Despite vaccination, immune suppression could leave some vulnerable

Immune Suppressed Vaccine Efficacy
Posted at 11:31 AM, Apr 16, 2021

CHICAGO — The fight against COVID-19 seemed to turn a corner when the highly effective Pfizer and Moderna vaccines emerged. But researchers are now finding that one vulnerable group of people could remain at risk because the vaccines may not produce enough of an antibody response.

Like so many, 67-year-old Barbara Creed was relieved to get vaccinated against the virus.

“I was so excited. I really felt that all I needed to do was get a vaccine and that life would be good,” she said.

Creed battled pulmonary arterial hypertension for years. She underwent a double lung transplant last May. She now takes 30 immunosuppressive pills a day, which makes her vulnerable to infection.

“One out of three immunosuppressed people who get COVID doesn't make it, so it's just imperative that I not get COVID,” said Creed.

Pfizer and Moderna’s vaccines are reportedly at least 94 percent effective at preventing severe disease and death and 100 percent at producing some antibodies.

But transplant recipients and other people who are immunocompromised were excluded from those original vaccine trials. That affects about 10 million people in the U.S.

“We have severely immune-suppressed individuals from things like AIDS. So, from HIV infection, from being on chronic steroids for inflammatory conditions, autoimmune conditions like rheumatoid arthritis or lupus,” explained Dr. Michael Angarone, associate professor of infectious disease at Northwestern University’s Feinberg School of Medicine.

Researchers at Johns Hopkins conducted their own study and disappointingly found only 17 percent of immunocompromised people produced detectable antibodies after receiving their first Moderna or Pfizer dose.

“We categorically do not think that transplant recipients or other immunosuppressed people should assume that they are immune to COVID after getting vaccinated,” said Dr. Brian Boyarsky, the Johns Hopkins study’s lead author.

For people like Creed, the Johns Hopkins research was like a gut punch.

“It just kind of sets me back a little bit, you know, that all these hopes that I had are not there,” she said.

Despite being fully vaccinated, some may live under a cloud of uncertainty.

“They may be immune suppressed, and so, you may say, 'Oh, they got the vaccine. It's all good,' but maybe it's not,” said Dr. Angarone.

Creed says she worries that others who are immunocompromised may be living with a false sense of security.

“I would like them to know that even though they're vaccinated, that they may not be safe," she said.

Johns Hopkins is studying the immune response after dose two. In the meantime, they’ve recommended the CDC update its guidelines to include masking, and strict social distancing for immunocompromised people, even if they are fully vaccinated.