Most doctors provide several reasons for getting a COVID-19 vaccine as soon as possible. Such as Dr. Robert Montgomery, who is a transplant surgeon at a busy New York hospital. He also is a transplant patient, which makes his heart now beating is not the one he was born with. Making Montgomery doubly distressed when his body failed to mount a detectable response to his two-dose COVID-19 vaccine.
He believed that his patients were among the most vulnerable to the disease. As the pandemic has exacted a terrible toll on transplant recipients. More or less about 20% of those infected died (2, 000) in New York City. Compared to just one or two transplant patient deaths in a typical flu season, he said.
Some medications prevent rejection of transplanted organs and also block many transplant patients from making protective antibodies. Recent studies found that only 17% of transplant recipients have antibodies after their first dose of a COVID-19 vaccine which includes an additional 35% responding after two shots by Johns Hopkins University School of Medicine.
But researchers are not exactly sure what an adequate immune response looks like or level of protection is enough.
As Montgomery approaches, he signs himself up for a clinical trial testing a third vaccine dose. For him, it worked. After the third shot, when the testing part of the trial showed that his immune system both has protective antibodies and longer-shielding T cells.
Some results are still unclear but Montgomery is satisfied he has at least some protection.
Unfortunately, his and other hospitals are now admitting COVID-19-infected transplant patients who have been properly vaccinated. “That’s almost unheard of in the general population,” he said. “We’re seeing this at a much higher rate in transplantation.”
Until results from clinical trials at Johns Hopkins Medical Center are in, Dr. Dorry Segev tells his transplant patients to “get vaccinated, act unvaccinated.” He is studying the effectiveness of a third dose, hoping that “there’s something we will ultimately be able to do for transplant patients.”
Segev will also see if transplant patients who haven’t developed a response after two doses of mRNA vaccines from Pfizer-BioNTech and Moderna do better following a booster. (According to his previous studies, the single J&J vaccine proved even less protective for transplant recipients than the two-shot immunizations.)
Luckily, most other immunocompromised people will get better protection than transplant patients, after being vaccinated as experts say.
The problem is that it’s impossible at this point to know how safe someone is. Generally, 90% of the population is protected by vaccines, there’s no need to worry, experts said.
The T cells, often known as immune system soldiers, are produced by vaccines and appear to provide longer-term protection, but there are no commercially accessible assays to detect them.
Immunocompromised patients should “build a wall of protection” around themselves by getting vaccinated and ensuring that everyone around them gets vaccinated, according to Dr. Rajesh Gandhi, an infectious disease expert at Massachusetts General Hospital.
According to a study published this month in the journal Cancer Cell, about 98% of persons with solid tumors generated protective antibodies after vaccination. Only approximately 85% of blood cancer patients and 70% of those on strong immune system therapy generated antibodies, according to the study.
If cancer patients catch COVID-19, Dr. Craig Bunnell, chief medical officer and a breast cancer expert at the Dana-Farber Cancer Institute in Boston, recommends monoclonal antibodies, which can minimize the risk of a severe case of the disease.
He said that the same medications could be useful in avoiding infection in people who can’t obtain protection from vaccines, such as cancer patients. There are currently studies being conducted to validate this.