Four in 10 immunosuppressed people have low protection after two jabs

Four in 10 immunosuppressed people have ‘low or undetectable’ levels of Covid antibodies after two vaccines, Government-funded study finds — as pressure mounts for booster jab rollout

  • One in 10 immunosuppressed people failed to produce any antibodies after jabs
  • Meanwhile, three in 10 generated very low responses after both Covid vaccines
  • Researchers say the Government should prioritise these groups for booster jabs 

Four in 10 people who have weakened immune systems show ‘low or undetectable’ levels of Covid immunity after being double vaccinated, a major UK study has found.

The finding will put pressure on the Government’s scientific advisers to green light a booster jab programme for the most vulnerable Britons this autumn. 

Researchers from the Universities of Glasgow and Birmingham measured antibody levels in 600 immunosuppressed people and compared them to healthy volunteers. 

About one in 10 in the vulnerable group failed to generate any detectable Covid antibodies four weeks after their second dose of Pfizer or AstraZeneca.

A further 30 per cent generated a significantly lower antibody response than healthy people, according to the study published as a pre-print in The Lancet. 

The scientists stressed that almost all of the people who did not show an antibody response had vasculitis, a condition which causes inflammation of blood vessels. 

They added that across almost all patients, the T cell response was similar to healthy adults, indicating that they were at least partially protected against Covid. 

While antibodies are the most obvious indicator of immunity, T cells – a type of white blood cell – also play a crucial role in priming the body against the disease. 

The experts behind the study have called for the Joint Committee on Vaccination and Immunisation (JCVI) to approve booster doses for the immunocompromised in the coming weeks.

Britain’s daily Covid infections, deaths and hospital admissions have been climbing slowly but steadily for several weeks which has raised fears of a fresh wave when schools go back and strengthened the argument for boosters. 

Researchers from the Universities of Glasgow and Birmingham measured antibody levels in 600 immunosuppressed people and compared them to healthy volunteers. About one in 10 in the vulnerable group failed to generate any detectable Covid antibodies four weeks after their second dose of Pfizer or AstraZeneca . A further 30 per cent generated a significantly lower antibody response than healthy people, according to the study published as a pre-print in The Lancet

Immunosuppressed people include those with certain types of arthritis, inflammatory bowel disease and some cancers. 

Sources say the JCVI is prepared to rollout third doses to this group from September, but will hold back on a mass booster campaign to entire age groups and wait on more evidence of the benefit.

To determine how much protection immunosuppressed people had from the vaccines, researches examined the antibody and T cell levels in 600 of them before a vaccine, after one dose and after both jabs. They compared this with samples taken from 231 healthy individuals. 

Four weeks after receiving a second dose, 100 per cent of healthy Brits produced antibodies.

The number of people dying from Covid every week in England and Wales has risen to the highest level since March, official data shows.  

A total of 571 people had the virus mentioned on their death certificates last week, according to the Office for National Statistics, which was up eight per cent on the previous seven-day spell.

This was the highest number since the week ending March 26, at the end of the second wave and when the countries were still in lockdown. At that time, the virus was behind 719 deaths.  

The latest figures mean Covid was behind one in 18 total fatalities last week.  While it marks a near five-month high, the rate at which Covid deaths are increasing appears to have slowed. 

The eight per cent rise last week was the lowest in nearly two months. And deaths are still a far cry from the levels seen in previous waves, thanks to the vaccine rollout. 

Seven out of nine regions in England saw their Covid deaths rise in the latest week compared to the previous seven-day spell. They only fell in the West Midlands and the North West.

Flu and pneumonia were involved in nearly three times more deaths last week than Covid. 

Meanwhile, the number of ‘excess deaths’ from all causes is at its highest since February. These are the number of fatalities above the average for the corresponding period in the non-pandemic years of 2015-19. 

A total of 10,372 deaths in England and Wales were registered in the week ending August 13, according to the ONS, which was 14 per cent above the five-year average, or 1,270 more deaths.

Excess deaths have not been this high since the week ending February 19, when 2,182 extra deaths were registered, 18.8 per cent above the five-year average. 

Some of the increase in excess deaths can be explained by the recent rise in deaths involving Covid-19, all of which are classed as excess deaths.


But just 89 per cent of immunosuppressed people did – meaning more than one in 10 of them people had zero antibodies to protect against the virus.

And there was even less in some sub-groups of people who are immunosuppressed. 

For example, 72 per cent of individuals with vasculitis did not produce antibodies after two doses. 

The researchers said these patients were on medication that shuts down the production of antibodies to calm their immune system, making it very difficult for them to mount a response from the vaccine.  Patients with solid cancers tended to have high levels of antibodies.

They claimed their findings ‘strongly’ supports giving booster doses to people with chronic diseases or on immunosuppressant drugs.  

Professor Iain McInnes, an expert in rheumatoid and psoriatic arthritis at the University of Glasgow and leader of the study, said the absence of an antibody response among some vulnerable was worrying, but he said there were positives to draw from the study.

He noted that it is unclear what correlation there is between antibody response and the likelihood of getting an infection or how serious the infection could become.    

Professor McInnes said: ‘I would emphasise that the group of patients who did not make antibodies was mostly contained in the vasculitis group, and the vasculitis group is a rare disease group in this country.’

And the ‘vast majority’ of people who have a solid cancer – a cancerous growth rather than one in the blood – as well as those have an immune disease, inflammatory bowel disease or arthritis ‘are probably going to be fine, but more work is required to be absolutely reassured’, he said.

The researchers also found that both healthy and immunosuppressed patients – including those with vasculitis – had similar T cell responses to the jabs. 

And Professor McInnes said the majority of immunosuppressed patients mounted an immune response that looks ‘remarkably similar’ to a healthy control group.

Some 60 per cent of participants with ‘rather significant conditions are in fact looking effectively the same as people who are otherwise have an unimpaired immune system’, he added.

Britain is under mounting pressure to launch its own mass rollout.

The JCVI is expected to only green light third doses for vulnerable adults with suppressed immune systems. 

The boosters will almost certainly be offered to the 3.7million Britons classified as ‘clinically extremely vulnerable’, with diseases such as cancer. 

But originally it was hoped that the programme would be open to all over-50s, key workers and sick patients – which would have included as many as 32m people.

Some scientists have said vaccines should be used to administer first doses to people in other countries before third doses are offered in the UK. 

Professor Eleanor Riley, an immunology and infectious disease expert at the University of Edinburgh, said the findings are ‘unsurprising’ but ‘important’

It is not surprising that many at-risk groups have lower antibody responses after two doses than healthy people, she said.

But it is promising that many did have a detectable antibody response after one dose that increased after a second jab, Professor Riley said.

She added: ‘It is quite possible that they will make an even better response after a third dose of vaccine.

‘These data therefore offer support for the notion that people with specific co-morbidities should be prioritised for a booster dose of vaccine in the next few weeks.’  

Professor Neil Mabbott, chair in immunopathology at the University of Edinburgh, said the findings suggests boosters should be given to those who have weakened immune responses.

He said: ‘There is much debate in the UK about whether we should be rolling out booster jabs to adults who have already received two doses. 

‘Of course, we don’t currently have a reliable serum marker that can tell us whether and how well an individual is protected from developing serious Covid disease after vaccination. 

‘Despite this, the results in this study provide useful evidence to inform these decisions. 

‘This study supports the suggestion that if booster jabs are to be used, they should be prioritised to those such as individuals in this study, who have weakened immune responses and responded poorly to their previous vaccinations.’

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