Millions of immunocompromised people may be left unprotected by vaccines, experts say

Millions of Americans have immune systems weakened by certain diseases, cancer therapies and other factors, leaving them unable to produce an adequate level of COVID-19 antibodies after a prior infection or after vaccination, The New York Times reported April 15. 

That leaves immunocompromised people in a constant state of vulnerability to the coronavirus even after being fully vaccinated. For instance, Andrew Wollowitz, MD, medical director of emergency medicine at New York City-based Montefiore Medical Center, had a cancer treatment in 2019 that essentially wiped out his immune system. Dr. Wollowitz was vaccinated against COVID-19 in January, but as he expected, he was unable to produce antibodies. 

As a result, Dr. Wollowitz's main protection has been hunkering down at home, even as many of his family and friends have returned to a sense of normalcy after vaccination. 

It's not yet clear just how many immunocompromised people don't respond to vaccines, though those with certain types of cancer, organ transplant recipients and those who have taken certain cancer drugs or other treatments for autoimmune diseases are at particular risk, the Times reports. A recent study published in the preprint server medRxiv, for example, found that among 67 patients with hematologic malignancies, or cancers that affect the blood, bone marrow or lymph nodes, 46 percent did not produce antibodies a few weeks after being fully vaccinated. 

"We're extremely concerned and interested in trying to see how we might be able to help those particular patients," Elad Sharon, MD, an immunotherapy expert at the National Cancer Institute told the Times. 

A potential solution could be routine infusions of monoclonal antibodies. While the FDA has authorized several such treatments in response to a COVID-19 infection, some now are being tested as a way to prevent infection. Convalescent plasma that includes coronavirus antibodies from the blood of healthy donors is not yet available, but could be another option for immunocompromised patients. 

In the meantime, experts recommend those with weakened immune systems should still get vaccinated, as some level of protective immune cells may be produced. Another recommendation is for clinicians to routinely monitor antibody responses in these patients after full vaccination to pinpoint those who may also benefit from monoclonal antibodies. 

To read the full New York Times article, click here.



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