90% of People on Immunosuppressant Drugs Still Make Antibodies After COVID-19 Vax

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  • A new study found 90 percent of people with weakened immune systems still make antibodies after receiving a COVID-19 vaccine.
  • The study looked at people who take immunosuppressing drugs for chronic inflammaotry diseases like IBS or rheutmathoid arthritis.
  • Patients receiving these drugs are at a greater risk of acquring the coronavirus and of more severe complications if they develop COVID-19.

New research published August 31 from the Washington School of Medicine in St. Louis finds COVID-19 vaccination stimulated antibody responses in nearly 90 percent of people with weakened immune systems due to chronic inflammatory disease (CID).

“What we found here is that the vast majority of immunocompromised patients with autoimmune diseases are able to mount antibody responses following COVID-19 vaccination. There’s clearly a benefit for this population,” co-senior author Dr. Alfred Kim, an assistant professor of medicine treating autoimmune conditions at Barnes-Jewish Hospital, said in a statement.

Immune-suppressing drugs are typically given to people with underlying autoimmune conditions or people who are recipients of organ transplants.

According to Dr. David Hirschwerk, an infectious disease specialist at Northwell Health in Manhasset, New York, the drugs are necessary but can leave people at risk of infection.

“These drugs are necessary to quiet an overactive immune system that could be harmful,” he told Healthline. “Unfortunately, this necessary treatment inhibits the capacity to mount as strong an immune response to vaccines compared to people not receiving immunosuppression.”

Patients receiving these drugs, he explained, are at greater risk of acquiring the coronavirus and more severe complications if they develop COVID-19.

What the study found

For the study, researchers gathered a participant group of 133 patients and 53 healthy people for comparison.

Each patient with CID took at least one immune-suppressing medication for illnesses that included inflammatory bowel disease, rheumatoid arthritis, spondyloarthritis, lupus, and multiple sclerosis.

Blood samples were taken from all participants within 2 weeks of receiving their first dose of Pfizer or Moderna mRNA vaccine and again within 3 weeks of receiving the second dose.

Researchers then measured participants’ antibody levels and counted how many antibody-producing cells were present in their blood samples. The CID patients stayed on their prescribed drug regimens, except for 3 whose medications were paused within 1 week of vaccination.

According to the study findings, all healthy participants — and nearly 90 percent of immunosuppressed participants — produced antibodies against the pandemic virus.

However, both antibody levels and number of antibody-producing cells were only one-third as high in the immunosuppressed group.

Results vary depending on the drug

Researchers found that patients taking two particular classes of drugs had particularly weak immune responses.

According to the study findings, only 65 percent of people taking glucocorticoids, a type of steroid, and 60 percent of those taking the autoimmune treatment called B cell-depleting therapyTrusted Source, developed a detectable antibody response.

However, they also found that a form of chemotherapy called antimetabolites — including methotrexateTNF inhibitors,Trusted Source or JAK inhibitors — didn’t significantly weaken immune responses compared to people not taking those drugs.

MRNA vaccines safe for immune compromised patients, expert says

Asked how safe mRNA vaccines are for those taking immune-suppressing drugs, Dr. Theodore Strange, interim chair of medicine at Staten Island University Hospital in New York, said the data is clear.

“The data so far on these new mRNA technology or platform has been one that is very safe, very effective, and causes as little side effects as any other drugs out there,” he said.

Strange confirmed that while the first dose already confers some immunity, the second dose “absolutely gives much more immunity.”

He emphasized that we now know the Pfizer and the Moderna vaccines confer better immunity than the Johnson & Johnson vaccine, which was “more in the traditional line of helping with the immune system.”

“So, I do not believe that this mRNA technology is going to do anything or have any significant issues that are a problem,” he continued. “Because of whatever the inflammatory disease was or from the drugs that these people were taking.”

Booster shots may be key to protection

“The immunity seems to wane in a shorter period, and that’s why the booster dose was so recently allowed by the EUA,” said Strange.

“But again, it improves the person’s immune system, whose immune system may have been compromised by the drug to re-stimulate itself to fight off things like COVID infection,” he added.

Strange was also enthusiastic about the future of mRNA technology to treat a host of diseases.

“I believe that mRNA technology is going to be the future of how we deliver other treatments for other things, besides just vaccinations,” he said. “Because it turns on your body’s immune system by sending the messenger carrier into the cell to allow for its [the body’s] own immunity to be turned on.”

The bottom line

New research finds that people taking immune-suppressing drugs for a broad range of inflammatory diseases receive significant benefit from mRNA vaccination against COVID-19.

According to experts, vaccine protection wanes sooner in immune-suppressed people, which is why booster shots have been granted emergency use authorization for these patients.

They also say that mRNA vaccines offer more protection than those using older technology, like the Johnson & Johnson vaccine.

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