We don’t yet know how effective COVID vaccines are for people with immune deficiencies. But we know they’re safe — and worthwhile


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Vanessa Bryant, Walter and Eliza Hall Institute and Charlotte Slade, Walter and Eliza Hall InstituteThe COVID vaccine rollout is underway in Australia, with people in phase 1b now eligible to be vaccinated.

So far, we have two vaccines available in Australia: the Pfizer/BioNTech vaccine, approved for people aged 16 and older, and the Oxford/AstraZeneca vaccine, approved for those over 18. Evidence has shown both vaccines are safe and offer near-complete protection against severe COVID-19, hospitalisation and, most importantly, COVID-related death.

Both vaccines are also safe and effective at generating immune responses in the elderly. But what about another vulnerable group — people with immunodeficiencies? Many people with immunodeficiencies are included in group 1b and will now be thinking about getting their vaccine.

Although we’re still gathering data to determine whether COVID vaccines will work as well in people with immunodeficiencies as they do in the general population, they’re likely to offer at least a reasonable degree of protection. And importantly, we know they’re safe.

What are immunodeficiencies?

Immunodeficiencies are conditions that weaken the body’s ability to fight infection. People’s immune system may be compromised for many reasons, and this can be transient or lifelong.

Primary immunodeficiencies occur when some or all of a person’s immune system is missing, defective or ineffective. These are rare and often genetic diseases that may be diagnosed early in life, but can occur at any age.

Examples of primary immunodeficiencies include severe combined immunodeficiency (SCID) and common variable immunodeficiency (CVID).




Read more:
What does it mean to be immunocompromised? And why does this increase your risk of coronavirus?


Secondary immunodeficiencies are acquired, and more common. They may occur as a result of other diseases (for example, via HIV infection), treatments and medications (such as chemotherapy or corticosteroids), or environmental exposure to toxins (for example, prolonged exposure to heavy metals or pesticides).

Sometimes the immune system in people with immunodeficiencies can react in exaggerated ways too, and cause autoimmune disease (such as rheumatoid arthritis or gut inflammation). So it sometimes makes more sense to describe the immune system as “dysregulated”, rather than “deficient”.

An illustration of SARS-CoV-2, the virus that causes COVID-19.
People with immunodeficiencies are more susceptible to being infected with viruses, such as SARS-CoV-2.
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Immunodeficiencies, COVID-19 and vaccines

People with secondary immunodeficiencies are generally at higher risk of becoming infected with SARS-CoV-2 and of developing severe disease. Surprisingly, although people with primary immunodeficiency may be at greater risk of getting infections, including COVID, most are no more susceptible to developing severe COVID compared with the overall population.

This may be because the most severe COVID-19 symptoms are usually not due to gaps in immunity, but to an overactive immune response to SARS-CoV-2.

In fact, immune-suppressing steroids may be an effective treatment for severe COVID. Clinical trials looking into this are underway.

However, as vaccines work by mobilising our immune systems, for people who have a weaker immune system to begin with, vaccines may not be as effective. They may generate an incomplete or short-lived response, so people with immunodeficiencies may need additional boosters to maintain protective immunity.




Read more:
What is a virus? How do they spread? How do they make us sick?


Efficacy and safety

It’s difficult to assess COVID vaccine efficacy in people with immunodeficiencies, because people with primary immunodeficiencies or cancer weren’t included in clinical trials.

A very small number of people with HIV have been included in trials of a few of the vaccines, but limited data is publicly available. So it’s too early to draw any firm conclusions on whether the vaccines will be as effective in people with HIV as for the general population.

We also don’t yet know how long immunity to COVID-19 or COVID vaccines lasts. This will be particularly important for immunodeficient people. Research is underway to determine whether they’ll need booster jabs more frequently to maintain immunity.

A woman wearing a head scarf looks out the window.
Clinical trials of COVID vaccines haven’t generally included people with immunodeficiencies.
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We do know the vaccines are safe for this group.

Neither the AstraZeneca nor the Pfizer vaccines can cause an infection, so they won’t present a problem for people with immunodeficiencies (or for elderly people, who may also have weakened immune responses).

Usually, we avoid giving “live attenuated” vaccines (vaccines that contain weakened elements of the virus) to anyone with immunodeficiency. Because of their weakened immune systems and increased susceptibility to infection, there’s a chance they could develop a full-blown infection. An example of this is the chickenpox vaccine. But no live attenuated COVID vaccines have been approved anywhere in the world.

Preliminary evidence from vaccine rollouts around the world has shown COVID vaccines are safe for immunocompromised people with cancer. Although, if you’re going through cancer treatment, you should discuss the timing of your vaccination with your specialist.

There have been no unusual safety concerns to indicate any increased risk for HIV-positive people receiving any of the COVID vaccines either.

Get the jab

Vaccination is most definitely recommended for people with immunodeficiencies, and they’re included in priority groups for vaccine rollout in Australia. Group 1b includes people with underlying medical conditions which may place them at higher risk from COVID-19, including “immunocompromising conditions”.

If you have a diagnosed immunodeficiency or autoimmune disease, you can talk to your doctor or specialist for specific advice on the timing of your COVID vaccination and your condition. There’s generally no reason to change your normal medications or therapies before receiving the vaccine.

Organisations including the Australian Society of Clinical Immunology and Allergy and the Immune Deficiency Foundation of Australia have published resources which offer guidance for people with immunodeficiencies in relation to COVID vaccination.




Read more:
The second phase of Australia’s COVID vaccine rollout is underway, despite a rocky start. Here’s what you need to know


The Conversation


Vanessa Bryant, Laboratory Head, Immunology Division, Walter and Eliza Hall Institute and Charlotte Slade, Laboratory Head, Immunology Division, Walter and Eliza Hall Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Digg and Diggnation


The Digg social network is in trouble. Digg is a place where people can share what they find on the web with others. There is a rating system of sorts – based on people ‘digging’ a post/site, which when done so is considered ‘dugg’ by the one doing the ‘digging.’ It had and has the potential to be a very useful site. However, as anyone who keeps up with developments in social networking and the like knows, Digg is in trouble. It is dropping users, with less and less people using the site and tools associated with the site. Recently Digg got an overhaul which has done nothing to stop the slide.

There was once a newsletter with the top ‘dugg’ stories of the day, but that seems to have vanished. I found it to be a useful newsletter.

To find out what Digg is all about visit:

http://digg.com/

I have been using Digg a fair bit of late and have always considered it to be a very useful site and experience.

My profile is at:

http://digg.com/particularkev

There is also a web television show known as Diggnation. I have just watched the latest episode of the show and I confess to believing the show is rubbish. It is not worth watching in my opinion and comes complete with terrible language and crass content. If the quality of the show is how we should take Digg it is no wonder it is in trouble. It is hosted by two men, with one being the founder of Digg – which does nothing for the credentials of Digg.

I still hold out hope for Digg, as it can yet be a very useful and worthwhile site and service.

Visit Diggnation at:

http://revision3.com/diggnation/

 

Time to Reassess Afghan Policy


There is no doubt in my mind as to the complete separation of the state and the Christian church. The United States government, the Australian government and all other governments involved in the war against terror are not acting as Christian Crusaders, but as responsible modern nations seeking to bring freedom from terror to oppressed peoples around the world. Having said that, in light of such articles as that previous in this Blog, perhaps it is time that the allies in the war on terror, reassess their policy on Afghanistan (and the same would be true of Iraq and Pakistan). Clearly, should the allies withdraw from the country, it seems relatively clear that it would only be a matter of time before the country moves towards an oppressive Islamic regime.

Why should western nations promoting human rights, democracy, freedom from terror and other worthwhile goals, continue to pour resources (human, financial, etc) into a country where overall, its citizens continue to espouse the rhetoric and policies of the enemy?  Already it seems clear that the principles of our freedoms are despised by the vast majority of the Afghan nation. Without a long-term commitment to police the country and keep the policies being promoted by the western allies, there is no point continuing the current mission in Afghanistan (or Iraq, Pakistan, etc). Do we have the capacity and the stomach to pay the price for such a continuing mission, when the undoubted price in human lives, finances and other resources, will continue to mount and become such that our own people will be unable to bear the dearness of the cost?

5000 VISITORS


This Blog had its 5 000th visitor today – a small milestone, but one that has amazed me. This is especially so given that there has been over 1240 visitors in the past week and 2232 visitors and counting so far this month. So there has been a dramatic increase in visitors to my Blog this month. On the 17th September this Blog had its highest number of visitors ever, with 387 on that one day.

So why mention this anyway – simply to say thanks for coming along and having a read. I appreciate it and hope the visit has been worthwhile.

Kevin for Particular Kev’s Random Thoughts