I have 4 weekly abatacept infusions & have for some years now with very good affect. I have been shielding for over a year now & I am very weary of changing things. I have diabetes, high blood pressure & I’m overweight ( made worse by shielding for so long) so my risk factors if I got covid are very high. I have just had my second Pfizer vaccination, so delayed my abatacept infusion by a couple of weeks to give the vaccine the best chance. Spoke to my rheumatology nurse yesterday where I asked about immune response with biologics & especially abatacept. She told me that they have some evidence that with some biologics there is some good response to the vaccine but with abatacept it is more complicated & it is not know yet. I am considering getting a private antibody test. Does anybody have any experience of getting antibody tests & how to get one.
I would be so grateful for any advise. Thank you
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Jacqbox
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There are two types of antibody tests available both on the NHS and privately: ones that give you a positive or negative, so either you have antibodies or you don’t, and there’s a single available test that gives a value for number of antibodies someone is seen to have in a sample. However, having the number of antibodies is at this point no more useful than a straight positive or negative because there are no established normal values, so no information as to how many antibodies would be a good response versus how many would be less good. My understanding is that you only need to mount a small response to prevent death and severe illness, in which case, spending a couple of hundred pounds on the quantitative test would for me seem a bit pointless. Some high street chemists offer yes/no lateral flow antibody testing.
As Charlie G says quantitative tests may not be hugely helpful, and expensive. And whilst the lateral flow tests give you a yes or no answer they are not 100%. Their sensitivity is pretty good...ie correctly identifying those with the antibodies. But the specificity is not so good, so doesn't always correctly identify those without the antibodies.
So if you got a positive result it wouldn’t help you as no way of knowing whether the level of antibodies you have is enough. So would it make you less careful?
And if you got a negative result there’s a fair chance it is wrong, so you would be fretting for nothing. Plus there’s nothing you could do about it. You won’t be given another dose of vaccine.
You’ve done what you can by delaying your drugs for a few weeks. I would try to wait till more research has been completed.
Thank you for your reply. There are so many mixed messages coming from the government & others. Shielding has ended but CEV are told to carry on reducing contacts & staying in as much as possible not to go to shops or pharmacies. Is this very different from shielding advice. I live in London & haven’t seen much social distancing or mask wearing or following the rules throughout the last year especially with my neighbours. I am not fretting or expecting another vaccine, I was just asking for advice on the virtual of antibody tests. Thank your advice.
Agree entirely, and until we can interpret the results of antibody testing in relation the vaccines’ efficacy more specifically, it’s not going to change much for me. If my immunoglobulin IgG does increase on this next routine test in a couple of weeks for Rtx monitoring I may think .. is this because I’ve now had two Pfizer’s? I won’t know for sure so ..... no it won’t change my behaviour as it isn’t conclusive. I said exactly this to my rheumy nurse and she agreed. She said we don’t know the required level to say you are really well protected but the vaccines should give even the immuno-suppressed enough to be safer. I won’t change much at all until we have more evidence. Just go places with much less people around outside and be sensible as usual re hygiene. Masks for a long time too I think.
(My French friend’s husband aged 58 has had his first AZ in Paris yesterday so some things slowly moving better there. )
With your conditions personally id just keep social distancing , mask wearing and ventilation. Its immaterial how much response you have just that you have some. All vaccines arent 100% anyway but the evidence so far , and lots of studies of course bring done, is that after vaccine we shouldnt get severe covid illness .I personally have done a keto diet in conjunction with my doctor as i had type 2 diabetes and obese and i hope this helped me a lot.
So we can only do our best by avoiding illness at the moment i think until we have more data. I do know they are looking into giving us a further vaccine in the autumn which again might bump up our protection if they feel we need it.
It is a worrying time for all of us but i find to get outside in very quiet places does make you feel better. Sending good thoughts.
I took an antibody test - it was £39 from Testing for All. It’s the Roche test which I’d done some research on and it looked good. It’s numbers based and does give you ranges where you fall vs. their other people tested. The pro: I learned I had antibodies which was good to see. The con: mine were in the bottom range compared to others. It was after one dose of AZ and I take MTX and RoActemra. So, it was not a surprise to see that. And the first pre-print has come out saying MTX reduces efficacy (as it does with other vaccines. But, peer reviewed studies are still to come!) I had stopped both for 3 weeks after the dose. Anyway, I’m glad I did it, but there’s no question that you have to be psychologically ready for the results. The thing is, regardless of how much research I’ve done (and I work with the researchers working on COVID even), I now have confirmation that I’m lower than others in antibody response. Even though we have much to learn about all the other areas that mount a response, how each body will react, etc....and believe me I really do know more than most about all this...I’m a little bummed. Of course, I’m still glad I did it. I now know I have some antibodies. Either way, my behaviors weren’t going to change. I’m waiting for confirmation that the vaccines protect against long COVID before I do anything different anyway (which has not been established.) So, I think it’s up to you what you do.
Thank you for your reply, it is exactly a reply to what I was asking. I was asking about antibody tests not antigen test used to test if you have convid. I was a nurse so I do have some knowledge of the body’s immune response. Abatacept works by reducing T cells response which seems to be a very important in the fight against developing COVID-19. I am not looking for an absolute answer to my immune status just some idea of my level so I can adjust & inform my friends & family that I may need to continue to shield especially with things opening up now. Thank you so much for the information you have given me, I will look into it.
Just read this article (googled most of the words in your post and found it). Thanks for posting. Although the research wasnt with patients who had the Astra Zeneca vaccine I think it's not too optimistic to extrapolate that, on methotrexate, I should have only a moderate decrease in efficacy and good protection . That's how I read it anyway!!!
My rheumatologist and also things I've read all say firstly that nobody yet knows how to interpret the results of antibody tests to give accurate answers as to how well protected we are after vaccination, secondly that other things besides antibodies are involved in our immune responses, so low antibodies is not necessarily the same as low protection. Here is a section from a CDC publication about it,
"Antibody testing is not currently recommended to assess for immunity to SARS-CoV-2 following COVID-19 vaccination because the clinical utility of post-vaccination testing has not been established. Antibody tests currently authorized under an EUAexternal icon have variable sensitivity, specificity, as well as positive and negative predictive values, and are not authorized for the assessment of immune response in vaccinated people. Furthermore, the serologic correlates of protection have not been established, and antibody testing does not evaluate the cellular immune response, which may also play a role in vaccine-mediated protection."
In other words, they just don't know yet, so don't waste good money on buying a test.
In a sense, we are guinea-pigs, but we can be pretty sure that covid-19 would do us a lot of harm, so we must get vaccinated, whatever the degree of protection it gives and not fling caution to the winds straight away. There will be answers to your question in due course.
Thank you so much for your reply. Since my post I took the very helpful advice I was given. As my Rheumatologist wasn’t offering any immunity tests, I booked an ‘immunity tracker’ test with ‘Test for All’ at £49. It showed I had good Ig response to the my vaccination. I waited 4 weeks after my 2nd jab to have this capillary blood test. I did make sure that I timed my 4 weekly Abatacept infusions so that I didn’t have my Pfizer vaccine until at least 3 weeks after my infusions. Hope this might be of some help to others that are concerned about their immune response to vaccination. I plan to repeat this test in 3 months or so.
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