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A new study has raised questions about how COVID-19 vaccines protect organ transplant recipients – and what precautions people with weakened immune systems should take after injections.
Vaccines stimulate the immune system to recognize the virus, which is more difficult to do if a person’s immune cells are not working properly. Transplant recipients take strong immunosuppressive drugs to prevent organ rejection, which also increases their risk of coronavirus – but excludes them from vaccine studies.
Experts say injections seem safe for transplant recipients and that any protection is better than nothing. But what protection do they get?
On Monday, researchers at Johns Hopkins University reported a first attempt to find out. They tested 436 people who had received new organs in recent years and were receiving the Pfizer or Moderna vaccines. Weeks after the first dose, 17% of transplant recipients had developed antibodies to the coronavirus, said Dr Dorry Segev, Hopkins transplant surgeon who co-authored the study.
Segev acknowledged that transplant recipients might do better after the second dose needed – he will verify this, too – but previous studies show that the first shot is enough to jumpstart antibody production in just about everyone. with a well-functioning immune system.
More concerning, people whose transplant drugs included a type called an anti-metabolite were much less likely to respond to the stroke than those who did not need this type of drug, the team reported in the Journal of the American. Medical Association.
The findings come after the U.S. Centers for Disease Control and Prevention said fully vaccinated people can relax some, but not all, of the coronavirus masking and distancing precautions.
Segev called on the CDC to consider a more nuanced message.
“From what we know, transplant patients cannot assume that they are safe after being vaccinated,” Segev said. They may need post-vaccination blood tests to be sure, he added.
The CDC did not immediately comment.
Dr David Mulligan, head of transplant surgery and immunology at Yale University, said Monday’s report was a disappointment but not a surprise because people with weakened immune systems fail to respond as well as other vaccines.
Some transplant groups, including the American Society of Transplantation, have already issued warnings about this.
Mulligan of Yale urged patients to check with their transplant center for advice. Those waiting for a life-saving organ transplant might be able to get the vaccine first. He said some people who have already had a transplant might be good candidates to temporarily cut back on certain immunosuppressive drugs. And people who are immunocompromised should be sure to receive both doses of the vaccine for the best chance of protection.
“Our patients are already asking” for advice, Mulligan said. “Until you get your antibodies checked and you know, boy, I have a vigorous immune response – or we have better data,” immunocompromised people shouldn’t let their guard down against the virus.
The Associated Press’s Department of Health and Science receives support from the Department of Science Education at the Howard Hughes Medical Institute. The AP is solely responsible for all content.
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