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For most people, COVID-19 vaccines promise a return to something akin to normal life. But for the hundreds of thousands of people in the U.S. living with organ transplants, it's a different story. New research published today by the medical journal JAMA suggests that many transplant recipients may not get protection from vaccination even after two doses. NPR's Maria Godoy reports.
MARIA GODOY, BYLINE: At 38, Valen Keefer has had a second chance at life, not once but twice - first at age 19, when a hereditary disorder left her in need of a kidney transplant. Then three years ago, her liver started failing. Another transplant saved her life. Keefer had finally recovered her health last year when the pandemic struck.
VALEN KEEFER: I'm the healthiest I've been in years and not able to go anywhere. I'm, like, bursting with gratitude and wanting to just seize every day, and now I've been stuck at home.
GODOY: Even though Keefer has been fully vaccinated, she's still living as if she's not.
KEEFER: I think it's really hard to know how to integrate back into some type of normalcy. Transplant recipients like me - we're not sure what to do.
GODOY: That's because the vaccine development trials did not include transplant patients, who must take powerful immunosuppressing drugs for life to prevent organ rejection. So researchers are now trying to fill in the blanks. What they've found so far is that for transplant recipients...
DORRY SEGEV: Vaccination does not mean immunity.
GODOY: Dr. Dorry Segev is a transplant surgeon at Johns Hopkins. He's one of the authors of a new study published in JAMA that looked at the antibody response to the Moderna and Pfizer vaccines in more than 650 transplant patients. They found that even after two doses of vaccine...
SEGEV: Forty-six percent of transplant patients have had no evidence whatsoever that they had an antibody response to the vaccine.
GODOY: And even in transplant patients who did get an antibody response from the vaccine...
SEGEV: It is less robust than people with competent immune systems.
GODOY: And for people who are on a certain class of drugs, the response is even less. Take, for example, Laura Burns (ph). She's a 71-year-old double lung transplant recipient enrolled in the study. She takes a drug called mycophenolate to prevent organ rejection.
LAURA BURNS: I was very excited when I got vaccinated but very, very disappointed I had no response whatsoever.
GODOY: Burns says she's longing to see her family in Europe.
BURNS: I have not seen them now for two years, and that's including my stepdaughter, you know? And it's very - that's hard.
GODOY: It's not clear when Burns will be able to travel again. While some of the world starts to reopen for vaccinated people, the advice for transplant recipients is, get vaccinated, but keep living cautiously with face masks and physical distancing. And assume you're not protected.
GHADY HAIDAR: I know it sounds lame, but this is all that can be offered.
GODOY: That's Ghady Haidar, a transplant infectious disease doctor at the University of Pittsburgh Medical Center.
HAIDAR: I'm hoping that in the coming months to years, we'll have something more concrete to offer.
GODOY: For instance, researchers are starting to explore whether there's a response going on in other parts of the immune system that they just haven't detected yet. It's also possible that giving immunocompromised patients a third dose of the vaccine, essentially a booster shot, will elicit a better antibody response. The vaccines aren't currently authorized for that use in the U.S., but some patients are doing it anyway. That includes Laura Burns.
BURNS: I got a third dose this past Wednesday. Knock on wood that it's going to work (laughter).
GODOY: But for now, Segev and other researchers say the best shot transplant recipients and other immunocompromised people have to be protected from getting COVID is for everyone to get vaccinated.
Maria Godoy, NPR News.
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