Immune problems, covid, and waiting for the right vaccine

[frozenborderline]

Any thoughts on myocarditis risk , @Hip ?

 

[frozenborderline]

With novavax ...

Now that its approved most places ...

Also What risks are there with evusheld

 

[Hip]

Any thoughts on myocarditis risk , @Hip ?

I have not looked into it much.

Some very interesting research by Professor Christine Stabell-Benn in Denmark indicates that the off-target effects of vaccines depend on whether the vaccine is live or inactivated.

She found that live vaccines not only protect from the pathogen they target, but also have off-target benefits, where they dramatically reduce all-cause mortality not related to the target pathogen. Whereas inactivated (dead pathogen) vaccines actually increase all-cause mortality.

In other words, both types of vaccine protect from the target pathogen, but the live vaccine also dramatically lowers other causes of death too. This was noted when the measles vaccines were introduced: they found not only did this lower the number of deaths from measles, but also greatly lowered deaths from non-measles causes.

So live vaccines seem to have substantial off-target benefits. But dead vaccines appear to increase off-target all-cause mortality.


She has been trying to extend her research to the COVID vaccines, and preliminary findings suggest that the mRNA vaccines behave as dead vaccines, whereas the adenovirus vector COVID vaccines act like live vaccines.

 

[hapl808]

Some very interesting research by Professor Christine Stabell-Benn in Denmark indicates that the off-target effects of vaccines depend on whether the vaccine is live or inactivated.

I've followed her research a bit and it's fascinating, but I think she's having great difficulty getting any traction because questioning the dogma of vaccination in any way is greatly discouraged. And part of the dogma is 1) there is never anything to question in any vaccine other than how often we should take it and 2) live vaccination is dangerous and inactivated or other forms are the gold standard.

 

[Hip]

live vaccination is dangerous and inactivated or other forms are the gold standard.

Live vaccines do have the disadvantage that they occasionally kill people who have weak immunity.

But if live vaccines in general are resulting in a massive reduction in all-cause mortality, then arguably that advantage would substantially outweigh the occasional deaths they cause.

Prof Stabell-Benn says that very little research actually goes into the off-target effects of vaccines. She says that the WHO are aware of these off-target effects, but they are completely ignoring them.

It seems that this area of off-target effects, good and bad, should be much more studied.

 

[hapl808]

Prof Stabell-Benn says that very little research actually goes into the off-target effects of vaccines. She says that the WHO are aware of these off-target effects, but they are completely ignoring them.

It seems that this area of off-target effects, good and bad, should be much more studied.

Agreed - it's a shame that the WHO is ignoring it. This is my complaint with so many health issues. They draw conclusions they want to be true, then refuse to study anything that could question that. I always thought live vaccines were more risky for the reasons you mention, but it would be worth studying if they change all-cause mortality. I don't know the answer, but we can't even begin to wrestle with it if we refuse to examine it.

 

[frozenborderline]

At this point I don't think evusheld or novavax are terrible risks compared to other immunization treatments against covid, or compared to effects of covid itself. However I do worry about one thing. i should like to ask an immunologist or a knowledgeable patient about this: if evusheld, the combination of two monoclonal antibodies made to be long lasting in the body, happens to cause a rare side effect or mcas reaction, will that reaction last for the whole time that the antibodies remain in the body, which is longer than many mabs? Even if the side effects are rare this is the one thing that concerns me. It is a type of biologic and is degraded similar to antibodies and natural igg in the body but it is also made to be particularly long lasting , which is good for protection from covid, but I guess i worry about what it means if one is the rare person to react to it.

I know there are some other mabs using the same technology to make them longer lasting. I know there are mabs that are short lasting which everyone seems to consider safe like regeneron.

I'm curious if the long lasting aspect would make evusbeld at all risky in rare cases of reactions and how immubologist would treat this. I may start a new thread for this.
@Learner1 you seem to know a lot about immune issues as does @Hip and @pattismith . What do you guys think about the problems with long lasting mabs like evusheld... they stay in the body for awhile but does that mean the side effects would necessarily last that long or does the body just stop rejecting them at some point

Evusheld and novavax and paxlovid are the three things I'm most excited for in terms of helping prevent getting even worse from covid. But I'm very frail so I do want to make sure that I am cautious about what decisions I make even if these are safer than the other vaccines.

 

[Learner1]

I'm more concerned about getting COVID and what that'll do to me. Both my immunologist and ME)CFS specialist were in favor of my getting Evushield and not concerned about long term effects.

Antibodies break down over time, so unless you make more, you need to boost them. Evushield is meant to protect for about 6 months, so we expect there will be another round of it.

 

[Learner1]

So live vaccines seem to have substantial off-target benefits. But dead vaccines appear to increase off-target all-cause mortality.

Some of us have been told not to get live vaccines by our immunologists. If one is immunodeficient, the live vaccine could cause an infection which could the immune system can't fight.

 

[frozenborderline]

I'm more concerned about getting COVID and what that'll do to me. Both my immunologist and ME)CFS specialist were in favor of my getting Evushield and not concerned about long term effects.

Antibodies break down over time, so unless you make more, you need to boost them. Evushield is meant to protect for about 6 months, so we expect there will be another round of it.

I'm also more concerned with covid than evusheld, but I can be concerned about both, given how hyperreactive i am. Many things like vaccines and contrast I react to even when doctors, including me/cfs specialists, have said I'll be fine, so scrupulousness/scrupulosity? Isn't irrational totally.

The reason I asked is you seem to have a good understanding of a lot of immune mechanisms in particular so I thought you might know the answer to this. Not what the general side effects are or how safe evusheld is but rather what the risks of making the mabs long lasting might be if any, or if there are no risks compared to a short acting monoclonal antibody . I accept the risks are generally rare , my concern in this case is that if you have something that lasts for six months in your body and you do have a reaction, like an mcas reaction or immune intolerance of it In some ways, then would that mean you stay reacting for the whole six months? I've never had a drug that has a 90 day half life so this is a question I've never had to contemplate.

 

[frozenborderline]

I'm more concerned about getting COVID and what that'll do to me. Both my immunologist and ME)CFS specialist were in favor of my getting Evushield and not concerned about long term effects.

Antibodies break down over time, so unless you make more, you need to boost them. Evushield is meant to protect for about 6 months, so we expect there will be another round of it.

Did you take evusheld before or after vaccination. I don't know what the proper order for me would be

 

[Learner1]

Did you take evusheld before or after vaccination. I don't know what the proper order for me would be

I did 3 full dose COVID vaccines first, because that's what was available. However, if your immune system doesn't respond to vaccines, you could just do Evushield. According to my immunologist, about half his immunodeficient patients responded to the COVID vaccine.

One thing to be aware of - I had reactivations of HHV6 and EBV, found by doing quantitative PCR tests, after one of the vaccines and the Evushield. It's an ongoing issue for me, with various physical stressors causing reactivations, so I've had to go back on Valcyte.

But, I've had to fly across the US several times and am currently in Florida, where most people seem to think COVID is over and don't wear masks even though it's raging all around them, so I'd rather be protected.

 

[frozenborderline]

However, if your immune system doesn't respond to vaccines, you could just do Evushield. According to my immunologist, about half his immunodeficient patients responded to the COVID vaccine.

I do have low immunoglobulins but I don't know that I could rule out responding to vaccines ahead of time. I am excited that novavax is out as it's got better side effect profile than the other vaccines are, I just don't know what order to get the novavax vaccines and evusheld (which I alresdy have prescribed as a standing order) in ...

 

[Learner1]

I think it depends on your risk level. If you're in an environment where you going to be exposed to COVID, Evushield is the antibodies and will give protection quickly. The vaccines stimulate your immune system to produce the antibodies, so there's a lag. However, Evushield lasts 6 months, so the vaccines could lengthen your protection beyond that, depending on timing.

 

[frozenborderline]

"The mean and individual concentration–time profiles for the components of REGN-COV2 — casirivimab and imdevimab — increased in a dose-proportional manner and were consistent with linear pharmacokinetics for single intravenous doses (Figs. S6 and S7). The mean (±SD) day 29 concentrations of casirivimab and imdevimab in serum were 68.0±45.2 mg per liter and 64.9±53.9 mg per liter, respectively, for the low (1.2 g) doses and 219±69.0 and 181±64.9 mg per liter, respectively, for the high (4.0 g) doses (Table S4); the mean estimated half-life ranged from 25 to 37 days for both antibodies (Table S5)"

I found this really interesting bc it's from an acute covid-19 MAB cocktail treatment. despite not being made to be a long term treatment, it is fairly long lasting. I think that the antibodies in evusheld have a specific modification to make them more long lasting, I forget the specific terminology, but MABs as a class might just be more long lasting even without that specific modification, maybe bc of the way antibodies in general are processed by the body, including endogenous produced antibodies... those antibodies may have different, longer lasting pharmacokinetics than most drugs. I hate having to research everything I put into my body bc of mcas and so on, but I have to admit this is somewhat interesting.

 

[zaika11]

I think it depends on your risk level. If you're in an environment where you going to be exposed to COVID, Evushield is the antibodies and will give protection quickly. The vaccines stimulate your immune system to produce the antibodies, so there's a lag. However, Evushield lasts 6 months, so the vaccines could lengthen your protection beyond that, depending on timing.

I saw info in study it can stay much longer time, till 12 months. And it seems to be true. Because after 7 months I still have about 60% of antibodies which got with first dose..
Btw did you notice any side effects/worsening with Evusheld?

 

[Learner1]

I saw info in study it can stay much longer time, till 12 months. And it seems to be true. Because after 7 months I still have about 60% of antibodies which got with first dose..

I don't know how you can tell that. The benefit to Evushield is it gives people who don't make antibodies the antibodies immediately. It is supposed to need a second dose at 6 months.

Btw did you notice any side effects/worsening with Evusheld?

Nope.