Vaccinated But Still Not Protected?

Like most people, I’m excited to see the relaxed CDC guidelines about fully vaccinated people being able to participate in so many vaguely familiar activities: dinners with friends indoors, movies that aren’t on our home screen, indoor Zumba classes, and on and on.

Yet for my son and many thousands of other immunosuppressed individuals, those still aren’t real options. Yes, he’s fully vaccinated, but the big unknown is whether he’s fully protected. His immune system, tamped down to coexist with his precious kidney, which used to be mine, doesn’t quite get the difference. That means it might not be protecting him the way it does most people following vaccination.

According to new studies by researchers at Johns Hopkins, about half of transplant recipients developed antibodies to COVID following the requisite post-vaccination period. That’s the good news. The bad news is that half didn’t. And even those who did, usually produced far lower levels of antibodies than someone with a typical immune system.

Researchers are looking into the other ways the body can protect itself (B cells and T cells, for example), additional options like a third shot, and much more that I don’t understand. But in the meantime, the bottom line is that unless a given transplant recipient is confirmed to have an adequate level of antibodies, they should behave as if they’re unvaccinated–that is, they may still be vulnerable. After the long months of waiting his turn to get the vaccine, and then counting down to the full-protection stage, the news was heartbreaking.

I guess it shouldn’t have come as a surprise to me, but I honestly don’t recall ever hearing or reading any cautionary statements on that point. The focus, understandably, was on safety: it’s safe for transplant recipients to get the vaccine because it’s not a live vaccine, and the known risks of kidney patients’ developing a severe case of COVID are far worse than any risks of the vaccine. I echoed that advice here too.

For now, the best protection against COVID for my son and other transplant recipients–or anyone with a weakened immune system–is for the rest of us to be fully vaccinated. If you are not vaccinated, please honor the honor system and continue to wear your mask and to social distance. At-risk people like my son need to continue to take the old precautions. So the next time you see someone wearing a mask in public, don’t just assume that they’re not vaccinated. That person may well be fully vaccinated–but still not fully protected.