Johns Hopkins Transplant Vaccine study

[iolaire]

iolaire, it looks like one needs a passcode to access the recording.  Did you participate/have you seen the recording?  If so, is there anything we would learn from it that you have not shared with us already?  Thank you!

Sorry I've trashed my invitation.  There is an email on the website try emailing that to see if they will let you watch it.  I tried to share everything but you probably would come back with other notable items.

[Simon Dog]

I believe there are different standard dosages depending on whether you take the original Cellcept or the delayed release Myfortic. I am only familiar with the Myfortic dosing.

The composition is such that you need different dosages to get the same amount of active ingredient.

[MooseMom]

Not to worry, iolaire.  You're always very good at telling us all of the relevant information you're given, and thanks again for that.

[kristina]

Hello again and I finally had my second Pfizer-vaccination and fortunately this time it went a little bit better afterwards and I feel a little better and hopefully "it" remains like that ...

 ... I was told to remain very careful and thoughtful at the same time about what I am doing/touching when going out, seeing doctors etc., just in case. I was also told that having had both my Pfizer-vaccinations should not "lead me into a false sense of security" and I should continue to be extremely careful, also because of my "underlying conditions" like my kidney-transplant plus "my" Systemic Lupus & MCTD.

Good luck to everyone and best wishes from Kristina.

[iolaire]

Looking in the footnote of the John Hopkin's study letter I found reference to this letter (Free):
Early Development and Durability of SARS-CoV-2 Antibodies Among Solid Organ
Transplant Recipients: A Pilot Study
https://journals.lww.com/transplantjournal/Citation/9000/Early_Development_and_Durability_of_SARS_CoV_2.95419.aspx
This was a very small study of 18 transplant patients who were positive tested for COVID.  Its an interesting read, 3 of 18 went to ICU, 1 ventilated and most developed antibodies.
Most participants (89%) had experienced COVID-19 symptoms; 72% were hospitalized. Among those hospitalized, 15% were admitted to the ICU and 8% were mechanically ventilated. COVID-19 convalescent plasma (CCP) was administered to 3 kidney and 2 lung recipients.  ... In this study of antibody development among immunosuppressed SOTRs, we found antibody levels suggestive of neutralizing immunity in the majority of participants. ... Interestingly, among those who had more severe disease, there was a trend towards higher antibody levels.

[iolaire]

I spoke to a transplant pharmacist this morning.  We talked quickly about the antibodies.  She was wondering what study I was getting my information from, and she acknowledged that the John Hopkins study is the only study transplant specific.  I asked if there were other studies she was following and she said for transplant specific it was Hopkins - but she made some comments along the lines of in the formal trials of the vaccines they had HIV patients and other immune compromised people and that there was delayed antibodies.  I didn't get clear specifics but she made the comment along the lines that some trial participants were waiting 4-6 months for the antibodies to show up.  I asked now that the the transplant center was allowed to provide vaccination to DC patients did they have a preferred provider over Pfizer and Moderna, she said they are giving Pfizer.  I could not tell if that is what they can get but she said they basically didn't have a preference (interesting since the Hopkins initial report showed advantages from Moderna) but Pfizer is a few percentage points better.  (I was unable to make notes as we talked.)

So informative, but as always the vaccine available to you the one get...  Hopefully in a few months all of our transplant centers will start having communications about antibodies and such.  Its amazing that we are were we are already just over 13 months after COVID became real here in the US.

[iolaire]

This is a good article about people with weak immune systems not creating antibodies.  I'm glad this type of article is coming out because there is a fairly large group of people with the same worries as us.
Vaccines Won’t Protect Millions of Patients With Crippled Immune Systems
https://www.nytimes.com/2021/04/15/health/coronavirus-immune-system.html

[MooseMom]

LOL, iolaire, just 30 seconds ago, I finished reading this from The Atlantic.

https://www.theatlantic.com/science/archive/2021/04/immunocompromised-vaccine/618596/?fbclid=IwAR2TJs3_H8vgIMvEWRmI0bCXGv_7kiyIBds3_Y8p2Gt3lHR6cuoiWRmI7G8

Thanks for the NYT link.  I had actually been wondering about monoclonal antibodies possibly being used as a preventive measure rather than just a treatment.  I'm glad to see this addressed in this article.

[iolaire]

LOL, iolaire, just 30 seconds ago, I finished reading this from The Atlantic.

https://www.theatlantic.com/science/archive/2021/04/immunocompromised-vaccine/618596/?fbclid=IwAR2TJs3_H8vgIMvEWRmI0bCXGv_7kiyIBds3_Y8p2Gt3lHR6cuoiWRmI7G8

Thanks for the NYT link.  I had actually been wondering about monoclonal antibodies possibly being used as a preventive measure rather than just a treatment.  I'm glad to see this addressed in this article.

Great your article has this quote from the transplant study.
Dorry Segev, a transplant surgeon and an author of both studies, told me that his team will soon publish data that show those percentages do drop after the second vaccine dose, down to below 50 percent or so in the transplant group.
So that’s sort of our target a month out where we hope to be part of the 1/2 of people with antibodies a month after the second dose rather then the 1/5 with antibodies a month after the first dose.

[iolaire]

Also
Robin Avery, one of the authors on the Johns Hopkins transplant study, told me. Even if antibody levels fall below the as-yet-undefined threshold of complete protection, the molecules might still be abundant and potent enough to curb the severity of symptoms, as they often do when the flu vaccine is given to people who are immunocompromised.

[UkrainianTracksuit]

This is a webinar hosted by The Transplantation Society that gathered some brains together.

The first half is a lot of basics about corona and the vaccine. At 42:00 (or around there), we get into more interesting topics. The Hopkins study was briefly mentioned. If you listen to the rest of the webinar from there, you’ll hear mentions that “antibodies aren’t everything” and other matters such a T-cell production as well as cellular immunity haven’t been investigated, but they’re important.

As well, they don’t know “clinically” how lack of protection will look just yet. Long story short — it’s early going.

Link if anything piques your fancy: https://tts.org/index.php?option=com_content&view=article&id=894&Itemid=119

[iolaire]

Thank you UT, that was a good overall background on covid and transplants including the vaccine response.  Again they said they are seeing vaccinated transplant people in the hospital so be careful.

I will say I scheduled a J&J shot last week and told Hopkin's I was going to do it.  I didn't get the shot because it was pulled and at the same time my center responded to my inquiry of the day before with a recommended against the additional J&J shot because of it being stopped.  Down here in Ashville there is LOTs of supply.  Hopkins responded asking if I wanted to participate in another study J&J related looking at T and B cell response, it would have required 5 vials of blood sent to Hopkins which would have been a problem because I'm on vacation and it would have been difficult to find some place willing to pull the blood.  Anyway it didn't happen, but I'm happy to know they are looking at those T & B cells because that keeps being suggested as a non measure thing that might help us beyond antibodies.  On Monday the 26th I'll get my 1 month after the second dose antibody test.

[UkrainianTracksuit]

Iolaire, indeed, that was one of the more stark moments of that talk: transplant patients who have been fully vaccinated still ending up in hospital. Definitely a good reminder to treat this thing as seriously as in the beginning.

Thank you for sharing that info about the T & B cells study! (Even though it did not pan out on your end.) Obviously, someone had to be studying it because it is an area of investigation that may denote some sort of protection outside of antibodies, but it feels almost good to know for certain a place like Hopkins is doing it.

[kristina]

There was an interesting Covid-research taking place in Italy (also in Sicily) about kidney-transplants and the Covid-Virus:

https://link.springer.com/article/10.1007/s40620-020-00794-1?sap-outbound-id=C756B690CF83C55C21C5475BAD1C850E964E8010&utm_source=hy

[iolaire]

I received my antibody results for my one month after my second shot (Pfizer) today.  My negative to antibodies range is unchanged at <0.40 - that's the same range I had prior to my first vaccination shot.
SARS-CoV-2 Semi-Quant Total Ab
SARS-CoV-2 Semi-Quant Total Ab
<0.40
Reference Range:  <0.80 U/mL
This sample does not contain detectable antibodies against the
SARS-CoV-2 spike protein receptor binding domain (RBD).
                                                  Interpretation:
                                                    Negative    <0.80
                                                    Positive    >0.79

J&J shorts are again available same day around my temporary home so I'll probably get one of those soon.  Its time for an AlloSure test so I might have a phlebotomist coming by, if that happens maybe I can get Hopkin's blood tubes filled.

My work is trying to motivate vaccinated (only) people back into the office.  They are running daily drawings of $10,000 to people in our offices so its clear that as some point soon real pressure will develop to get everyone back in the offices.

[MooseMom]

iolaire, I have heard anecdotally from a few people who do take mycophenolic acid and have had both shots that they have developed antibodies after 2 months.  I don't know if this is just a fluke or if it is a real reason for hope.  I'm not quite sure to make from these stories, and I have not heard any verification of this from any "official" medical body.

What is your reasoning behind getting the J&J shot?  Is this something JH or your tx clinic has proposed/recommended?

[fifal9]

I know you didn't ask me MM, but I was hoping to get the J&J shot because I hate needles and it means one less needle in my arm.

But I was also told to do the right thing by not 'vaccine shopping' and the J&J vaccine was pulled out of circulation, so I ended up with Pfizer.
I've was on Cellcept (which I think is mycophenolat) when I got the first shot, but I'd already been having a lot of GI issues with it and my Dr has now switched me.
I get my second shot on Saturday.

I really hope it works. I hate the thought of getting shot up with needles and not have it do any good.

 

[iolaire]

Thanks M&M.  J&J is a different technology so I'm interested in that. Plus I'm away from home so I don't want to think beyond the single shot.

[MooseMom]

Thanks M&M.  J&J is a different technology so I'm interested in that. Plus I'm away from home so I don't want to think beyond the single shot.

Oh, I'd be interested in the J&J, too.  Did you ask your tx clinic if they thought this might be worthwhile, or did you just decide for yourself that you might as well; why not?  Do you know other people in the study who are considering doing the same?

[MooseMom]

I know you didn't ask me MM, but I was hoping to get the J&J shot because I hate needles and it means one less needle in my arm.

But I was also told to do the right thing by not 'vaccine shopping' and the J&J vaccine was pulled out of circulation, so I ended up with Pfizer.
I've was on Cellcept (which I think is mycophenolat) when I got the first shot, but I'd already been having a lot of GI issues with it and my Dr has now switched me.
I get my second shot on Saturday.

I really hope it works. I hate the thought of getting shot up with needles and not have it do any good.

I hope it works for you, too!  If you have to have a needle stuck into your arm, you want there to be a point!  (pun intended lol).

[tigtink]

Here's a Mayo Clinic study from Florida that just came out. It is a small sample, only seven people, 2 who received one dosage of mRNA vaccination and 5 who received both shots. All tested positive for COVID after vaccination and only one showed any antibodies after vaccination.

https://www.eurekalert.org/pub_releases/2021-04/mc-mcr042621.php

[iolaire]

Thanks tigtink that is a good writeup.  I feel like fairly soon there will be more pressure from my work to get back into the office so real papers like this will be helpful should I need to justify my risks.

[MooseMom]

Thanks M&M.  J&J is a different technology so I'm interested in that. Plus I'm away from home so I don't want to think beyond the single shot.

Have there been any studies on the efficacy of the J&J vaccine on SOT patients?  All of the studies so far seem to feature only the mRNA vaccines, but I might have missed something.

[iolaire]

Thanks M&M.  J&J is a different technology so I'm interested in that. Plus I'm away from home so I don't want to think beyond the single shot.

Have there been any studies on the efficacy of the J&J vaccine on SOT patients?  All of the studies so far seem to feature only the mRNA vaccines, but I might have missed something.

I have seen nothing on the J&J. Hopkins seems fairly happy to have me in the J&J study. I have an AlloSure blood draw on Tuesday so I’ll try to get the blood for Hopkins then and get the J&J shot soon afterwards.

At this point it looks like the pressure is building for return to the office, and we want to continue to do more out things so I feel like it’s best to give J&J a try. It’s an easier decision since vaccinations are readily available here.  I signed up on a grocery pharmacy website on Sunday (trying to see availability slots) and received a message on Monday both that Moderna and J&J was available as soon as that day.

I feel like it can not hurt to much to get it since things are looking poor on the mRNA side.

[MooseMom]

Apologies, iolaire, as I must be having some sort of brain fog, but to make sure I am understanding, you are in a J&J study that is not affiliated with Hopkins?  Is that right?  Who's conducting the study?  The J&J vaccine is easily available (or, so I understand) here where I live, so I am seriously considering getting it, too.  I can't see where it would hurt, but I think I'd talk to my clinic first.

Please keep up updated on this!  Thanks, and good luck!