Arab Times

Extra jab may protect transplant patients

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NEW YORK, June 15, (AP): A small study offers the first hint that an extra dose of COVID-19 vaccines just might give some organ transplant recipients a needed boost in protection.

Even as most vaccinated people celebrate a return to near normalcy, millions who take immune-suppressin­g medicines because of transplant­s, cancer or other disorders remain in limbo - uncertain how protected they really are. It’s simply harder for vaccines to rev up a weak immune system.

Monday’s study tracked just 30 transplant patients but it’s an important step toward learning if booster doses could help.

It didn’t help everybody. But of the 24 patients who appeared to have no protection after the routine two vaccinatio­ns, eight of them - a third - developed some virus-fighting antibodies after an extra shot, researcher­s from Johns Hopkins University reported in Annals of Internal Medicine. And six others who’d had only minimal antibodies all got a big boost from the third dose.

“It’s very encouragin­g,” said Dr. Dorry Segev, a Hopkins transplant surgeon who helped lead the research. “Just because you’re fully negative after two doses doesn’t mean that there’s no hope.”

Next up: Working with the National Institutes of Health, Segev’s team hopes to begin a more rigorous test of a third vaccinatio­n in 200 transplant recipients this summer.

For transplant patients, powerful immune-suppressin­g drugs prevent rejection of their new organs but also leave them extremely vulnerable to the coronaviru­s. They were excluded from initial testing of the COVID-19 vaccines, but doctors urge that they get vaccinated in hopes of at least some protection.

Some do benefit. The Hopkins team recently tested more than 650 transplant recipients and found about 54% harbored virus-fighting antibodies after two doses of the Pfizer or Moderna vaccines - although generally less than in otherwise healthy vaccinated people.

It’s not just a concern after organ transplant­s. One study of patients with rheumatoid arthritis, lupus and other autoimmune disorders found 85% developed antibodies, said Dr. Alfred Kim of Washington University in St. Louis. But those who used particular kinds of immune-suppressin­g drugs produced dramatical­ly lower levels that are a cause for concern.

“We tell our patients to act like the vaccine is not going to work as well as it does for their family and friends,” said Kim, who would like to test a third dose in autoimmune patients, too. “This is very frustratin­g news to them.”

Doctors sometimes give extra doses of other vaccines, such as the hepatitis B shot, to people with weak immune systems.

And guidelines issued in France recommend a third COVID-19 shot for certain severely immune-suppressed people, including transplant recipients, Segev noted.

The US hasn’t authorized extra COVID-19 vaccinatio­ns. But around the country, a growing number of immune-compromise­d patients are seeking third doses on their own - the people Hopkins sought to test.

In San Francisco, Gillian Ladd agreed to blood tests before and after an extra dose. The recipient of a kidney and pancreas transplant, Ladd, 48, was terrified to leave her house after learning she had no measurable antibodies despite two Pfizer shots.

Precaution­s

With the additional dose, “I had gotten what I needed in order to survive,” Ladd said, but she’s still is sticking with masks and other precaution­s.

“I am being as careful as I possibly can while acknowledg­ing that I’m coming back into the world of the living,” she said.

Further research is needed to tell if a third dose really helps, who’s the best candidate and if there are brand difference­s - plus whether the extra immune stimulatio­n could increase the risk of organ rejection.

But Segev cautions boosters aren’t the only possibilit­y. In addition to antibodies, vaccinatio­ns normally spur other protection­s such as T cells that can fend off severe illness. He and several other research groups are testing whether immune-compromise­d patients get that benefit.

For now, “the best way to protect these people is for others to get vaccinated” so they’re less likely to get exposed to the coronaviru­s, stressed Washington University’s Kim. ❑ ❑ ❑ South Africa’s COVID-19 vaccine rollout has been hit by further delays as it will have to discard at least 2 million Johnson & Johnson vaccines produced in the country.

The vaccines were found by the U.S Food and Drug Administra­tion to be unsuitable for use due to possible contaminat­ion of their ingredient­s at a Baltimore plant. South Africa was expecting to use them to inoculate its health care workers and people aged 60 years and older.

This is the latest setback to South Africa’s vaccine rollout which has so far given shots to just over 1% of its 60 million people.

Early this year the country rejected about 1 million doses of the AstraZenec­a vaccine it received from the Serum Institute of India after a small, preliminar­y study found that the vaccine offered minimal protection against mild to moderate cases of the COVID-19 variant that is dominant in South Africa. Those vaccines were sold to the African Union for distributi­on to other African countries.

To date, the country has given jabs to more than 1.7 million people, including nearly 480,000 health workers who were inoculated as part of a study trial of the Johnson & Johnson vaccine.

The production of the J&J vaccine at South Africa’s Aspen Pharmacare manufactur­ing plant in the eastern city of Gqeberha, formerly known as Port Elizabeth, was eagerly awaited to give a much-needed boost to the country’s vaccinatio­n drive.

The factory has contracted with J&J to produce the vaccine using large batches of the basic ingredient­s supplied by Johnson & Johnson. The South African plant then blends those components and puts them in vials - a process knowns as “fill and finish.”

The South African plant has the capacity to produce about 200 million doses annually of the J&J vaccine and had already manufactur­ed 2 million. But they were produced using ingredient­s from the Baltimore plant and therefore must not be used, according to the ruling by the FDA and South Africa’s health officials.

The South African Health Products Regulatory Authority issued a statement saying it had “reviewed the data provided by the FDA and has made a decision not to release vaccines produced using the drug substance batches that were not suitable.”

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