Non-responders are people who after vaccination against COVID-19 did not develop antibodies responsible for fighting the SARS-CoV-2 virus. It is estimated that this may apply to 5-10 percent. vaccinated people. Does this mean that these people will die when faced with the virus? – This is not the same as the fact that a person will be completely defenseless against the pathogen against which they have been vaccinated. They are protected against severe complications and hospitalization by the second line of protection, i.e. cellular immunity, says physician Bartosz Fiałek. How can I tell if we have antibodies after vaccination? Who should do it?
- After vaccination against COVID-19 in 5-10 percent. the vaccinated did not develop the humoral immune response responsible for protection against the virus
- How are such people to check if they have immunity? Should they do an antibody test? The doctor answers these questions
- Performing an antibody test after vaccination against COVID-19 is not recommended because the results are not standardized – says Bartosz Fiałek, physician in an interview with Medonet.
- More information can be found on the Onet homepage
Adrian Dąbek, Medonet: There is a lot of talk now about non-responders, i.e. people who do not respond to vaccines. It can be as much as 5-10 percent. vaccinated people. Does the lack of side effects after administration of the preparation make you suspect that the vaccine is not working?
Bow. Bartosz Fiałek: Vaccines work whether or not any symptoms appear after vaccination. You don’t need any symptoms for the vaccine to work. People who are asymptomatic after vaccination are also considered to generate the expected immune response.
Non-responders, i.e. people who – to put it simply – do not respond to a given vaccine, and therefore do not generate a humoral immune response, are people who have – most likely, because you cannot be sure – probably some genetic or enzymatic defect that affects functioning of the immune system. Due to these disorders, this group of people does not develop anti-SARS-CoV-2 antibodies.
However, we must have knowledge, which is rarely mentioned, although in my opinion it is very important that in the situation of non-responders we only talk about the level of antibodies, i.e. the first line of protection against pathogen invasion, about the humoral response. However, this does not apply to the so-called the second line of defense against pathogens, ie the cell line – T cell-dependent immune response. It cannot be said that these 5-10 percent. people will not generate any type of vaccine immune response at all. In order to say unequivocally that these people do not respond to vaccination, research should be carried out on the ability to activate T cells.
Non-responders are people who do not develop immune antibodies with the ability to neutralize a given pathogen. However, this is not the same as the fact that the person will be completely defenseless against the pathogen against which they have received the vaccine. It may not be immune in the first line of protection against mild to moderate COVID-19, but it may not be immune from severe course, hospitalization, invasive mechanical ventilation, or death, because the second line of protection, cellular, is against this. protects.
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Having symptoms after receiving the vaccine does not necessarily mean that you have developed immunity. Also, people who do not have these symptoms generate the expected post-vaccination immune response.
And if someone wants to see if they actually made antibodies, what test should they do?
The latest research and recommendations are clear – we do not test for SARS-CoV-2 antibodies after vaccination. The latest research published in Nature actually shows the antibody titers on the basis of which we can judge the effectiveness of vaccines, and therefore – presumably – the titre that may protect us against COVID-19. But at the moment we do not know the antibody titer that would say, for example, that 1: 320 is sufficient to protect against COVID-19. In the case of polio, antibodies in the 1: 4 titer are known to protect us from infection. We do not know such a name in the case of COVID-19.
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Performing an antibody test after vaccination against COVID-19, I say it with full responsibility, and this is how I write back to my patients, in accordance with the recommendations of the CDC or FDA, it is not advisable. Because the results are not standardized. The performance of the test and the presence of antibodies will not always provide sufficient protection against the disease.
When we get vaccinated against COVID-19 and the antibody test is positive, and we are talking only about the S protein, i.e. the one against which the immune response has been created, because such a mechanism of COVID-19 vaccines is currently available on the market, we will be able to just say that the person generated the given titer of antibodies against the SARS-2 coronavirus spine protein. Nothing more can be said about the quality of immunity today.
Perhaps soon we will be able to tell what level of anti-SARS-CoV-2 antibodies is the protective level against COVID-19. Then it will make sense to perform such tests. By the way, on the basis of this information, we will be able to decide whether to administer a supplementary dose.
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Again, checking for antibodies after vaccination tells us very little today. Just a waste of money. When we gain access to more knowledge, when tests and antibody titers are standardized, then such a procedure will make sense.
I am faithful to the philosophy of American professors who say that every research should be done for a specific purpose. I order my patients only for tests that will help in the diagnosis of their disorders. Antibodies are additional tests that are performed to confirm or even strengthen the basic ones: an interview and a physical examination.
Bow. Bartosz Fiałek – specialist in the field of rheumatology, chairman of the Kujawsko-Pomorskie Region of the National Physicians’ Union. As he says about himself – a social activist in the field of health protection and promoter of medical knowledge. He is an active user of social networking sites where he often and willingly shares medical recommendations. He constantly comments on all the data, nuances and discoveries related to COVID-19.
I get a lot of questions each week about interpreting a person’s vaccine antibody titer. I answer that the given result only proves that after vaccination, antibodies to the protein were generated, which is then produced in the vaccination against COVID-19, i.e. the S protein.. End, period. We can’t say more. People have different titers of antibodies. Some have 40 units, others 600 units, and still others 6 units. j. We are not able to say today what the individual values mean, which are already “sufficient” in the context of protection against COVID-19. This is purely academic knowledge.
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Scientists need to find out what titer is sufficient to protect against infection. When this happens, it will be possible to decide on the administration of a supplemental dose in people who did not generate minimal protective titres of anti-SARS-CoV-2 antibodies against the disease.
What if anyone thinks the low amount of antibodies is a vaccine issue? So “I would like a second dose with a different preparation”. It’s a good idea?
The CDC’s recommendations are obvious and understandable to me, because I prefer to rely on the message of experts than just my knowledge that the qualification for vaccination is not conditioned by the presence or absence of anti-SARS-CoV-2 antibodies. This is the basic point. Whether you have no antibodies or 10 antibodies, you qualify for vaccination based on your clinical condition. So we check if you have passed COVID-19, like yes, then wait 30 to 90 days, sometimes it is said that even longer. The result for the presence of antibodies against SARS-CoV-2 is not an element on the basis of which we qualify for vaccination.
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As for mixing vaccines, we don’t know that yet. We know that reactogenicity, i.e. the occurrence of side effects after administering a mixture of Oxford-AstraZeneca + Pfizer-BioNTech vaccine, is higher than in the case of administration of a vaccine from one manufacturer. At the moment, we do not have conclusive scientific evidence that mixing vaccines is advisable. The standard is to administer the vaccine from one producer, in the time interval specified by this producer.
It seems that taking antibody tests can only be confusing. Some people will be scared that their titer is too low, and others – that their titer is so high that they may not take the second dose. This leads to unnecessary confusion.
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