Face the Delta variant, “given the seriousness of the situation for immunocompromised patients, the wait is no longer appropriate“estimates Professor Michel Goldman, professor of immunology at ULB, who once again warns of the measures to be taken as a priority and without delay with regard to these patients.
“These are not only patients on dialysis but also all patients whose immune system is deeply weakened following organ or cell transplantation, immunosuppressive treatment administered for chronic inflammatory disease (multiple sclerosis, rheumatoid arthritis , Crohn’s enteropathy), severe immunodeficiency. In Belgium, their number can be estimated at at least 40,000“.
A deficient vaccine response
These patients are in fact particularly poor in the face of the Delta variant insofar as, despite a complete vaccination at two doses, their response to the vaccine is often very weak: among transplant patients, 60% do not develop antibodies despite a vaccination considered complete.
“This deficient vaccine response is all the more worrying as these patients are at high risk of developing serious forms with a high mortality rate which can reach 30% when hospitalization is necessary.“, adds the immunologist.
What to do in practice? For Professor Goldman, faced with the increase in contamination by the Delta variant, which is likely to increase even further in the weeks to come, “it is also about offering solutions to those who, although vaccinated, remain highly vulnerable. The measures to be considered quickly consist of administer a third dose of vaccine without delay to messenger RNA in these patients, as is the practice in Israel and France. In transplant patients, this third dose increases the percentage of responders from 40 to 70%. They must also be protected by wearing a mask and strictly respecting barrier gestures in their immediate environment. Finally, it is necessary to perform a PCR test at the slightest suggestive symptom. If positive, urgent treatment with an appropriate monoclonal antibody should be considered. Four of the five anti-Covid treatments that the European Commission plans to approve in the fall are treatments of this type“.