‘Significant’ number of patients with chronic diseases had low response after two Covid vaccines
A ‘significant’ number of people affected by a range of chronic conditions showed a low immune response after two Covid vaccines, a new study found.
Early data from a major trial led by the University of Glasgow involving 600 patients with conditions such as inflammatory athritis or bowel disease, cancer or diseases of the kidney or liver found that 40% had a low serological immune response.
Approximately 11% failed to generate any antibodies four weeks after two vaccines and it was most common in patients with ANCA-Associated Vasculitis who had received the drug Rituximab.
The study used a variety of state-of-the-art immune tests performed on blood samples taken before and/or after vaccines.
The proportion of patients with lower levels of antibody reactivity was dependant on the disease.
It affected 90% of those with Rituximab treated ANCA-Associated Vasculitis, 54% of those with inflammatory arthritis, 21% of those on haemodialysis, 42% of those on Haemodialysis receiving immunosuppressive therapy, 17% of those with solid cancer and 33% of those with Haematological malignancies.
Prof Iain McInnes, lead of the OCTAVE trial, and Vice Principal and Head of the College of MVLS at the University of Glasgow, said: “The roll-out of the vaccine programme was extremely important for these vulnerable groups of patients, however due to their underlying medical conditions and treatments, which can weaken their immune systems, we were concerned that people with these medical conditions may not receive optimal protection, so it was, and remains, extremely important to investigate this unanswered question.
“While 40% of these clinically at-risk patent groups were found to have a low or undetectable immune response after a double dose of the vaccine, we are encouraged that this figure isn’t higher.
“However, it is possible even partial protection may be clinically beneficial, and this is something we will closely monitor.
“There are also imminent plans in place to investigate the effects of administrating an alternate vaccine dose to the group with an undetectable or low vaccine immune response; and we hope these findings will support the role out of an immunological screening programme for vulnerable patients to identify those who will benefit from a subsequent vaccine boost.”
Professor Pam Kearns, Director of the University of Birmingham’s Cancer Research UK Clinical Trials Unit which is co-ordinating OCTAVE, said the preliminary results would be instrumental in helping inform how best to vaccinate patients with chronic conditions in the future.
Dr Rob Buckle, Chief Scientist of the Medical Research Council, part of UKRI, which co-funded the trial, said: “Today’s results will be of concern for the subset of people within those who are immunosuppressed for whom the vaccine didn’t trigger a large protective response.
“We’re funding an extension to the OCTAVE study to give third jabs to this group, which we hope will deliver a much-needed immunity boost, or identify those who could benefit from other interventions.
“One of the real strengths of the UK’s scientific response to the pandemic has been the way that we’ve assembled teams of experts to lead cutting-edge and responsive studies like this, to inform our vaccine roll-out and government decision-making in real time.”
So far more than 2,500 patients have been recruited to the The OCTAVE (Observational Cohort Trial-T-cells Antibodies and Vaccine Efficacy in SARS-CoV-2) trial making it one of the largest global studies in which detailed immune response is being assessed post-vaccination.
The universities of Birmingham, Oxford, Liverpool, Imperial College London and Leeds Teaching Hospitals NHS Trust are also involved.
As the study progresses, around 3000 people will be recruited. Participants have all received either the Pfizer or AstraZeneca vaccines.
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