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Are COVID-19 vaccines safe for people with weakened immune systems? https://covid.joinzoe.com/post/covid-vaccines-immunocompromised Professor Ellie Barnes, Oxford University Causes of immunosuppression Auto-immune conditions (e.g. lupus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, Crohn’s disease) Genetic conditions Chronic diseases, liver, kidney disease, cancer Post organ or bone marrow transplant Complications of vaccination in immunocompromise Problems with live vaccines Measles, mumps, rubella Smallpox Yellow fever Reduced immune response may lower vaccine efficacy Are the COVID vaccines safe for people who are immunocompromised? Currently in UK, Oxford/AstraZeneca vaccine and the Pfizer vaccine Neither of these are live vaccines. And because of that, there's no theoretical reason why these vaccines would not be completely safe, even for people who are severely immunocompromised Pfizer mRNA vaccine No virus involved with that at all Oxford/AstraZeneca vaccine Viral vector carries RNA to cells Cannot replicate in cells or cause disease These vaccines have been shown to be very safe There's no reason why an immunocompromised person would have a different adverse effect profile, compared to a healthy person after receiving a COVID-19 vaccine Allergies Extremely rare Not expected to be more likely in immunocompromised people Vaccine efficacy in immunocompromise The phase three vaccines studies generally recruited healthy people and excluded people with severe disease and immunosuppressive therapy Although it’s likely that vaccines can provide some level of protection for people who are immunocompromised, right now we don’t have any solid data on how well COVID-19 vaccines will work in people with weakened immune systems OCTAVE study British Society for Immunology While COVID-19 vaccination might provide a lower level of protection in people who are immunosuppressed or immunocompromised compared with the rest of the population, it is still very important that you get vaccinated as it will offer you a certain amount of protection against catching COVID-19. It is important that you receive two doses of the vaccine to maximise the protection that vaccination offers you. COVID-19 vaccination will work best if you have a functioning immune system. It’s important to remember that the COVID-19 vaccines can protect you from getting seriously ill with COVID-19, although if your immune system isn’t functioning optimally this protection will not be complete.” Professor Ellie Barnes The vaccines will not harm you, and they may give you some protection So my advice to patients currently is: if you're offered a vaccine, take it When You’ve Been Fully Vaccinated Two weeks after second dose in a 2-dose series, like the Pfizer or Moderna vaccines Two weeks after a single-dose vaccine, like Johnson & Johnson’s Janssen vaccine https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html What Hasn’t Changed Keep taking precautions in public places, wearing a mask, 6 feet, avoiding crowds, poorly ventilated spaces until we know more In public Gathering with unvaccinated people Visiting an unvaccinated person Still avoid medium or large-sized gatherings Still delay domestic and international travel Still watch out for symptoms Still get tested if symptomatic Still self isolate Still need to follow guidance at your workplace. What’s Changed Gather indoors with fully vaccinated people without wearing a mask Gather indoors with unvaccinated people from one other household, unless any of those has an increased risk of severe illness If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms. However, if you live in a group setting, and are around someone who has COVID-19, you should still stay away from others for 14 days and get tested, even if you don’t have symptoms What We Know and What We’re Still Learning We know COVID-19 vaccines are effective at preventing COVID-19 disease, especially severe illness and death. We’re still learning how effective the vaccines are against variants We know that prevention measures help stop the spread of COVID-19, and that these steps are still important We’re still learning how well vaccines prevent spread We’re still learning how long vaccines can protect people. Estonia https://www.bbc.co.uk/news/live/uk-56330945 New lockdown from Thursday, education and shops UK variant Detection dogs in Germany https://www.dw.com/en/coronavirus-trained-dogs-detect-covid-94-of-the-time-german-study-finds/a-56447514 Esther Schalke, Armed forces school for service dogs 94% accuracy, even if asymptomatic From 1,000 + samples coronavirus odor, emitted from cells in infected people Holger Volk, Hanover's University of Veterinary Medicine

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