Thread by @MonicaGandhi9

I wanted to go back to this question of the redundancy of the immune system when we assume that those who don't have antibodies aren't protected after vaccination (e.g. immunocompromised patients). Please remember how redundant & complex the immune system is

We have paper from our group last week that shows people with HIV may have lower antibodies after natural infection but follow-up analyses shows T cells (CD4 and CD8) preserved. If one line of immune system down, other line can help.
thelancet.com/journals/lanhi…

Know this thread is super long & sorry but it really discusses why antibodies are just "tip of iceberg" in terms of immunity (or feeling 1 part of elephant!). My patient on cancer treatment had low antibodies, but T cells just fine in research lab.

https://twitter.com/MonicaGandhi9/status/1373510909868470272

So, for those of us treating immunocompromised patients, may want to check T cells before assuming little immunity from antibodies and also we submitted a grant (as have many) on studying whether boosters (3 doses of a vaccine instead of a 2) would help immunocompromised

I am quoted in this @washingtonpost article about vaccines in immunocompromised patients. PLEASE don't consider only antibodies when you consider if protected. Immune system complex. 2 ideas: 1) Get T cell panel; 2) Booster (3rd dose). My patient here too!
washingtonpost.com/health/2021/05…