Two doses of mRNA COVID Vax, which is insufficient for immunosuppression

Studies have shown that the COVID-19 vaccine worked fairly well to keep immunocompromised patients away from the hospital, but still less than those with a competent immune system.

After two doses of vaccination, immunocompromised patients showed 77% vaccine efficacy (95% CI 74% -80%) for confirmed COVID-19 admissions and hospital SARS-CoV-2. The test positive rate was 3.9%, but those who were not vaccinated.

Efficacy was similar between Moderna and Pfizer in these patients, but depended on the type of immunodeficiency, ranging from 59% of solid organ or stem cell transplant recipients to 81% of rheumatic or inflammatory recipients. Met.

For inpatient immunocompetents, vaccine efficacy is expected to be 90% (95% CI 89% -91%), with 3.8% vs. 24.8% positive testing, respectively, with or without vaccination. There was, Peter J. Embi, MD reported.The Regenstrief Institute, a research organization belonging to the Indiana University School of Medicine in Indianapolis, and Weekly morbidity and mortality reports..

Their study of about 89,000 hospitalizations for diseases like COVID explained age, local viral circulation in the patient community, and other factors.

“People with immunodeficiency benefit from and need to receive the COVID-19 vaccine,” the researchers conclude, and their finding that they are less effective than those with immune capacity is at this high risk. He said he supported the recent CDC recommendations for the population.

The CDC Advisory Committee on Immunization (ACIP) in August found that people with moderate to severe immunodeficiency who were vaccinated with mRNA were 3 times.. Even in the provisional CDC guidance in October amplifier For vaccine recipients who are immunocompromised at least 6 months after the third mRNA dose, or at least 2 months after the Johnson & Johnson single dose regimen (2 doses in total).

“In addition to vaccination, immunocompromised people should implement non-pharmaceutical prevention strategies such as masking to help prevent SARS-CoV-2 infection. If they are infected with SARS-CoV-2. , Proven treatments that may impede progression need to be closely monitored and considered early, for severe diseases (eg, monoclonal antibodies), “enbi’s group added.

Their research is VISION network -A group of 187 hospitals in nine US states working with the CDC-Investigating 69,116 immunocompromised adult patients and 20,101 immunocompromised adult patients admitted with illnesses such as COVID-19 .. Patients were able to obtain molecular test results for SARS-CoV-2 from January 17th to September 5th, 2021.

Overall, 43% of immunocompromised patients and the remaining 53% were vaccinated twice with the mRNA COVID-19 vaccine at least 14 days before admission (median 89 days) and appear to be fully vaccinated. It was done.

Vaccine efficacy was also similar between age group and timing of admission compared to the prevalence of delta mutants in hospital.

The limits of the study included potential fluctuations in the prevalence of respiratory viral infections other than COVID-19 between immunocompromised and immunocompromised patients. However, Embi’s group wrote that their test-negative design meant that such differences were not expected to affect the validity of the vaccine efficacy estimates stratified by immunodeficiency status. ..

In addition, discharge diagnoses such as cancer and rheumatoid arthritis were used as a substitute for immunodeficiency, which could lead to misclassification. Selection bias could not be ruled out if vaccination status affected the likelihood of SARS-CoV-2 testing. The Johnson & Johnson vaccine was excluded in this study.