Immunosuppressed individuals should stay vigilant even if vaccinated, experts say

Featured photo: Gabrielle Hellinger and her daughter, Tillie, are taking extra steps to be careful because of Gabrielle’s immunosuppressed condition. (courtesy photo)

I got my first coronavirus vaccine in early March.

The process went smoother than I could have hoped for, especially given all the panic around signing up for an appointment. But before the volunteers gave me the shot, they told me I might not get the full benefits from the vaccine.

That is because I’m on a medication for Crohn’s disease called Remicade, which suppresses the immune system. Given the significance of this information, you’d think my doctor at the time would have said something earlier.

While the CDC and medical experts are still advicing people with underlying health conditions to get the vaccine as there don’t appear to be any adverse effects, a few early studies have found that post vaccination, 15 to 80 percent of immunocompromised individuals produced fewer antibodies, making them more susceptible to contracting COVID-19 than others who were vaccinated.

Winston-Salem resident Gabrielle Serang Hellinger is in a similar situation. Hellinger is on a medication called Ocrevus for multiple sclerosis, which decreases B cell function that is necessary to help the body fight off infection. Many other conditions, such as lupus, rheumatoid arthritis, type 1 diabetes and cancer may also also decrease immune function or require medication that suppresses the immune system.

“It’s something that, if you add up everyone who would be impacted, it’s a lot of people,” Hellinger said. “Everyone who has had a cancer treatment or an autoimmune condition. Everybody knows somebody. It’s not that rare.”

Hellinger has done much of her own research on infectious diseases and immune function regarding the vaccine. She also reached out to her doctor, who told her to continue practicing social distancing and not to take very many risks.

Still, she feels for her kids, ages 11 and 13, who will also have to continue to be very careful. Tillie, 13, recently received her first vaccination.

“She’s counting down the days until her next dose,” Hellinger said. “But she was really looking forward to the end of the whole thing.”

Tillie usually goes to theater camp for the summer. It was cancelled in 2020, but she was hoping to go this year, Hellinger said. Given that the CDC is no longer advising people who have been vaccinated to wear masks, she does not feel comfortable sending her daughter.

“That was her struggle, that she had that expectation that it would be her passport to freedom, and it isn’t,” said Hellinger. “Even if she has her vaccine, she might get it and bring it home.”

Jillian Staiti also has MS and was on the same medication as Hellinger from September 2019 to April 2021. Now, she takes Tysabri, which works by stopping harmful cells from crossing into the brain and spinal cord.

Recently, Staiti got a spike protein antibody test for COVID-19 and tested positive, which she said was a huge relief. Because she had been on Ocrevus recently, her doctor was not sure her B cells would have replenished themselves in time for her vaccine.

Staiti’s household also includes her husband and three children, only one of whom is currently old enough to get the coronavirus vaccine. Her husband had been working out of the house for the past year, though Staiti says he has been very careful.

“There was a possibility it might have been more severe for people on Ocrevus,” she said of the virus. “It’s super important people get vaccinated because of populations that are at risk or can’t get vaccinated. I feel like people forget that.”

Doctors recommend people with certain conditions continue to socially distance, wear masks and see friends and family outside when able, though they are not sure just how cautious people need to be in these cases.

Dr. Carl Fichtenbaum, a doctor of infectious disease conducting vaccine research at the University of Cincinnati College of Medicine, says enough studies on people with compromised immune systems hasn’t been conducted, though that is beginning to change.

“Almost all of the major studies excluded people with immune conditions,” Fichtenbaum said. “Anyone can be vaccinated because we don’t see any harm, but they want to take some precautions still.”

Regardless, Fichtenbaum advises those on medications consult with their doctors.

“We’ve been looking very carefully at what recommendations to make, recognizing that we don’t have all the information yet,” he said. “It’s frustrating for those people, for their families and for healthcare providers because we like to be able to give people answers.”

To learn more about immunocompromised people and vaccinations, visit the CDC’s website here.