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If You Take These Meds, You May Not Have Antibodies Post-COVID-Vaccine



Zachary Mack



JULY 6, 2021



By now, there's both clinical and real-world evidence that shows getting vaccinated for COVID-19 offers you plenty of protection against the virus. After all, the shots have drastically reduced infections in the U.S. and bring down case numbers to their lowest levels since the earliest days of the pandemic. But if you're one of the millions of Americans who rely on certain types of medications to help with an ongoing health issue, research says there's a chance you may not have the antibodies you need to keep you safe from COVID-19 post-vaccine.


A large study published in the medical journal Cancer Cell on June 5 set out to determine how effective currently available COVID-19 vaccines are for cancer patients. Researchers used data from 200 eligible patients at Montefiore Health System and Albert Einstein College of Medicine in New York by testing their antibody levels after they were fully vaccinated. Results found that while most cancer patients in the study responded well to the shots, 30 percent of those taking immunosuppressant medications showed no signs of seroconversion, which is the medical term for the production of antibodies in response to a virus.

RELATED: Half of People Who Did This Had No Antibodies After Vaccination, Study Says.


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The findings add to mounting evidence that the roughly six million Americans who rely on medications such as methotrexate, Rituxan, and certain steroids that suppress the immune system—which can be used to treat certain cancers, arthritis, psoriasis, and to stave off rejection of organ transplants—are not seeing the full effectiveness of their COVID-19 vaccines after regular dosages. It's also added fuel to the argument that additional doses should be administered to immunocompromised people to shore up their immune response.


"There should be already a national study looking at post-transplant patients getting booster shots," Balazs Halmos, MD, an oncologist at the Montefiore Medical Center in New York City and the study's lead author, told The New York Times. "It shouldn't be our little team here in the Bronx trying to figure this out."

The use of a planned booster shot for such patients is already in practice in countries such as France. A study there found that while only 40 percent of immunocompromised patients had antibodies after two doses, it was increased to 68 percent four weeks after a third shot was administered.


A May study published in the Journal of the American Medical Association found that 46 percent of transplant patients who got two doses of either the Moderna or Pfizer vaccine didn't produce any COVID-19 antibodies, the key indicator of whether or not the vaccine was effective. The good news is that another 40 percent of the 658 transplant patients studied had no antibodies after their first vaccination but did develop antibodies after their second shot. However, that still leaves a large percentage of patients without any protection against COVID.


Another study, published earlier this month in the journal Annals of the Rheumatic Diseases, looked at two groups of people who were vaccinated against COVID-19: 84 patients with autoimmune diseases (like rheumatoid arthritis, inflammatory bowel disease, psoriasis, and certain kinds of arthritis) and 182 healthy participants. In the latter group, all but one of the patients developed antibodies against COVID-19. In the former, as many as 1 in 10 people failed to develop any antibodies.


In particular, the research showed that patients who take as methotrexate (sold as Rheumatrex, Trexall, Otrexup, Rasuvo) and rituximab (Rituxan) for their autoimmune diseases respond poorly to the vaccine, WebMD reports. That's because these medications suppress the immune system so that the disorders, which cause your immune system to be overactive, are kept under control.


RELATED: If You Got This One Vaccine, Get a Booster Now, Virus Expert Warns.


While Moderna and Pfizer are each planning studies on the use of a third dose in immunocompromised patients, some researchers argue that the slow pace of federal agencies is making it difficult to gather vital information. "It's a very simple study," Jose U. Scher, MD, a rheumatologist at NYU Langone Health who led a study of methotrexate's effect on the vaccines, told The Times. "There's no rocket science here."

For now, the U.S. Centers for Disease Control and Prevention (CDC) advises that "antibody testing is not recommended to assess for immunity to SARS-CoV-2 following COVID-19 vaccination" as the results may not be accurate or helpful. The agency also says that "at this time, revaccination is not recommended after people who received COVID-19 vaccines during chemotherapy or treatment with other immunosuppressive drugs regain immune competence," adding that their recommendations on additional shots may change when more information becomes available.


RELATED: If You Got Moderna, This Is How Your Antibodies Respond to the Delta Variant.

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