Q for experts: Immunosuppressants and Vaccine

823 Views | 2 Replies | Last: 2 yr ago by SamHou
SamHou
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https://pubmed.ncbi.nlm.nih.gov/33851176/

I'm concerned after skimming that article.
I have a family member on an IL-23 inhibitor who got both Pfizer shots in February.
1) Do you think the vaccine will not be effective for them?
2) Is it even worth it to get an antibody test at this point given that it's been over three months post booster shot?
Infection_Ag11
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AG
Quote:

I have a family member on an IL-23 inhibitor


Stelara I'm guessing? That would just be the most common one.

Quote:

1) Do you think the vaccine will not be effective for them?


The study in question looked specifically at those on steroids and B cell depleting agents, which are more profoundly immunosuppressive than interleukin inhibitors and more directly interfere with antibody generation and vaccine response.

Interleukin inhibitors increase the risk of specific types of infections (such as tuberculosis reactivation) based on their mechanism and you shouldn't receive live virus vaccines while on them, but they are less likely to prevent an appropriate response to vaccines. It's a risk, but nowhere near as much as so as with the agents in question.

Quote:

Is it even worth it to get an antibody test at this point given that it's been over three months post booster shot


I can't tell you if it's "worth it" but with an appropriate vaccine response you should still have robust titers at 3 months out. If they get it done just be sure they are checking specifically for the spike-protein IgG neutralizing antibody.
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Capitol Ag
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AG
I'm on remicade. Yes, it's worth getting. I did feel a reaction after the first and second dose. Especially the 2nd. So it did kick in.

The fact is, if one is immunosuppressed than it makes sense that they could be at more risk for catching the virus, so they probably should get the shot given their condition.
SamHou
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Thank you for these replies!
Tremfya.

I'll advise them to get an antibody test. I guess if it's low, then they should get J&J given they had the Pfizer shots?
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