According to a recent publication in the American Journal of Transplantation, the efficacy of a mRNA vaccine against treatment for COVID-19 disease is 77% for immunocompromised patients, compared with 90% for immunocompromised patients, and varies in different subgroups of patients. The Doctors of the Therapeutic Clinic of the Medical School of the National and Kapodistrian University of Athens Theodora Psaltopoulou, Panos Malandrakis, Giannis Danasis and Thanos Dimopoulos (Rector of EKPA) summarize the data.
Certainly the immunocompromised benefit from the vaccine, but they are less protected than the healthy from the severe form of the disease. Those immunosuppressed according to the CDC guidelines are advised to receive three doses of vaccine and one dose of booster and in case of illness to be closely monitored both for possible exacerbation of the disease and for immediate administration of other possible treatments (eg monoclonal antibodies).
Between January and September 2021 in data from 187 hospitals in 9 US states, 53% of immunocompromised patients (10564 from 20101 people) and 43% of immunocompromised patients (29456 from 69116) were fully vaccinated respectively receive two doses of a mRNA vaccine (Pfizer or Moderna) more than 14 days before the day of hospitalization. Among the immunocompromised, 41% had received the Moderna vaccine and 59% had received the Pfizer vaccine, and the corresponding rates for the immunocompromised were 42% and 58%, respectively. The efficiency seemed to reach 90% in the healthy, while 77% in the immunocompromised patients.
This percentage ranged from 59% for solid organ or hematopoietic cell transplants, to 81% in patients with rheumatic or inflammatory diseases. The efficacy of the Moderna vaccine for the immunocompromised was 81% and that of the Pfizer vaccine at 71%, although the areas of reliability of the two percentages overlapped. This reduced efficacy for the immunosuppressed was seen both before and during the delta strain.
The authors conclude that immunocompromised patients should continue to use the mask as a preventative measure, it is important to be candidates for treatments that reduce the risk of developing a serious disease such as monoclonal antibodies, and more studies to determine the effectiveness of vaccines in various subgroups of immunocompromised patients around the world are needed. It is important for these patients to receive the fourth dose of the vaccine, 3 to 6 months after the third dose, according to recent decisions in Greece.
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