Immunosuppressed

[Morrison10]

Can someone please educate me what this means, condition, diagnosis etc. Thanks

[sassy59]

Hi Jean, it means your immune system isn’t working as well as it should making you more susceptible to infection etc. There are many causes. Has your doctor mentioned anything? Xxxx

[Hidden]

Basically, you can be really ill but still have a working immune system. It seems bizarre, I know. If you had one of the immunosuppressive conditions, someone would’ve told you, and it would be on your diagnosis in your hospital letters. But I’ve pasted the list from the Green Book for you. There are only 0.5m people in the country who fall within these categories:

Individuals with primary or acquired immunodeficiency states at the time of vaccination due to conditions including:

● acute and chronic leukaemias, and clinically aggressive lymphomas (including Hodgkin’s lymphoma) who were under treatment or within 12 months of achieving cure at the time of vaccination

● individuals under follow up for a chronic lymphoproliferative disorders including haematological malignancies such as indolent lymphoma, chronic lymphoid leukaemia, myeloma, Waldenstrom’s macroglobulinemia and other plasma cell dyscrasias (Note: this list is not exhaustive)

● adults and children aged 12 years and over with immunosuppression due to HIV/AIDS with a current CD4 count of <200 cells/μl

● Primary or acquired cellular and combined immune deficiencies – those with lymphopaenia (<1,000 lymphocytes/μl) or with a functional lymphocyte disorder

● those who had received an allogeneic (cells from a donor) or an autologous (using their own cells) stem cell transplant in the 24 months before vaccination

● those who had received a stem cell transplant more than 24 months before vaccination but had ongoing immunosuppression or graft versus host disease (GVHD)

● persistent agammaglobulinaemia (IgG < 3g/L) due to primary immunodeficiency (e.g. common variable immunodeficiency) or secondary to disease / therapy

Individuals on immunosuppressive or immunomodulating therapy at the time of vaccination including:

● those who were receiving immunosuppressive therapy for a solid organ transplant at the time of vaccination

● those who were receiving or had received in the previous 3 months targeted therapy for autoimmune disease, such as JAK inhibitors or biologic immune modulators including B-cell targeted therapies (including rituximab but in this case the recipient would be considered immunosuppressed for a 6 month period), T-cell co-stimulation modulators, monoclonal tumour necrosis factor inhibitors (TNFi), soluble TNF receptors, interleukin (IL)-6 receptor inhibitors., IL-17 inhibitors, IL 12/23 inhibitors, IL 23 inhibitors. (Note: this list is not exhaustive)

● those who were receiving or had received immunosuppressive chemotherapy or radiotherapy for any indication in the 6 months before vaccination

Individuals with chronic immune-mediated inflammatory disease who were receiving or had received immunosuppressive therapy prior to vaccination including:

● high dose corticosteroids (equivalent to ≥ 20mg prednisolone per day) for more than 10 days in the month before vaccination

● long term moderate dose corticosteroids (equivalent to ≥10mg prednisolone per day for more than 4 weeks) in the 3 months before vaccination

● non-biological oral immune modulating drugs, such as methotrexate >20mg per week (oral and subcutaneous), azathioprine >3.0mg/kg/day; 6-mercaptopurine >1.5mg/kg/day, mycophenolate >1g/day) in the 3 months before vaccination

● certain combination therapies at individual doses lower than above, including those on ≥7.5mg prednisolone per day in combination with other immunosuppressants (other than hydroxychloroquine or sulfasalazine) and those receiving methotrexate (any dose) with leflunomide in the 3 months before vaccination

Individuals who had received high dose steroids (equivalent to >40mg prednisolone per day for more than a week in the month prior to vaccination

But, as I say, in a few weeks’ time you should qualify anyway, by virtue of age 😊

[Morrison10 in reply to Hidden]

Wow, Thanks so much for that interesting list, I don’t fit any specification! Think because I’ve been and felt ill and on antibiotics most of last 6 months I’m just keen to go out if my latest sputum sample shows I’ve finally got rid of two nasties who’ve enjoyed winter in my lungs. I’ve also got repairs needed in house, including wash machine that flooded my kitchen few weeks ago, but been afraid to have people in house who may not want to wear proper mask. Finally managed to get telephone consultation with own GP on Friday, will message if get any better information and news re 4th Jabs. Jean xxx

[Hidden]

Immunosuppression either arises as the direct result of an underlying condition, like an immune disorder, or as the result of treatment given to treat something e.g. having had a solid organ, bone marrow, or stem cell transplant where we suppress the immune system to prevent the body rejecting it, if you’re receiving chemo or radiotherapy for cancer, or if you take (some) immunosuppressant drugs to manage autoimmune conditions like inflammatory arthritis. Based on the reply from Hanne, I’m guessing this has come up in relation to being refused another covid vaccine? The extract from the green book she’s provided is the up to date guidance on who needs a third primary and fourth booster dose. The majority of people deemed immunosuppressed on this board would primarily fall into the category of those that regularly take or had been taking pred at relevant doses at the time of vaccination.

If it’s any reassurance, as someone that’s in the immunosuppressed group, I can tell you there have been quite a few studies done about this over the last 12 months, so the views as to who would be most at risk and therefore benefit from the extra jab are based on science, not arbitrary decisions. It’s entirely decided on the likelihood of having NOT mounted an effective response as a result of the immune system not working properly, either as a result of disease, or treatment.

[knitter]

I am on long term oral steroids so immunosuppressed.I had my fourth Covid booster on Saturday .

See in the press and BBC that over 75 s and older residents in care homes to be offered 4 th booster in Spring, six months after their previous dose .

[AngieB72]

Very frustrating for you but I’m sure in a few weeks when the over 75 roll out begins again you can get the next booster. You do know you can buy antibody tests online that you can check your present antibodies - you may have lots and therefore feel able to do all the things you want to, with precautions of course.

[Morrison10 in reply to AngieB72]

Hi, thanks for that information. Where do you live, B72? I’m B74 x

[AngieB72]

I’m in Surrey - it’s not my postcode, it’s my year of birth 🤣🤣🤣

[Morrison10 in reply to AngieB72]

Oh, thanks! Best wishes xxx