The COVID-19 vaccines have been hailed as miracles, but for some people with conditions that weaken their immune systems the shots may not be a panacea. That's because the vaccines may not provide them with enough antibodies to fight off the novel coronavirus.
A healthy immune system is often compared to a giant army attacking infections and other health conditions. But at least 10 million Americans have compromised immune systems, many because they have a condition that requires them to take anti-inflammatory drugs or similar medications. They include organ transplant patients who are prescribed an array of drugs to prevent the rejection of the transplanted organs, cancer patients and people with lupus, multiple sclerosis, rheumatoid arthritis and HIV/AIDS.
For them, that vulnerability could undercut the promise that the vaccines now being injected into the arms of millions nationally will bring immunity and liberation from COVID-19 for everyone.
In general, doctors treating patients with these conditions recommend they get a COVID vaccine because some protection is better than none. But experts and the Centers for Disease Control and Prevention (CDC) suggest that people with these conditions consult with their health care providers before getting vaccinated.
The CDC also recommends that even after getting vaccinated, those with compromised immune systems should consider still taking precautions against COVID-19, including wearing a mask and staying six feet apart from people who don't live with them. Doctors also recommend that people with these conditions ask their relatives and friends to get vaccinated.
Doctors performed 39,000 organ transplants in 2020, with kidney transplants leading the way.
Those receiving new organs typically take medications that prevent the immune system from going to war against the donated organ. “If the immune system is too active, it attacks the new organ,” says Peter Chin-Hong, a professor of medicine at UC San Francisco who directs its immunocompromised host infectious diseases program.
Those same drugs appear to undercut the vaccine's antibodies. In fact, a May 2021 study of 658 transplant recipients found that 46 percent had no antibodies after they received two COVID-19 vaccine shots.
The study, from the Johns Hopkins University School of Medicine in Baltimore, has received widespread attention among transplant recipients, experts said. They said they were not surprised by the results.
That's why transplant doctors often try to plan ahead and have patients get vaccinated before surgery, said Joseph G. Timpone, M.D., section leader for transplant and immunocompromised services at MedStar Georgetown University Hospital in Washington, D.C.