Landmark study shows vaccine response in vulnerable patients
Patients in Southampton have helped show how well COVID-19 vaccines protect those clinically at risk.
Results from the OCTAVE study provide an insight into real-world vaccine responses and infection outcomes for the first time. They suggest a small number of patients may not respond to vaccination.
University Hospital Southampton NHS Foundation Trust (UHS) was a top recruiter to the national study. Recruitment focused on patients with stem cell transplants.
Researchers published their findings this month in Nature Medicine.
Weakened immune system
People who are immunocompromised have a weakened immune system. This affects their ability to fight off infections and diseases.
Around 500,000 people have a weaker immune system in the UK. This includes people with blood cancer, stem cell transplants, inflammatory arthritis and diseases of the kidney or liver.
Preliminary data published in 2021 showed COVID-19 vaccines are less effective for these people. 40% mounted a low, or undetectable, immune response after two doses.
Some patients failed to generate an adequate T-cell response, which is also important for fighting off infection.
Low infection rate
The OCTAVE study was led by researchers at the University of Glasgow and University of Birmingham. Over 2,600 people took part across several centres in the UK.
Researchers performed a range of state-of-the-art immune tests on blood samples taken before and after COVID-19 vaccination. They also collected infection and severity data to better understand the real-world impact of a low vaccination response in these patient groups.
These new data show that overall COVID-19 infection rates were low in most at-risk patient groups.
Important insights
Some groups were at greater risk of severity and death from COVID-19, despite vaccination. This was particularly the case during the Delta wave.
Vaccines were less effective for people with kidney diseases and some inflammatory conditions.
There were low rates of severe disease in patients with Crohn’s disease and ulcerative colitis.
Dr Kim Orchard, Consultant Haematologist at UHS, was local lead for the trial. He worked closely with UHS trial nurse Clare Hutchison to recruit patients that had received allogeneic stem cell transplants for blood cancers.
Dr Orchard said: “The OCTAVE study answers important questions about how well the COVID-19 vaccine works in people with a weakened immune system.
“The results will help us to care for our transplant patients, who remain vulnerable to COVID-19.”
He added: “I am proud to have led on this trial in Southampton. It was a privilege to work with the British Society for Blood and Marrow Transplantation and Cellular Therapy on the development of this study in stem cell transplant recipients.”