Vaccine booster shots may help strengthen the defense of some organ transplant recipients against Covid-19. When the pandemic restriction ends, groups that fear suppression of the immune system can be vulnerable.
According to a small study reported in the Annals of Internal Medicine on Monday, one-third of organ recipients who did not have antibodies after the second dose developed antibodies after the third dose. The researchers also found that participants with slightly elevated antibodies after the double-dose regimen had higher levels after taking additional shots.
The results are thought-provoking Johns Hopkins University researcher.But they were eagerly waiting Porting community As the pandemic weakens, we are about to return to normal activity. Since 2017, about 160,000 transplants have been made in the United States.
“It shows us that the immune system of immunosuppressed patients can be activated,” he said. Dolly Segef, One of the university researchers and a professor of surgery and epidemiology.
Early research by Johns Hopkins researchers Indicated Transplant recipients who must suppress the immune system with drugs so that the body does not reject the donated organs are less likely to develop antibodies after two doses of the messenger RNA vaccine. Pfizer Japan Inc And its partners BioNTech SE And Moderna Inc.
Results of those surveys Spurred Some patients go to pharmacies or clinics themselves to get booster shots. Johns Hopkins researchers then recorded antibody levels in 30 of these patients to create up-to-date data.
Segev said on the phone that further research is needed to determine the timing and conditions of the third dose and what options are available for patients who do not respond after the third dose. ..
Segev says his team is working with the US Food and Drug Administration, National Institute of Health Attempts to begin clinical trials in the next few months when researchers can give patients a third dose in a controlled setting.
The FDA states that it needs data to evaluate alternative dosing regimens. Centers for Disease Control and Prevention At this time, we do not recommend taking multiple vaccine series. For transplant patients, taking the new vaccine risks inducing the immune system in ways that can lead to organ rejection, Segev said.
In the Johns Hopkins study, researchers did not observe anaphylactic reactions or neurological complications. One heart transplant recipient experienced rejection that was found to have antibodies to the donated organs one week after the third dose, but recovered and was the rejection related to the vaccine? I don’t know.
According to Segev, a small number of patients have received or are considering a fourth dose, and researchers are studying them as well. However, he said, if someone does not respond after the third dose, it is unlikely that they will respond after the additional dose.
Patients who do not respond after the third dose may need to take other steps, such as adjusting immunosuppressive drugs, but may be at risk for transplant patients due to the risk of organ rejection. ..
Regulators caveat Against the use of antibody testing as a measure of vaccine efficacy and as a means of assessing immunity. Given the low number of cases of Covid and the fact that immunocompromised people take precautions to prevent infection, Segev finds it difficult to study the effectiveness of vaccines in that population and is a representative. Said it needs to be used.
Antibodies do not give a complete picture of immunity, and the other arms of the immune system may help protect the patient if it becomes infected. Segev’s team also studied the cell-mediated immune response of patients who received a third injection and confirmed that antibody levels after the third dose correlated with neutralizing antibodies, he said. It was.
Real world results
on the other hand, Virginia Commonwealth University We sought to determine how antibody findings would translate into actual results in transplant patients.
they found Of the 380 kidney recipients in the vaccinated healthcare system, 7 have symptomatic infections, suggesting an early breakthrough rate of 1.8%. Four out of seven people were hospitalized, two of whom needed oxygen supplementation and treatment, according to a study published in. Transplant infections in late May..
The low breakthrough rate is promising, but it’s higher than what is found in the general public, said transplant pharmacist Chelsea Song, who worked on the study. She recommends vaccination of patients, but still maintains social distance and masking precautions.
There is a lack of published data on the safety and efficacy of third shots, and her transplant center also wants to begin clinical trials to study the patient’s third dose, she said.
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