Patients with compromised immune systems have lower immune responses to COVID-19 vaccines, ET HealthWorld

Sheffield: researchers and clinicians in University of Sheffield and Sheffield Teaching Hospital NHS Foundation Trust They are part of the ongoing OCTAVE (Observational Cohort Trial – Efficacy of T Cell Antibodies and Vaccines in SARS-CoV-2) trial, University of GlasgowBirmingham and Oxford, and a consortium of leading British institutions.

The latest report, published in Nature Medicine, contains important new data on infection rates, severity and mortality in patient groups studied up to one year after the first vaccination.

Preliminary data from the OCTAVE study in August 2021 show that a significant proportion of clinically at-risk patients who are immunocompromised or It was shown to have an undetectable immune response. Now, with new peer-reviewed data, researchers can now share real-world infection outcomes for this clinically at-risk group.

Data from this study cover the period from 2021 to mid-2022 and include patients infected with SARS-CoV-2 alpha, delta, and omicron strains. The data do not estimate the impact of the third and fourth vaccinations subsequently provided to patients in the study group.

These new data suggest that overall in most at-risk patient groups COVID-19 Despite vaccination, infection rates were low and symptomatic subgroups were at high risk of severe illness and death from SARS-CoV-2. This was especially true during delta waves. In addition, the data show that Omicron, the SARS-CoV-2 strain that currently predominates worldwide, has increased infection rates among at-risk patients, while fewer patients became severely ill or died. is shown.

OCTAVE (Observational Cohort Trial – Efficacy of T Cell Antibodies and Vaccines in SARS-CoV-2) is led by the University of Glasgow and consists of the Cancer Research UK Clinical Trials Unit at the University of Birmingham and major academic and clinical centers Provided by a national consortium. This research institute will conduct COVID-19 vaccines to assess real-time immune responses following COVID-19 vaccination in patients with immune-mediated inflammatory diseases such as cancer, inflammatory arthritis, and kidney and liver disease. Founded in the middle of a viral pandemic. Previously, preliminary data published by OCTAVE in 2021 showed that most patients had a successful immune response after two doses of the vaccine, but some patients with certain immunosuppressive conditions had a lower immune response. , or showed an undetectable response. immune response. The study found that 12 percent of patients enrolled in the trial failed to produce antibodies, and another 27 percent produced only low levels of antibodies. Some patients failed to generate adequate T cell responses after vaccination. Vaccine failure rates were higher in some subgroups, including patients with ANCA-associated vasculitis receiving rituximab, patients undergoing hemodialysis and receiving immunosuppressive therapy, and patients undergoing solid organ transplantation.

In this study, to better understand the real-world impact of COVID-19, a variety of modalities were performed on blood samples taken before and/or after vaccination with COVID-19. Advanced immunoassays and patient infection and severity data were used. Response to vaccination in these patient groups.

In the UK, more than 60% of people aged 65 and over were found to have one or more chronic conditions in 2019, and more than 12 million people aged 18-65 had a chronic condition lasting longer than 12 months. living. Government estimates suggest that about 500,000 people in the UK suffer from immunosuppressive diseases, which could put them at higher risk of severe COVID-19 if vaccination fails to fully protect them. It is an important group that has

Tushan de Silva, Professor of Infectious Diseases at the University of Sheffield and Emeritus Physician for Infectious Diseases at the Sheffield Teaching Hospitals NHS Trust, added: Greater efforts need to be made to find ways to protect the most vulnerable people in society. “

John Snowden, Director of the Blood and Bone Marrow Transplant Program at Sheffield Teaching Hospitals NHS Trust and Professor Emeritus at the University of Sheffield, said: Many people are particularly susceptible to severe complications from COVID-19, but have a poor response to vaccination.

“The OCTAVE study has provided important insight into how to identify the most vulnerable patients and protect them from severe complications as much as possible.

“The Sheffield team worked with a number of national teams, led the section of the OCTAVE study focused on bone marrow transplantation and CAR-T patients, and was the largest patient recruit into this high-risk cohort. We sincerely thank all the patients and staff involved.”

The OCTAVE trial is one of the world’s largest post-vaccination studies of SARS-CoV-2 in immunocompromised patients to date and is funded by the Medical Research Council (MRC).

Professor Ian McInnes, Director of the OCTAVE Trial and Vice Chancellor and Dean of the MVLS Department at the University of Glasgow, said: patient group. The main benefits of this study include identifying the small number of patients who may not respond to the vaccine, allowing health care providers and policy makers to make the best decisions to protect these groups of people. includes. Importantly, this study reassures us that the majority of immunocompromised patients in the UK are protected from severe COVID-19 by vaccination programs. ”

Professor Pamela Kearns, Director of UK Clinical Trials, Cancer Research, University of Birmingham, said: “OCTAVE provides important understanding of how vaccines have protected many groups of the most clinically vulnerable people and how disease variants may have impacted vaccine efficacy. increase” .

“We see areas of particular concern where vaccines have failed to adequately protect against COVID-19, such as some patients with kidney disease and some inflammatory conditions.”

“With all participants for providing the clearest picture yet of how the most clinically vulnerable are protected and where their weaknesses need to be addressed. I am very grateful to each center.”

Professor Eleanor Burns, Professor of Hepatology and Experimental Medicine, Nuffield School of Medicine, University of Oxford, said: “Importantly, both T-cell and antibody responses to the vaccine have been shown to prevent severe disease in immunocompromised patients. It is.”

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