weeks after getting my 2nd shot, I was tested to see if I had built up antibodies. I was positive for antibodies. I know there are a lot of transplant recipients that have built up no antibodies at all. I guess like everything, it depends on the person. Maybe it also depends on your immunosuppressants - which ones you are on and the dose. I am sure in the future this will all get sorted out. At least I hope so. I know there is a study being done now at Johns Hopkins regarding this.

Kbristow profile image
Kbristow

Dr. Dorry Segev (Johns Hopkins) shared the latest findings today. yes, France is giving a 3rd booster to transplant patients. I wouldn't be surprised if US does the same at some point.

npr.org/sections/health-sho...

Morello profile image
Morello

Here in Seattle I'm about 3 months post 2 doses of Pfizer vaccine. I'm in this limbo land where I'm not yet certain if I have little to no protection, or some significant protection. My neph at Kaiser doesn't recommend getting antibody levels checked because she's uncertain what the test results actually mean in real life - i.e. what activities would I do or not do based on the test results. I'm an MD by training, and agree with the logic there. I've been following this web page for updates on studies - nephjc.com/news/covid-vaccine - although it hasn't been updated in a while.

The data I want to start seeing are compilations of breakthrough infections of Covid in fully vaccinated immunosuppressed transplant patients. Some case studies are trickling in, and I want to see more.

This is from a neph at Johns Hopkins - medpagetoday.com/infectious...

- he says he is seeing 'some' patients hospitalized with breakthrough infections, but knowing the numbers is essential, not just that there are cases.

If anyone here knows where this data can be found, I'd love to see a link.

Yours,

Bob

Westbourne profile image
Westbourne

My searches have discovered one interesting study. No doubt there might be others. This one actually mentions Oxford-Astra Zeneca, whereas the USA and French experience is mostly NOT with AZ, they use other vaccines. Of course who knows if there is a small difference and how that might affect us.

birmingham.ac.uk/news/lates...

Vikhi profile image
Vikhi

HiI'm in the uk. I had two doses of the astra zenecca oxford vaccine. 2nd dose 12 weeks after the first. Testing 28 days after the second dose and very little antibodies 4.6 au. My unit are not routinely testing as they advise there is too little data to understand what this means but said they would do if i really wanted. I am 13 years transplanted but on triple therapy tacrolimus, micophenalate and v low steroids. My understanding is that the meds that stop the kidney rejecting are what stops the vaccine effectiveness. We have a good web reference kidneycare.co.uk for info if anyone wants to view. Whilst i am disappointed to be honest i am not surprised. Its a case of keeping an eye on levels of cases in your community and being vigilant with your contacts . I will not be changing my routines any time soon and am keeping my fingers crossed on science and potential new options coming through albeit probably later in the year. I do not believe a booster dose will make any difference but would love to be proved wrong. Take care everyone.

Vikhi profile image
Vikhi

Sorry i put wrong website refkidneycareuk.org/

Lots of info.

Djangosmom profile image
Djangosmom

I had 2 jabs and a booster for immuno-compromised people. I then had a blood test which shows I’ve created NO antibodies after 3 shots! I have heard the info about taking a booster from a different company and how it could help, but I’m in the US. All my shots were Pfizer. My transplant was 17 months ago. I take Everlimus and Prednisone daily and monthly infusions of Belatacept and Ultimirus. (Sp?). Just be very careful until Spring. That’s what I’m doing. Godspeed!

Leekee profile image
Leekee in reply toDjangosmom

Have you had any reactions to Belatacept? I started infusions in October.

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