Many people who are immunocompromised will not fully develop the appropriate antibodies after COVID-19 vaccination, but there is hope in the form of an alternative treatment.
Even with multiple COVID-19 vaccines and boosters, there are still groups of people who do not get the full benefit of vaccines due to immunosuppressed conditions that prevent the body from producing adequate antibodies. But an alternative treatment option is to give hope.
Known as Evusheld, the medicine contains protective antibodies against SARS-CoV-2.
The antibodies are given as two injections at the same time to a patient, and after injection, they are in the system ready to work if the patient in the future is exposed to another person with acute COVID-19 infection.
Vineeta Kumar, MD, Professor of Nephrology i University of Alabama at Birmingham‘s Marnix E. Heersink School of Medicinesays this is an effective option for immunocompromised populations, such as transplant patients.
“We know that transplant recipients develop less antibody response to the vaccine because of their immunosuppressive drugs,” Kumar said. “In other words, the medicine or the immunosuppressed state can prevent their body from producing adequate antibodies, and in some patients any antibody. This can result in a decrease in the vaccine’s ability to provide protection against COVID-19 infection.”
Kumar adds that this treatment is meant to be given before one person has been exposed to another with COVID-19 infection.
“Evusheld should not be used as a substitute for vaccination or for primary prevention strategies, including masking, social distancing, and avoiding large indoor social gatherings,” Kumar said. “Vaccination of close contacts, including household members, remains an important measure to protect transplant recipients from COVID-19 infection.”
For transplant patients, Kumar says it is crucial that they receive the infusion as soon as they are cleared after the transplant.
“Due to limited supply of Evusheld nationwide, patients given Evusheld first priority after transplantation or early after receiving medication that suppresses their immune system,” she said.
She says it is possible that Evusheld may reduce the body’s immune response to a COVID-19 vaccine. If someone has received the COVID-19 vaccine, they should wait at least two weeks after vaccination to receive Evusheld; but booster doses of vaccine can be given at any time after Evusheld has been administered.
“We will continue to monitor the response of the new virus variants to this infusion,” Kumar said.
UAB and doctors across the state are still working to ensure that as many people as possible have it.
“And these include referrals through our state Department of Public Health and referrals from other medical centers,” said Anoma Nellore, MD, associate professor of Department of Infectious Diseases. “We want to make sure all patients are protected.”
At UAB, Kumar Robert and Cutessa Bourge are gifted professors of transplant nephrology.