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Are Covid vaccines safe in the immunocompromised?

A study led by the Primary Immunodeficiency Unit of the Bellvitge University Hospital (HUB) and the Bellvitge Biomedical Research Institute (IDIBELL) indicates that SARS-CoV-2 vaccines are safe and effective in most patients with immunodeficiency .

As the researchers point out, although vaccines are being very effective in people with a competent immune system, the response that people with immunosuppression may have is not yet well established. Thus, the article, published in the journal Frontiers in Immunology shows that three out of four people with a serious immune system defect called common variable immunodeficiency produce antibodies and mount a correct immune cell response to vaccination.

On the other hand, half of the people who for medical reasons take medication that reduces the number of B cells, the antibody-producing cells, do not generate an adequate antibody response after SARS-CoV-2 vaccination, but they do show a protective cellular response in almost all cases.

It is lower than that of the healthy population.

Therefore, despite the apparent lack of a protective antibody response, these individuals also benefit from the protection conferred by these vaccines through the cellular response. The main researcher at IDIBELL and a specialist at the Bellvitge Hospital Internal Medicine Service, Dr. Xavier Solanich, points out that the efficacy of these vaccines in people with immune defects is lower than that of the healthy population, but “it is still very high” and, therefore, it is an “essential” prevention measure for this group.

The study also identifies predictive factors, such as the levels of certain immune system cells, that indicate whether or not a patient with birth defects will respond to the SARS-CoV-2 vaccine. “Having predictive factors can be very useful in clinical practice because it can allow us to anticipate certain situations. In our study we have been able to determine only one of the subgroups of patients and, therefore, new studies are necessary in this regard” , declares the first author of the article and researcher at IDIBELL and the Bellvitge University Hospital, Dr. Arnau Antolí.

The researchers finally point out that not having developed an ideal response to vaccination does not imply that these patients should have severe Covid-19. In fact, the evolution of Covid-19 is partly determined by immunosuppression, but it depends to a large extent on many other factors, such as advanced age or certain comorbidities.

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