• It can be difficult for people who have had an organ transplant to get the same benefits from vaccines as other people.
  • A new study suggests giving them 3 doses of COVID-19 vaccines, instead of 2, may help.
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For tens of thousands of Americans with weakened or weakened immune systems, full vaccination against COVID-19 has not led to protection against disease. Getting a third dose of the vaccine might help solve the problem, at least for some of these patients.

A new study – conducted on organ transplant patients who took it upon themselves to be illegally vaccinated in the United States – suggests that the third trial may be the charm when it comes to some immunocompromised people and vaccination.

Of the 30 patients included in the study, published Monday in the Annals of Internal Medicine, 12 achieved high antibody levels after the third vaccine, two patients had weak but detectable antibodies, and the remaining 16 patients remained antibody negative after their third booster dose.

It doesn’t matter whether the participants mix and match their shots. Success was limited with all of the different third dose combinations of Pfizer, Moderna and Johnson & Johnson (none of the patients had J&J to begin with).

“People want to get back to their lives, and they will go to great lengths to do so: go back to work, go back to church, see the grandchildren,” Dr. William Werbel, infectious disease clinician at Johns Hopkins who led the new study said. “They were somewhere on the spectrum between frustrated and desperate.”

Hoping that a third dose might be the ticket to resuming some of their past activities, many have rolled up their sleeves again. Their mixed success in the third dose trial is a promising signal that COVID-19 booster injections can be safe and effective, and that the side effect profile of a third injection could be quite similar to a second. .

Hundreds of transplant patients have already received a third dose of vaccine

Lung transplant patient smiling, arms crossed, preparing to run

Edgardo Diaz, 30, prepares for a run in his Oak Forest, Illinois neighborhood on June 17, 2020. He is believed to be the first lung transplant patient to receive plasma for COVID-19 and recover.

Zbigniew Bzdak / Chicago Tribune / Tribune News Service via Getty Images

Werbel said there are already “hundreds” of transplant recipients in the United States who have decided to receive a third vaccine, although the practice is not recommended at the federal level.

On the contrary, because so many transplant patients are active on a nationwide organ network that connects patients and doctors to share experiences and best practices, he already knew it was happening.

“We’ve basically had the privilege of working with patients who have said, ‘Hey, I’m going to get the shot next week. How can I help determine if this is working? “” said Werbel. “I have to plead some ignorance of how people used to do it, because it’s not allowed that way.”

He called the new study results, which are still preliminary, “encouraging.” But the third doses were not a huge success, only dramatically improving antibody levels in about half of the participants.

This does not necessarily mean that the 16 patients in the study who remained antibody negative did not gain any benefit from the third dose of vaccine; Antibodies aren’t the only piece of the puzzle in determining a person’s immunity to COVID-19. But it does suggest that there might be something about their immune system functioning that doesn’t give them great vaccine protection.

“These patients are taking drugs specially designed to prevent rejection of their heart, lungs or kidneys, no matter what they are given,” Werbel said. “These drugs are explicitly designed to reduce the potential for reacting to new things. That is why patients do not always create a good response to vaccine antigens, the proteins in vaccines.”

In France, government approves third doses of COVID-19 vaccines for organ transplant recipients and others with weakened immune systems.

Proof of concept that boosters can work

Dr Rishi Seth of Sanford receives COVID vaccine

Dr Rishi Seth, hospitalist at Sanford Health Fargo, receives an injection of COVID-19.

Sanford Health

The study is one of the first to show that mixing and matching Booster doses of COVID-19 vaccines are both safe and effective, at least for some people.

“It’s a bit difficult to generalize to the healthy population, just because the healthy population produces so many antibodies and other immune responses to these vaccines,” Werbel said.

Side effects after a third dose of the vaccine were similar to those experienced after a second, including mild to moderate fatigue and pain in the arms. A patient rejected her donated organ – a heart – seven days after her booster vaccination, but it is not known if this was related to the administration of the vaccine. (She is now recovering.)

Werbel warned that it is still too early to say how much these patients can be protected against the disease by vaccination.

“Transplant patients really shouldn’t consider themselves fully protected or vaccinated until we know more, and that honestly means it’s important to the people around them – really important to the people around them. surround – to get vaccinated, ”he said.

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