1/x ***New Research***. 🧵Relevant to the #immunocompromised with @bloodcancer_uk + #forgotten500k campaign. By a trusted lab in New York- Greenberger lab. Looking at immune responses to COVID vaccination. It is my new fav journal due to their colours! aacrjournals.org/bloodcancerdis…
2/x. It was done as many blood cancer🩸patients have no detectable immune response following coronavirus vaccination 💉. It is accepted that if you don’t respond to a vaccination, you aren’t as well protected from COVID-19. This answers the counter-argument- is this okay?
3/x. In 505 patients with B-cell malignancies, in a real world setting. This is a new form of study scientists use nowadays (vs a randomised study-RCT, where 50% of people get a sugar injection). RCT are generally not thought to be acceptable. They looked at patient's blood.
4/x. It looked at T-cells, as maybe if you don’t have an antibody response, you might have T-cells. After all, there’s two parts of immunity. (GCSE biology- 😀or maybe☹️) So if you haven’t got coronavirus vaccine antibodies, you might have a T-cell response giving protection.
5/x They found that after dose 2, 45% of those with no antibody responses had anti-spike T cells. 55% did not. And after dose 3, only 22% had good antibodies and only 40% had detectable responses. Figure below. No T-cell immunity is not ideal.
6/x To summararise, we can’t say that all blood cancer patients have good levels of protection from vaccination. They says this 🗣️👇. The most eminent global scientist/teams repeat call for more protection for the #immunocompromised, flagging ***prevention*** and ***antibodies***
7/x Why does this matter? There are half a million immunocompromised people in the UK. Many are still shielding, still in isolation, still unable to work, see friends or hug loved ones. They are #forgotten500k, unheard and calling on us to notice.
8/x. In the UK, the 4th wave has seemingly started. For the population who have responded to the vaccination, it will probably be mild. But for those who haven’t, and have 2020 levels of protection, this is not guaranteed. Thanks @timspector
@timspector 9/x. It is good to see patient advocacy & democracy spring into action. Representatives from #forgotten500k are writing to MPs. Only this week, 7 questions were asked in parliament of DHSC about why they are not protecting the #forgotten500 sooner, but waiting till 2023.
@timspector 10/x. We know that DHSC has incredible civil servants. We clearly have the best talent there to make it happen if prioritised. From my time there, they are the very best of the public sector. 🏛️🦸‍♂️🦸‍♀️🦸
11/x We have heard this week, that the stream of letters to DHSC is now increasing with further letters from incredible societies like British Society of Immunology and the UK drug safety research Unit. 📧💌📩📨
12/x 32 countries are delivering additional levels of protection this winter to protect immunocompromised patients who have not responded to the coronavirus vaccine, using new therapies, not available in the UK- prophylactic antibody therapies.
13/x Prophylactic antibody therapies like #evusheld give back an “immune” system to those who are immunocompromised. It is given in a similar way to a vaccine and it prevents infections. Studies from Israel/France/US show it is working well, even against omicron. @TomChivers
14/x Thanks to patients, clinicians @AlexRichter3 @ProfBMT + myself as champions, the clinical community has also sprung into action. Patients, 125 clinicians from 17 medical specialities & 4 nations are bringing online professional organisations/charities for a call to action.
15/x No one is sure if DHSC will offer protection or consider a pilot to protect #immunocompromised patients with #evusheld this Winter. Budgets might be an issue. However, patient power has seemingly swung into action. They are asking in mass about what they need.
16/x. It is good to see ongoing universal unwaivering support from clinicians/charities/researchers & patient groups. My thoughts are with our #immunocompromised patients. Thousands of people are backing their #forgotten500k campaign for prophylactic antibody therapies. #evusheld

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More from @drlennardlee

Sep 27
1/x 🧵I was humbled by #immunocompromised patients for a surprise gift as we try to "surface" the #forgotten500k issue. Nice surprise before my busy NHS clinic. Our clinical leads didn't plan to be here and are glad to support the coronavirus Winter plan/pilot call #evusheld.
2/x I believe that calls for action/help from patient groups + charities are important + need acknowledgement. If people are in difficult positions, still shielding after 2.5 years 😢🏠, the best we can do is try & carefully evaluate. I am glad they trust us/me to speak for them.
3/x. Thanks as ever to the @APPG_VGP for starting this patient action campaign. I don't know if we will get their pilot by Winter, for some patients to benefit, but if they do, I know they can count on our doctors and the 125 across 17 specialities to support!😀
Read 4 tweets
Sep 23
1/x 🧵What happens when a diverse group of patients at risk from COVID-19 try to ask what they need? In this case, #immunocompromised & their small ask for protection from COVID-19 with #evusheld. This is my honest assessment as a UK NHS doctor. 👨‍⚕️🏥. Pls RT.
2/x What's the background? In this case the group affected from COVID-19 are both young + old. They are #immunocompromised. They may have cancer, blood cancer, transplant, autoimmune disease or immunosuppressants. A patient group hasn't linked them before. 🧑‍💻👩‍⚖️👨‍🍳👨‍🌾
3/x. The pandemic brought them together, because many of them were checking if they had an immune response to coronavirus vaccine, the best form of protection from COVID-19 and they found they had low/absent immune responses. 🙄. itv.com/news/2022-08-1…
Read 25 tweets
Sep 21
1/x 🧵This is an important issue that many clinicians are worried about & I am glad to have been put forwards to talk on behalf of the @APPG_VGP, its 19 patient charities and the National Clinical Expert group which pulls representation from 17 medical specialities & 4 nations...
2/x What's the background? We are living with coronavirus and most of us have high levels of protection from our vaccination 👍😃. However, not everyone gets high levels of protection. If you have a weakened immune response, your protection may not be as quite as high....
3/x. People with a weakened immune response are #immunocompromised & it can affect the young and old. It can happen because you have a cancer or blood cancer, a transplant, an autoimmune condition or because of drugs you receive from your doctor. 🧑‍⚕️💊😷. There are 500,000 people.
Read 18 tweets
Sep 3
1/x. 🧵With HEALTH policy, there should be transparency + solid evidence that standard process was followed. RACI- RESPONSIBILITY 📝 1️⃣who made decisions, 2️⃣who was the clinical teams advising 3️⃣who was providing scientific input. ACCOUNTABILITY 🎖. With a decision of this
2/x magnitude affecting so many #immunocompromised people, normally very eminent & respected medical physicians would have been involved 👨🏼‍⚕️👩🏽‍⚕️🧑🏻‍⚕️. CONSULTATION🎪- stakeholder dialogue across 4 nations, across the specialities 🏥treating these groups
3/x. Finally INFORMED GROUPS🧑🏻. They are normally key 🔑 and informed as part of the process. For participation and to minimise potential distress. 🙁. They need to understand the nuances why and why not and that decisions were not “predecided”. It had to be “fair” at the time.
Read 9 tweets
Aug 31
1/x ***New data 🧵 *** Landmarker paper from France- @Timothee_B from the Pasteur institute in France. Brilliant article for #immunocompromised (#Evusheld). A fascinating science study about how long you are protected for. medrxiv.org/content/10.110…
2/x What's the background? With winter coming and the high transmissibility of omicron, across the Northern hemisphere, countries are moving to protect their immunocompromised. These are people who may have lower levels of protection from vaccination.
3/x This paper looked at 6 antibodies against variants -Delta, BA2, BA.4 and BA.5 isolates. This was important as vaccines provide lower levels of protection against these variants, & it was unclear if antibodies maintain or lose protection too. ❓❓❓
Read 14 tweets
Aug 19
1/x ***New data 🧵 *** Data from qcovid data team, @JuliaHCox, one of UK's population covid analytics platforms. It provides useful insight into who is vulnerable now & what safety nets there are available for them and issues... medrxiv.org/content/10.110… & medrxiv.org/content/10.110…
2/x What's the background? Well... that data might save lives during this pandemic 🖥️💽💾. You use NHS data to know exactly who you need to protect 🔫and who is already well protected 💪. Several platform exists. This is one of the two Oxford big ones, along with @OpenSAFELY..
3/x. Both papers are pre-prints. Here is paper 1⃣. It's got JVT on 🦸‍♂️ (seal of confidence). It is QCOVID4 and it answers 🗣️📢"who is now at risk during the omicron wave". 1.3M adults were analysed. The primary question ⁉️❓ "who is dying from covid-19?"
Read 13 tweets

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