People with compromised immune systems face potential threat from people not vaccinated for COVID-19
Tricia Fedie, a 32-year-old mother of two daughters and a woman who is being treated for a rare form of liver cancer, has been vaccinated for COVID-19.
She and her physicians, however, are unsure whether the vaccine will trigger a full immune response because of her ongoing treatment for cancer.
It means that she could be at risk from people who have not gotten the vaccine and who could transmit the virus.
“It’s a little selfish if you are able to get the vaccine,” said Fedie, a registered nurse.
She understands that some people contend that it’s their personal right to not wear a mask or not get vaccinated.
“But I have a right to safely go to the grocery store and get groceries for my family,” Fedie said.
Thousands of people in Wisconsin — and untold numbers throughout the country — with compromised immune systems face a similar risk.
They are people with medical conditions that weakened their immune systems and who in some cases develop less immunity from the COVID-19 vaccine, leaving them vulnerable to infection.
Those most at risk are people who have had solid-organ transplants, such as kidney and liver, and cancer patients who are undergoing chemotherapy.
But some people with autoimmune conditions — such as rheumatoid arthritis, lupus, Crohn’s disease, ulcerative colitis, psoriasis, psoriatic arthritis and multiple sclerosis — also may have less protection from the vaccines.
And some people with severe asthma who are being treated with Prednisone, a type of steroid, could be vulnerable.
The risk they face depends on the drugs they are taking. It also varies by person. And the immune response from the vaccine may be only slightly weaker for some people.
Studies on the immune response triggered by the vaccines for people who have weakened immune systems — what is known as immunocompromised — are in the early stages.
Their numbers, though, are not insignificant.
As many as 23.5 million people in the United States have an autoimmune disease, according to the National Institutes of Health.
“There are countless thousands and millions of people that have immune-compromising conditions,” said James Conway, a physician and pediatric infectious disease specialist at UW Health.
Not all of them will be at risk.
“It’s not a black-and-white thing,” Conway said. “There’s a whole sliding scale. You can be a little compromised and you can be way compromised.”
Solid organ transplant patients at risk
Without question, people who have had solid organ transplants are at risk.
“They are on very strong immuno-suppression drugs to prevent rejection of the organ,” said Robert Citronberg, chief of infectious disease and prevention at Advocate Aurora Health. “And that predisposes them, makes them more susceptible, to infection.”
For those people and others, every person who is not vaccinated is a potential threat.
This is because they could be infected with the coronavirus and capable of infecting others. They also are likely to be unaware that they are a threat. An estimated 40% of the people infected with the virus have no symptoms.
As of Friday, 46.3% of the state’s population had received at least one dose of a COVID-19 vaccine, compared with 60.5% nationally.
“That really is one of the values of getting vaccinated,” Citronberg said. “You are not only protecting yourself, but you are protecting other people who are vulnerable to the disease.”
The vaccine makes it more difficult for the virus to spread, reducing the risk to people who have weakened immune systems — and Citronberg said that there are many more people with compromised immune systems than most people realize.
Loss of a mother with kidney disease
Olivia Kingree, who died on May 17 of COVID-19, was one of them.
Kingree, who was 75 and lived in Madison, had been vaccinated but was on drugs for a rare kidney disease that weakened her immune system.
“This story is about what will increasingly happen if people refuse to get the vaccine,” said Luke Kingree, a Madison attorney and one of her sons.
His mother — whose story was first reported by the Wisconsin State Journal — had several other medical conditions but was not close to death.
“We thought we would have significantly more time with her,” said Luke Kingree, whose first-born child now is 21 months old. “She could have spent more time with us and her grandson.”
The risk of spreading the disease to people with compromised immune systems, he said, is an additional reason for people to get the COVID-19 vaccine.
To Conway, of UW Health, getting the vaccine to protect others is “one of the things we do as charitable members of society.”
“It makes it that less likely those people are going to be exposed," he said.
No return to normal life
People who have not been vaccinated also will prevent people with compromised immune systems from returning to the lives they lived before the pandemic.
“Most of us feel they deserve an opportunity to be part of society as well,” Conway said.
In contrast, people who are healthy and who have been vaccinated face almost no risk.
“It’s becoming more and more apparent that the risk of actually developing an infection — at least in the first six months — is pretty close to nil.” Conway said.
Less than 1% will become infected, and roughly half of them will experience no symptoms. Others will experience mild symptoms similar to having a cold.
That’s the reason for the new guidelines from the Centers for Disease Control and Prevention.
Life essentially will return to what it was like before the pandemic for people who are healthy and have been vaccinated.
The risk is that people who haven’t gotten vaccinated — and could be unaware that they are infected with the virus — will do the same.
“Immune-compromised people are going to be exposed to more people with the virus,” said Citronberg, of Advocate Aurora. “There’s no doubt about it.”
Fedie, who was diagnosed with Stage 4 liver cancer with a rare mutation, doesn’t know how much protection she has gotten from the COVID-19 disease. But, for now, she does worry and does see people who are unvaccinated as a risk.
“It is very frustrating when people don’t take it seriously,” she said, “and don’t take the precautions that are needed.”