21 August 2023

People with compromised immune systems, including those with lymphoid malignancies, are less likely to have COVID-19 antibodies even after three or more vaccinations, researchers have reported.

The MELODY study, led by a team of doctors and researchers from several UK institutions, found individuals were more likely to have antibodies if they were younger, had more vaccine doses or had previously had COVID-19.

The researchers hope their findings, published in The Lancet Rheumatology, will help in the care and treatment for people living with these conditions.

Lead researcher Dr Michelle Willicombe, from the Department of Immunology & Inflammation at Imperial College London, said: “We know from previous research that people who have a weakened immune system were more likely to catch COVID-19. They were also more likely to need to go into hospital for treatment or die from COVID-19.

“Vaccines trigger the immune system to make antibodies. But if your immune system is weak, you may not produce enough antibodies needed to fight infection and prevent serious illness. Clinically vulnerable patients who are at increased risk are encouraged to attend if they are invited for a booster vaccine, in order to get the best protection against COVID-19.”

More than 23,000 people were recruited to the study through UK national disease registries. Antibodies were found in 77% of those who had a solid organ transplant, 79% of those with a blood cancer, and 86% with rare autoimmune disease.

“We now know that the majority of immunosuppressed people produce antibodies after having a COVID-19 vaccine,” said study co-author Professor Sean Lim from the University of Southampton.

“In the future, we could offer home antibody tests to those who we know are least likely to have antibodies and provide them to have quick access to preventative treatments if this is the case. The findings could also help to develop bespoke booster vaccination schedules for different groups.”

Among those involved in the study were: Imperial College London, The Universities of Southampton, Nottingham, and Cambridge, Nottingham University Hospitals NHS Trust, NHS Blood and Transplant, the National Disease Registration Service at NHS England, and IPSOS MORI.



Pearce FA, Lim SH, Bythell M, Lanyon P, Hogg R, Taylor A, Powter G, Cooke GS, Ward H, Chilcot J, Thomas H, Mumford L, McAdoo SP, Pettigrew GJ, Lightstone L, Willicombe M (2023) “Antibody prevalence after 3 or more COVID-19 vaccine doses in 23,000 immunosuppressed individuals: a cross-sectional study from MELODY.” Lancet Rheumatology, doi: 10.1016/S2665-9913(23)00160-1

Link: https://www.sciencedirect.com/science/article/pii/S2665991323001601

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