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Double Whammy for Autoimmune Patients?

Double Whammy for Autoimmune Patients?
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We’ve been detailing the scientific evidence showing the increased risk of serious adverse events for autoimmune patients receiving the COVID vaccine. Emerging data is now showing that patients with compromised immune systems, such as those on immunosuppressive medications and organ transplant recipients, do not generate as strong an immune response to the COVID vaccines as healthy patients. Not only are autoimmune patients at greater risk for serious adverse events, but the vaccine may not even work for them—we just don’t know. Like organ transplant recipients, autoimmune patients have compromised immune systems; autoimmune patients also take immunosuppressive drugs that studies are showing dampen the immune response to the vaccine.

A handful of studies have demonstrated how the vaccine doesn’t work very well in patients with compromised immunity:

  • One study found that patients on glucocorticoid medications, which are often used to treat autoimmune conditions, “severely impeded” a proper response to the vaccine.
  • Patients with irritable bowel disease treated with infliximab, a common immunosuppressant, also had a blunted response to the vaccine.
  • A study of organ transplant recipients, many of whom take immunosuppressant drugs, concluded that a “substantial proportion of transplant recipients likely remain at risk for COVID-19 after two doses of mRNA vaccine.
  • Researchers were not able to detect antibodies in about 46% of blood-cancer patients who had received both doses of a COVID vaccine. Blood cancers like lymphoma, for example, can impair the immune system.

Many patients take the kind of drugs that dampen the response to the vaccine: patients with AIDS, organ transplants, cancers, autoimmune diseases, etc. In some cases, patients taking certain drugs are told to wait six months after drug treatment to get the vaccine. The issue is even more complicated by patients with ongoing drug treatment; the CDC says that patients on these medications can receive the vaccine, and decisions to delay drug treatment to receive the vaccine should consider the risks related to the patient’s underlying condition.

Part of the reason we don’t know even more about the vaccine’s effectiveness is that special populations of patients (autoimmune patients, organ transplant recipients, cancer patients, and those on immunosuppressive therapy) were underrepresented or entirely excluded from COVID vaccine trials.

This deepens the conundrum for autoimmune patients. As we’ve mentioned in our white paper, the data show an increased risk of serious adverse events, including life-threatening blood clots in the brain, from COVID vaccination. Now we’re seeing that, even if they do expose themselves to this additional risk, the vaccine may not even work. The point is that this hasn’t been studied specifically, so we just don’t know yet.

There are even more danger signals from the COVID vaccine that are emerging. There is animal data from a Japanese study commissioned by Pfizer showing that the lipid nanoparticles used to transport genetic instructions for the COVID spike protein do not stay at the site of injection, but enter our circulation and end up elsewhere in the body. As our friends at ANH International point out, this raises a whole new set of questions:

If the lipid nanoparticles are distributed systemically, does that mean the mRNA might instruct cells well beyond the deltoid muscles to generate the spike protein? Or do proteolytic enzymes break some or all of it down before this happens to any significant degree? Could this increase the risk of autoimmune reactions in areas distant from the injection site? Might the systemic exposure go some way to explain the continued emergence of adverse reactions affecting organs or tissues distant from the site of injection, such as heart and brain. What could the long-term implications of this be?

We also know that the CDC is investigating the recent reports of myocarditis predominantly in young males. Myocarditis (inflammation of the heart) is mostly caused by infection, but in some cases is the result of an autoimmune reaction. These are important considerations for patients, especially patients with an autoimmune profile, in making the decision about whether to get the COVID vaccine.

These important medical decisions are being made in a climate of increased social pressure to vaccinate. Businesses are re-opening and privileging vaccinated individuals. Governor Cuomo of New York just announced that Radio City Music Hall will re-open at full capacity for the Tribeca Film Festival, but only to vaccinated individuals. Many restaurants are re-opening dine-in services, but only for vaccinated individuals.

While it’s a relief to many of us that the country is re-opening and the economy is rebounding from the pandemic, we must ensure that we don’t discriminate against people who make an informed decision not to get vaccinated for legitimate medical reasons.

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