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While France is pre-emptively giving third shots to immunocompromised individuals and Israel is weighing its options, others are yet to move.
Experts have never tired of repeating that vaccination is our most potent tool in our fight against COVID-19. Recent studies have shown that nearly all of the casualties due to COVID-19 in recent months have been in unvaccinated individuals. But even as at-risk groups like pregnant women are given an all-clear to receive COVID-19 vaccines, others, like the immunocompromised, face a different problem.
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Immunocompromised individuals are people whose immune system is not working at full capacity. This may be due to underlying health conditions like leukaemia, HIV AIDS, genetic disorders; or because they are on immunosuppressive therapy for health conditions like organ transplants, autoimmune disorder or rheumatoid diseases.
The immunocompromised are particularly susceptible to COVID-19, simply because their immunity is substantially weakened. This would make them ideal candidates for being among the first to receive the vaccine.
Except for one problem.
Vaccines work by eliciting and, in essence, ‘training’ an immune response against particular viral agents, in this case SARS CoV-2. But how do vaccines work when the immune system itself is compromised?
According to the latest scientific findings, even when fully vaccinated, immunocompromised individuals have no to very little antibodies against COVID-19. The report revealed that even when 'fully vaccinated,' immunocompromised people are rarely any better off than what they started with against COVID-19. Not only does this open such groups to risk of infection, but it also generates a huge gap in the vaccine policy of any country.
There are no concrete estimates of the number of immunocompromised individuals in a country. But the ballpark figure for this segment is around 2-5 percent of the total population both in India and the US.
Dr Dorry Segev, transplant surgeon at Johns Hopkins University and lead author of the study, said, "They have to continue to act unvaccinated until we figure out a way to give them better immunity."
But some researchers opted for a simple solution, inoculating immunocompromised patients with a third dose of a vaccine in a follow-up study. The introduction of a third dose saw 33 percent of the patients who had no immune response from two doses finally develop antibodies, and the antibodies level being increased in the patients who had recorded low levels after two shots. While the second study was small in number, only 24 patients, it might pave the way for future research.
While medical practitioners in France are pre-emptively giving third doses of COVID-19 vaccine to immunocompromised individuals, with Israel examining the use of same, there are few or no plans for such people in other countries.
The study highlights the need for global and national inquiries on the effectiveness of COVID-19 vaccines for immunocompromised individuals. Further studies on the effectiveness of third doses, or a change in immunosuppressive medicine for those under therapy, also needs to be considered.
(Edited by : Shoma Bhattacharjee)
First Published: Jul 5, 2021 8:24 PM IST