Research studies reveal that even after receiving 2 doses of COVID-19 vaccines, people who have had organ transplants may not achieve immunity to the disease. A team of researchers from Johns Hopkins found that 46% of study participants produced no antibodies after the first and second doses of either the Pfizer or Moderna vaccines.
Dr. Dorry Segev, M.D., professor of surgery and epidemiology at Johns Hopkins University and one of the study authors, said that while the second dose was helpful, it did not guarantee immunity, according to The Boston Globe. Even the participants who did respond to the vaccines produced fewer antibodies than healthy people who are not transplant recipients.
Segev said that he did not expect the Johnson & Johnson vaccine to perform any better, although it was not included in the study. The reason, he said, is that transplant recipients need to lower their immune systems so they will not reject the organ. The medications they need may interfere with vaccine response.
John A. Nucci, 69, received a living-donor kidney in 2018 and said that the research news "is an emotional letdown for sure," according to the Globe. "Like everyone else, I was hoping that it would be over soon for us. It looks like we’re going to have to wait a little longer."
Nucci said that the new information emphasizes why it is important for people to get vaccinated.
"This is not about how you feel about getting a vaccine. This is about how you can effect other people," he said, adding while he is fortunate to be able to work remotely, other transplant recipients are not as lucky and face increased risk of COVID-19 at the workplace.
The Johns Hopkins findings are similar to the results of other studies with organ transplant recipients, said Dr. Camille Nelson Kotton, M.D., the clinical director of Transplant and Immunocompromised Host Infectious Diseases in the Infectious Diseases Division at the Massachusetts General Hospital, the Globe reported.
"We suspect transplant patients are less well protected," she confirmed.
Researchers from the Perelman School of Medicine at the University of Pennsylvania and several centers across the U.S. and abroad, also noted a reduced response to COVID-19 vaccines in their studies and said that until more data is accumulated on when these people can safely return to normal activities, "we should advocate continued adherence to diligent mask use, hand hygiene and social distancing."
Segev pointed out that the Johns Hopkins study did not measure T-cell response which is another critical part of the immune response to neutralizing pathogens. But he said that many transplant recipients take medications that lower the T-cells in their bodies to prevent organ rejection, so it’s unlikely that immune response to COVID-19 would improve by calculating these levels.
The good news is that a little over a third (39%) of study participants who did not mount an immune response after the first dose of COVID-19 vaccine did respond after the second dose. Segev and other researchers plan to study the effects of a third dose in improving immunity.
The expert urges organ transplant recipients to get vaccinated despite the disappointing results of his report.
"It gets your immune system started," said Segev, according to the Globe. He said that any protection is better than none, and the vaccine may make the disease less severe. But he also encouraged transplant patients to behave socially as if they were not vaccinated and adhere to the Center for Disease Control guidelines about wearing masks and social distancing. And Segev advised them to avoid contact with unvaccinated individuals.
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