IS IT SAFE FOR OUR PATIENTS TO COME OUT?

ABSTRACT

Background: Vaccination against COVID-19 commenced in England in December 2020, most haematology patients iwere included in the first wave as they are identified as extremely vulnerable. A second dose was administered 12 weeks after the initial dose, and booster doses became available in September 2021. Severely immune compromised patients started to be contacted in December 2021 to offer them a fourth dose of vaccine. With the availability of treatments there arose a need for early confirmation of presence or absence of antibodies against COVID-19 and testing for antibody was introduced into routine practice for patients about to commence chemotherapy, or those who had yet to complete the four-dose protocol. On the 1st of March most restrictions imposed during the pandemic were removed, in the expectation that the majority of people would have protective antibodies from vaccination. Aims: Over a period of six months from October 2021 to February 2022 we tested 90 patients attending routine haematology clinics, with a number of conditions, mainly malignancy under follow-up or recieving treatment. We reviewed the results of these tests, to assess degree of protection Methods: Retrospective analysis of all requests for SARS-Cov antibody tests carried out in our patient populations. Results: There were 55 males, and 35 females, with an average age of 65y (range 24-90) The majority attended clinic for management of haematological malignancy (Plasma cell disorders, Chronic Leukaemia, Lymphomas) with a smaller number of patients being managed for congenital or immune conditions. Diagnosis No detectable antibody Antibody<500 units Antibody > 500 units (Table Presented) Summary/Conclusion: Despite early availability of vaccines, and delivery of more than two doses to the majority of our patients, only half our patients had significant antibody response, and almost one quarter still had no detectable antibody. Although the number of new cases is reducing, in the vicinity of our Hospital there were 483 new cases per 100,000 on the last day of February, and during the six months of this study two fully vaccinated patients with CLL with no detectctable antibody died in Hospital with covid-19 pneumonitis. For some haematology patients particulalry those with CLL it is still not safe to come out.