The 2003 study you cited above talked about "emergent" data that vaccines could help immunocompromised/immunodeficiency and immunosuppressed patients. That term is still used in reports from 2021. It represents a desire to find a correlation rather than proving one.
You asked for a citation. Don't get too excited by the headline.
However, people treated for autoimmune conditions produce weaker responses than healthy people
medicine.wustl.edu
As I pointed out in post #115, mRNA vaccines can elicit weak immune responses in about 90% of triple-vaccinated immunocompromised recipients, the antibody load is only a tad over 30% of the antibodies an uncompromised immune system would produce. Whether this is enough of an antibody load to fight an aggressive viral infection is unlikely but is nonetheless being debated in the literature.
From my cited article:
There is as yet no evidence clearly indicating that immunocompromised or immunosuppressed patients get any real benefit from vaccination. I wish it were otherwise, but the data is simply not there to support such a claim.
Worse still the weak antibody load is short lived in immunocompromised and immunosuppressed individuals so any benefit which may yet be discovered will very likely be short-lived.
Thus, at this point in the research, there is no reliable data that immunocompromised and immunosuppressed patients derive any effective benefit from vaccination and thus are as susceptible to infection as the unvaccinated, due to their compromised or suppressed immune systems. I really hope we find the supporting data, but that's where we stand right now as far as I know.
Cheers and be well.
Evilroddy.
The problem is the doctors are investing massive resources into this and every transplant. In the face of uncertain evidence, no evidence of benefit, no evidence vaccines do not provide benefit, what's their obligation? To wait for the research to prove to them beyond any doubt or beyond reasonable doubt that the vaccine does lower the odds of death?
I'm also certain that the immune response to vaccines and the course of COVID will vary tremendously from person to person, and the data show this variability. The transplant team cannot know in advance the antibody response to this patient to the vaccine until they give him the vaccine, then measure the response, to the vaccine, then exposure to COVID. What happened on average isn't helpful, and their obligation, their duty, is to tilt the odds as far in favor of life, versus death. In uncertainty, how does it make sense to withhold vaccines given that duty?
You also don't know because no one does what level of antibodies provide what level of protection against COVID. Is 30% enough? We don't know. More to the point, is 30% better than 0%? If it's your family member, would you prefer they have 30%, or 0%, in the face of uncertain evidence, given the data so far is clear that vaccines pose no significant risks to the patient, and that COVID poses a massive risk to post-transplant patients?
And you say they're not trying to "prove" benefit, but how would you do that? You'd have to randomly assign transplant patients to the vaccine or no-vaccine group, see them exposed to COVID, and count up how many died. That study is obviously impossible. Alternatively, the transplant team has to willingly allow a patient to refuse the vaccine when there is no evidence the vaccine provides no protection, and they know and we know that transplants lower immunity.
Your sources also refer to transplant patients, but he's not a patient yet. He's on the list, and likely hasn't started on the cocktail of powerful immunosuppressants. That's why the article I cited recommended those vaccines prior to, rather than post, surgery.
Finally, it's been routine for transplant centers to require other vaccines prior to surgery or to get and stay on the list. Nothing changes here. All that has changed is vaccines are a political issue, versus a medical one we've left to the transplant team. Now patients are their own 'experts' and demand the 'freedom' of choice, but that there be no downside to their choices.
