The analysis of five studies carried out by researchers at the Bambin Gesù Hospital on frail children aged 12 to 25 suggests that the vaccine generates fewer antibodies: they need a personalized strategy
In children and young people with a compromised immune system the efficacy of anticovid vaccines may be lower (even absent) compared to healthy peers due to the pathology they suffer from or the effects of the therapies they must take. They prove it five studies conducted by researchers at the Bambino Gesù hospital in Rome on a total sample of 165 fragile patients aged between 12 and 25 years.
We need a reinforcement and personalized vaccination strategy
Each research analyzes the responses to the first two doses of the Pfizer vaccine in a different group of patients: 21 subjects with primary immunodeficiency, 34 with a heart and lung transplant (namely: 30 heart, two heart and kidney and two others lung), 30 with chronic intestinal inflammatory disease, 40 with Down syndrome and as many with HIV. «For these patients it is important to intervene with aa reinforcement and personalized vaccination strategy – declares Paolo Palma, head of the complex operational unit of clinical immunology and vaccinology of the Vatican hospital -. For now we can remodel the treatments whenever possible and select the best type of vaccine to be administered among those on the market depending on the health condition by establishing any additional doses. The ambition for the future is to study the biological mechanisms that reduce immunity to the virus in order to be able to produce vaccines that protect these categories of population in the light of the results obtained from our investigations “.
Patients with HIV
The studies are part of the “Convers” project and examine both serological immunity (ie the amount of antibodies present in the blood) and cellular immunity against the virus (which consists in the production of T lymphocytes capable of destroying infected cells) . Specifically, all patients with perinatal HIV infection developed specific antibodies against SarsCov2 but in an amount 15 percent lower than the control group.. In 89 percent of cases, however, there was no production of specific T lymphocytes due to the inflammatory state induced by HIV and the poor ability of the patient’s immune system to counteract it. The survey was published in the journal Clinical infectious diseases. While from the research on subjects with chronic inflammatory disease, published in Vaccines, it emerges that in patients undergoing a therapy based on anti-TNF drugs (monoclonal antibodies), the serological reaction drops by 43 percent compared to the group treated with other therapies immunospressive.
Children with Down syndrome respond as over 65
In children and teens with down syndromeon the other hand, the number of antibodies developed following the vaccine is similar to that of adults over 65 and therefore decidedly lower than healthy peers. At the origin of the problem is the premature aging of the immune system typical of the syndrome. The study in this case was published in the Journal clinical medicine. The fourth investigation, released on Frontiers in Immunology and relating to patients with primary immunodeficiency, highlights that 14 percent of the boys did not produce antibodies after the vaccination course and 24 percent were without specific T lymphocytes. Again, responsible for the low efficacy of vaccines is the malfunction of the immune system which characterizes the disease. Finally, the study edited on Transplantation found that in children they have had a heart or lung transplant the serological reaction is absentl 31 per cent of cases and in the remainder it is less than 95.6 percent when compared with healthy peers. And that in three out of ten patients there is also a failure to increase anti-SarsCov2 T lymphocytes.
To protect the fragile, keep the masks
The researchers of the Infant Jesus, in essence, have shown that the majority of immunosuppressed children and adolescents, despite developing a response to the vaccine, have fewer antibodies and less T lymphocytes than healthy subjects of the same age and a smaller minority does not acquire any form. of immunity to Covid. “The next objective of the ‘Convers’ project – concludes Palma – will be to evaluate the maintenance of the vaccination response over time”. Then an appeal in conclusion: “Given the lower efficacy of current vaccines in these subjects, to protect them, vaccination of both their caregivers and the general population and the use of masks indoors and in situations of social aggregation is essential. . In hospitals, waves of Covid patients are creating a slowdown in the care pathways of these fragile categories “.
July 13, 2022 (change July 13, 2022 | 16:34)
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