Anniken Kvaal was shocked when she came across an article about the coronary vaccine last week.
– At first I was scared. Then I got pissed. Why has no one told me this ?, says Kvaal.
On May 19, the 63-year-old from Bergen was fully vaccinated. Finally, she could hug her grandchildren, meet friends, and go on a cabin trip. But the joy was short-lived.
Anniken was recently told that she does not have antibodies in her blood, even though she has been fully vaccinated.
– I am afraid that there are more transplant recipients who have not experienced this, says Kvaal.
– INSULATED: Now Anniken must again be careful and isolated in order not to be infected. Photo: Kåre Breivik / TV2
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Had finally got my life back
17 years ago, both Anniken’s kidneys stopped working. The rescue was a kidney transplant from the cousin.
– That kidney has worked absolutely fantastic, without any problems, says Kvaal.
As a kidney transplant recipient, Anniken is in the high-risk group for covid-19. In the last year, she has therefore followed a strict infection control regime.
– It has been a tough year, but after I got the vaccine I thought I would finally get my life back, says Kvaal.
But no one had warned Anniken that the medication she must take after the transplant can reduce the vaccine’s effect. She found out for herself after reading an article on her website National Association for Kidney Patients and Transplants.
– When I read it, I just thought “help”. This means that I have exposed myself to infection for several weeks. It is frightening when you know that mortality is higher for us who have had a kidney transplant, says Kvaal.
– ALONE: Anniken no longer dares to be visited by children and grandchildren. Photo: Kåre Breivik / TV 2
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– Everything ends
For Anniken, the summer holidays will not be as she had planned. Now she must return to distance, bandages and strict infection control.
– I have felt how wonderful we have had it in these weeks, also suddenly this happens and everything ends. Now it is back to the way it was before, says Kvaal.
Both she and her family thought that the vaccine would be the rescue, but now the future looks uncertain.
– I had imagined a very cozy summer with the whole family at the cabin. We were supposed to grill, swim and drive a boat, but that’s not the case now. We have informed the children that they can no longer visit, says Kvaal.
Criticizes the hospital
After reading the article, Anniken called the kidney department at Haukeland University Hospital. There she was confirmed that what she had read was true.
– They recommended me to live as if I had not been vaccinated, says Kvaal.
She responds that she herself had to contact the hospital to get this message.
– I have received fantastic follow-up from Haukeland for many years, but here they have failed. I think it is a matter of course that the necessary information should be given to the patients, says Kvaal.
– HAUKELAND: Anniken has received follow-up at Haukeland Hospital in Bergen after the transplant. Photo: Frode Hoff / TV 2
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– We are sorry
Haukeland Hospital regrets that Anniken did not receive the information she needed.
– Providing good information is an important part of the treatment. We regret that we have not succeeded in this case, says Per Olav Rui, chief physician at the section for kidney diseases.
In the future, the hospital will do its best to follow up the kidney transplant patients.
– We want to provide good follow-up of our kidney transplant patients and will do our utmost to inform patients quickly about the consequences of the antibody test, in addition to the public information available to patients, including under the auspices of the National Association for Kidney Disease and Transplant, says Rui.
20-40 percent do not receive antibodies
There has long been uncertainty about how good the vaccine will be for those who have had an organ transplant.
– We know from before that organ transplant recipients have a weakened immune system which means that they have lower conditions for responding well to vaccines, says chief physician Sara Viksmoen Watle in FHI.
– DISAPPOINTING: The FHI superior has a great understanding that many transplant recipients think these are disappointing figures. Photo: Per Haugen / TV 2
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It is only a few weeks since the first international studies on the effect of the coronary vaccine on immunosuppressed people were completed, and the results were disappointing.
Studies from France, Israel and USA shows that the majority of organ transplant recipients do not receive antibodies from the vaccine, even after two doses.
– There have now been publications in international medical journals that have shown that approximately 20-40 percent of the kidney transplant recipients form antibodies after two vaccine doses, write four researchers at Rikshospitalet in a post on the website of National Association for Kidney Patients and Transplants.
Same result in Norway
A research study has also been started in Norway to find out how good the vaccine is on organ transplant recipients.
So far, the team at Rikshospitalet of researchers has analyzed the blood samples of over 700 kidney transplant recipients, taken four weeks after the second dose.
– ORGAN TRANSPLANTATION: All organ transplants in Norway are performed at Rikshospitalet in Oslo. Photo: Aage Aune / TV 2
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– I think it is very important that we have Norwegian studies on this, says Watle.
The preliminary data in the study show the same result as the international studies.
This means that between 60 and 80 percent of Norwegian kidney transplant recipients do not have antibodies in their blood, even though they have been fully vaccinated.
This is the reason
Anyone who has been through an organ transplant must take immunosuppressive drugs that inhibit the body’s immune system. These medicines are used to prevent the body from repelling the new organ, and are something patients have to use all their lives.
But the drugs also affect other parts of the immune system.
– When you take these drugs, you inhibit several parts of the immune system, including the cells that are supposed to contribute to making antibodies, says chief physician Sara Viksmoen Watle in FHI.
– RESEARCH: NIPH closely monitors the Norwegian and international research studies on the effect of the vaccine in transplant recipients. Photo: Per Haugen / TV 2
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According to the prescription register, in 2020 there were over 77,808 people in Norway who used immunosuppressive drugs.
– These medicines can to some extent lead to poorer protection after vaccination. But there is a big difference between the patients who use these drugs, says Watle.
Organ transplants use strong medications that cause a severe immune weakening. There is therefore a big difference between these patients and those who, for example, use weaker medications such as cortisone for asthma.
Can provide protection anyway
Although many organ transplant recipients do not have antibodies in their blood, they may still have some protection from the vaccine.
“Vaccination not only produces antibodies, it also provides other immune responses that can be important in protecting against the virus,” Watle said.
– OFFER: All Norwegian kidney transplant recipients have been offered to participate in the study at Rikshospitalet to check if they have antibodies in their blood. Photo: Truls Aagedal / TV 2
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There are now several studies, both in Norway and internationally, which examine how well protected one can be without having antibodies.
– I have a great understanding that it is scary and disappointing to be told that you do not have antibodies in your blood. But that does not mean that the vaccine has no effect, says Watle.
– A giant downturn
The National Association for Kidney Patients and Transplantation (LNT) has been busy with questions and reports of concern in recent weeks.
– I think many have suffered both mentally and in other ways during the pandemic. Then it has been thought that the vaccine should be the solution, but then it is not certain that it is like that anyway. It is a gigantic downturn for many, says Jon Anker, communications manager at LNT.
– THIRD DOSE: Anker believes a third dose of vaccine can be of great help to transplant recipients. Photo: Tom Rune Orset / TV 2
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They have tried to keep their members up to date on the situation, but fear that there may be members who have not caught up.
– For some transplant recipients, these figures probably came as a shock, while others were more prepared for it to happen, says Anker.
Three doses
This week, a comprehensive study was started to investigate how effective the vaccine is for transplant recipients and others with weakened immune systems.
In the study, participants who have a low or no immune response after two doses will receive a third dose of vaccine to see if the effect is higher.
– We see that many patients with a weakened immune system respond poorly to covid-19 vaccination. We will now carry out several studies to identify patients who may benefit from additional vaccination, says Professor John T. Vaage at Oslo University Hospital in a press release.
If this study shows that transplant recipients have a good effect of a third dose, it may be relevant to offer this to all transplant recipients.
– It can definitely be relevant in Norway, says Sara Viksmoen Watle in FHI.
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