Immune System

Doctors Are Still Hunting For The Cause Of Long COVID Brain Fog

Studies show 30% of COVID patients report brain fog a few months after they’re sick. It’s 65 to 85% for long-haulers sick beyond that.

COVID-related brain fog is a condition that can feel very defeating and overwhelming.

Newsy’s Lindsey Theis has COVID-related brain fog herself. And it’s a topic she’s covered since 2020. She says each person she’s spoken with tells her it’s a dramatic change that impacts how they think and move throughout their lives. For this story, Theis met a family dealing with what she says is one of the worst cases she’s ever seen.

On a bright, sunny day in rural Rensselaer, Indiana, 45-year-old Kari Lentino’s mind is a slow-moving storm.

“I feel like a brain blizzard half the time,” she said.

Lentino is immunocompromised. She’s had COVID twice. Since June 2021, it’s left her with several neurological setbacks. She says her brain fog is among the worst of it.

“I couldn’t remember passwords to get into certain systems. I worked at the library and I would forget what I was doing while I was doing it,” Lentino said.

Her conversations now go at a snail’s pace as she searches for words.

The mother of four and grandmother of two had to quit work and file for disability.

She can’t watch her grandkids. She won’t run errands or drive. Now, her time is spent mothering her brain.

Dr. Igor Koralnik is chief of neuro-infectious diseases and co-director of the Northwestern Medicine Comprehensive COVID-19 Center, where he also runs a lab.

He says 70% of his COVID brain fog patients are like Lentino — women in their early 40s.

“We see that attention is their main cognitive problem,” he said. “Problem with attention, problem with memory, problem with multitasking and briefly, problems getting through their daily life and working in their current job capacity. … We have people who have been infected back in March 2020 and still have decreased quality of life because of those symptoms and decreased cognitive function.”

Scientists think COVID cognitive dysfunction is from brain inflammation — but what causes it is still itself foggy.

One leading theory is that long COVID is an autoimmune disorder, where the immune system attacks healthy cells in the body, including the brain.

“We find that the virus has confused the immune system, and we think that it’s driving the immune system towards autoimmunity,” Koralnik explained.

Studies show 30% of COVID patients report brain fog a few months after they’re sick. It’s 65 to 85% for long-haulers sick beyond that.

Researchers haven’t found brain fog treatments yet, so they tackle someone’s symptoms.

But even diagnosing brain fog is tricky. It’s invisible. There’s no set case definition but it can include trouble focusing, struggling to remember names, places, or words, reacting slowly, confused judgment, losing a train of thought often and fatigue or exhaustion from concentrating.

Back in Rensselaer, Lentino’s husband helps her prepare her pills. She takes eight medications and two vitamins daily, plus a handful more as needed. That’s in addition to her therapies and memory aids like calendars and post it notes. Those cues share spots in the Lentino home near the signs of her former creative and vibrant self. Prescription bottles near her paintings. Reminders near her Star Wars string art.

“It’s frustrating and depressing. It takes so long to do anything,” she said.

In the spot where she used to stand to paint, brushes and acrylics wait patiently.

Lentino is waiting too, like so many brain fog sufferers. It’s a long, draining wait and the ultimate test of patience.

On a hopeful note, research shows many brain fog patients recover memory and attention near the 6-to-9-month mark. For treatment, some doctors prescribe medicine, like steroids or antihistamines, plus therapies like speech or cognitive rehabilitation therapy. If you have brain fog yourself, experts say you can try memory games and puzzles, and focus on quality sleep and healthy eating.

: newsy.com

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Pandemic Fatigue Could Cause Problems For Public Health

As most people get tired of dealing with the pandemic, experts worry Congress will too, which could affect vaccines, tests and other policies.

It’s been a long pandemic, and COVID still isn’t fully gone. Now, monkeypox and polio have entered the conversation.

Many are still trying to figure out what a degree of normalcy looks like, but as tired as people are, how much worse is it for the actual public health system?

It’s led to a whole array of challenges for public health, and that could have major consequences for an already weary U.S. health system.

While public health got a boost in funding during the heights of the pandemic, the Biden administration is already pulling back on funding for tests and vaccines because of a lack of funding from Congress.

It worries experts like Thoai Ngo, an epidemiologist working at the health justice research nonprofit the Population Council.

“My main worry right now is that because of how we operate, we will erode trust from people in public health institutions,” Ngo said. “We will make it harder for us to control and manage the current epidemics: COVID-19, monkeypox, polio and future epidemics.”

So, what does the U.S. public health picture look like with COVID now?

Federal officials in places like the White House and CDC celebrate the role vaccines have played in preventing severe disease and death. The numbers show they definitely have, with COVID deaths in the last few months largely staying at a low point that we only saw briefly last spring and summer.

The CDC has used this as the basis for its new guidance from mid-August, which do away with the recommendations to practice social distancing and to quarantine if exposed to COVID.

It’s that reduction in severe disease and death that has underpinned the rollback of universal mask mandates nationwide and vaccine mandates in many places.

Dr. Shira Doron, a hospital epidemiologist at Tufts Medical Center, has helped advise officials in Massachusetts on COVID policies, including in schools. She welcomes some of the new policies that roll back restrictions now that ways to prevent severe outcomes are readily available.

“The fact that we have all of those layers now, vaccines, tests and treatments just puts us in a completely different place in terms of that risk of severe disease, which is what we care about, which is the only thing we can hear about because we just can’t prevent infection,” Dr. Doron said. “That infection is too contagious.”

But even with low death rates, the U.S. is still losing more than 500 people every day. That means the U.S. is still losing as many Americans from COVID-19 in two weeks as it lost from two decades of fighting in Iraq and Afghanistan.

For those who center their work on immunocompromised people, policies rooted in fatigue with the virus look like an admission that the virus has won.

“I just think that, particularly with the recent CDC guideline, it’s confirming to me that the Biden administration and our federal health officials have given up on controlling infections of COVID-19, and they left the vulnerable, the elderly, the immunocompromised, people with disability in the cold,” Ngo said.

Then there’s long COVID, which is more than just a few extra weeks of the sniffles.

It’s personal for Elizabeth Jacobs. She’s an epidemiologist at the University of Arizona who has two illnesses that suppress her immune system.

“We’re seeing things like fatigue,” Jacobs said. “That is really hard to describe. I think that a lot of people use fatigue in the colloquial sense of, ‘I’m just tired.’ But for somebody like me who has genuine fatigue caused by autoimmune diseases, it’s not like that. It’s more like you have cement blocks tied to your legs and arms, and you just can’t really even move around a lot. You have trouble getting out of bed and even sitting up in front of a computer is really difficult.”

Beyond her concern about her own risk if she contracts COVID, Jacobs worries that a shift away from preventing infection could make it harder to solve other problems tied to it.

“Is it that people are tired of mitigation with masking, or is it that we are tired of things like flight cancellations and supply chain issues and having our children out sick from school and needing to care for our loved ones and seeing our neighbors die?” Jacobs asked. “Because if it’s the latter that is causing fatigue in us, then that is not being caused by mitigation. It’s being caused by the lack of mitigations.”

Then, there’s monkeypox.

In short, public health officials at federal and local levels have said they believe the response started slower than it should have. Tests and vaccines have also been hard to come by, although there’s hope that new shipments in the coming months should make it easier to vaccinate people at risk.

It sounds similar to some of the early missteps in addressing COVID-19, and that might not be a coincidence.

“The response to monkeypox, from what I can tell, is very much influenced by the law over the last two years of COVID, right?” said Jared Auclair, director of the biopharmaceutical analysis and training lab at Northeastern University. “People just don’t want to think about it and just don’t want to deal with it. Taking that mindset of slow rolling into a response because you are exhausted from COVID and don’t want to, you don’t want to have any repercussions like you’re being alarmist.”

The good news about vaccine demand outstripping supply is that there’s a high degree of interest from at-risk groups. Monkeypox is primarily affecting gay and bisexual men who have sex with men.

“In general, that community has been very direct and forthcoming about wanting to take steps to to to protect itself and others,” said Jen Kates, director of the global health and HIV policy Program at the Kaiser Family Foundation.

While those affected by monkeypox aren’t putting aside getting their shots, pandemic fatigue is having a knock-on effect for other outbreaks.

“What has happened though is because of this pushback on the public health authorities putting in place requirements or guidance, there’s been an increasing move, as we’ve seen across the country, to attack, to sort of apply this to other public health interventions,” Kates said. “Well, we don’t want our children to be forced to have immunizations for schools, things like that, which is frankly very dangerous.”

So polio, diphtheria and all those other diseases many get vaccinated against without thinking about as a kid — if pandemic fatigue continues to translate to underfunding public health, all of those could also come back.

“The worst case scenario of that is that we get used to having those old diseases come back, that we have children dying of diphtheria, we have communities impacted by polio and… with limited resources,” said Amanda McClelland, senior vice president of the Prevent Epidemics Team at Resolve to Save Lives.

Even going back to COVID, the message from public health experts about how to keep things from getting much worse is to invest in the tools we need to keep risk low.

“I am not terribly concerned about pandemic fatigue when experienced by somebody with a fair amount of immunity, but I am concerned about Congress having pandemic fatigue,” Dr. Doron said. “I think that it is still really important that the government be focused on COVID-19, even though I don’t think every individual needs to be so focused on COVID-19 anymore because we can be pretty safe if the government continues to fund the things that are keeping us safe.”

: newsy.com

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Moderna Sues Pfizer Over Patents Behind COVID-19 Vaccine

By Associated Press

and Newsy Staff
August 26, 2022

Moderna said in 2020 that it would not enforce its COVID-19-related patents while the pandemic continued. But later said it would update that pledge.

COVID-19 vaccine maker Moderna is suing Pfizer and the German drugmaker BioNTech, accusing its main competitors of copying Moderna’s technology in order to make their own vaccine.

Moderna said Friday that Pfizer and BioNTech’s vaccine Comirnaty infringes on patents Moderna filed several years ago protecting the technology behind its preventive shot, Spikevax. The company filed patent infringement lawsuits in both U.S. federal court and a German court.

Pfizer spokeswoman Pam Eisele said the company had not fully reviewed Moderna’s lawsuit, but the drugmaker was surprised by it, given that their vaccine is based on proprietary technology developed by both BioNTech and Pfizer.

She said in an email that the company would “vigorously defend” against any allegations in the case.

BioNTech did not immediately respond to a request from The Associated Press seeking comment.

Moderna and Pfizer’s two-shot vaccines both use mRNA technology to help patients fight the coronavirus.

The mRNA vaccines work by injecting a genetic code for the spike protein that coats the surface of the coronavirus. That code, the mRNA, is encased in a little ball of fat, and instructs the body’s cells to make some harmless spike copies that train the immune system to recognize the real virus.

That approach is radically different from how vaccines have traditionally been made.

Moderna said it started developing its mRNA technology platform in 2010, and that helped the company quickly produce its COVID-19 vaccine after the pandemic arrived in early 2020.

By the end of that year, U.S. regulators had cleared shots from both Pfizer and Moderna for use after clinical research showed that both were highly effective.

Moderna CEO Stephane Bancel said in a prepared statement that the vaccine developer pioneered that technology and invested billions of dollars in creating it.

The company said it believes its rivals’ vaccine infringes on patents Moderna filed between 2010 and 2016.

Moderna said it recognizes the importance of vaccine access and is not seeking to remove Comirnaty from the market. It also is not asking for an injunction to prevent future sales.

Moderna said in 2020 that it would not enforce its COVID-19 related patents while the pandemic continued. But the company said in March, with vaccine supplies improving globally, that it would update that pledge.

It said it still would not enforce its patients for vaccines used in low- and middle-income countries. But it expected companies like Pfizer and BioNTech to respect its intellectual property, and it would consider “a commercially reasonable license” in other markets if they requested one.

“Pfizer and BioNTech have failed to do so,” Moderna said in a statement.

Additional reporting by The Associated Press.

: newsy.com

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CDC Endorses More Traditional Novavax COVID Shot For Adults

CDC officials said between 26 million and 37 million adults haven’t had a single dose of any COVID vaccine.

U.S. adults who haven’t gotten any COVID-19 shots yet should consider a new option from Novavax — a more traditional kind of vaccine, health officials said Tuesday.

Regulators authorized the nation’s first so-called protein vaccine against COVID-19 last week, but the final hurdle was a recommendation from the Centers for Disease Control and Prevention.

“If you have been waiting for a COVID-19 vaccine built on a different technology than those previously available, now is the time to join the millions of Americans who have been vaccinated,” Dr. Rochelle Walensky, CDC’s director, said in a statement, endorsing an earlier decision from an influential advisory panel.

Most Americans have gotten at least their primary COVID-19 vaccinations by now, but CDC officials said between 26 million and 37 million adults haven’t had a single dose — the population that Novavax, for now, will be targeting.

“We really need to focus on that population,” said CDC adviser Dr. Oliver Brooks, past president of the National Medical Association. Hopefully, the vaccine “will change them over from being unvaccinated to vaccinated.”

While it’s unclear how many will be persuaded by a more conventional option, “I’m really positive about this vaccine,” agreed fellow adviser Dr. Pablo Sanchez of Ohio State University.

THE NOVAVAX DIFFERENCE

All of the vaccines used in the U.S. train the body to fight the coronavirus by recognizing its outer coating, the spike protein — and the first three options essentially turn people’s cells into a temporary vaccine factory. The Pfizer and Moderna vaccines deliver genetic instructions for the body to make copies of the spike protein. The lesser-used Johnson & Johnson option uses a cold virus to deliver those instructions.

In contrast, the Novavax vaccine injects copies of the spike protein that are grown in a lab and packaged into nanoparticles that to the immune system resemble a virus. Another difference: An ingredient called an adjuvant, that’s made from the bark of a South American tree, is added to help rev up that immune response.

Protein vaccines have been used for years to prevent other diseases including hepatitis B and shingles.

HOW WELL IT WORKS

Large studies in the U.S., Mexico and Britain found two doses of the Novavax vaccine were safe and about 90% effective at preventing symptomatic COVID-19. When the delta variant emerged last summer, Novavax reported a booster dose revved up virus-fighting antibodies that could tackle that mutant.

Typical vaccine reactions were mild, including arm pain and fatigue, but regulators did warn about the possibility of a rare risk, heart inflammation, that also has been seen with the Pfizer and Moderna vaccines, mostly in teen boys or young men.

But early on, manufacturing problems delayed the Novavax vaccine — meaning the shots were studied long before the omicron variant hit, so it’s not clear how well they hold up against the immune-evading mutant.

Still, Novavax points to lab testing that shows the first two shots do spur production of virus-fighting antibodies that are cross-protective against omicron, including the BA.5 subtype that’s currently the nation’s top threat. A booster dose further revved up cross-protective antibodies.

HOW TO USE NOVAVAX SHOTS

The CDC’s advisers unanimously endorsed the two-shot primary series. But several noted that it was important for regulators to clear a booster by the time, five or so months after their last dose, that Novavax recipients will need one.

Also, the two doses typically are given three weeks apart. But CDC officials said that like with other COVID-19 vaccines, it’s possible to wait up to eight weeks for the second dose — except for people at the highest risk, who need protection quickly.

WHAT HAPPENS NEXT

Walensky signed off on recommendations for adults to get the first two Novavax doses. In its first purchase, the U.S. government bought 3.2 million doses and vaccinations are expected to begin in the next few weeks.

The Novavax vaccine also is used in Europe, Canada, Australia, South Korea and other countries. Many allow booster doses, and European regulators recently cleared the shots to given as young as age 12.

The Maryland-based company likewise expects U.S. authorization of a booster dose and teen vaccinations to follow fairly soon.

And like other vaccine makers, Novavax is testing shots updated to better match the newest omicron subtypes — in anticipation of another round of boosters this fall and winter.

Additional reporting by The Associated Press.

: newsy.com

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Robert Malone Spreads Falsehoods About Vaccines. He Also Says He Invented Some.

“And almost without exception, these influencers feel that they have been wronged by mainstream society in some way,” Mr. Brooking added.

Dr. Malone earned a medical degree from Northwestern University in 1991, and for the next decade taught pathology at the University of California, Davis, and the University of Maryland. He then turned to biotech start-ups and consulting. His résumé says he was “instrumental” in securing early-stage approval for research on the Ebola vaccine by the pharmaceutical company Merck in the mid-2010s. He also worked on repurposing drugs to treat Zika.

In extended interviews at his home over two days, Dr. Malone said he was repeatedly not recognized for his contributions over the course of his career, his voice low and grave as he recounted perceived slights by the institutions he had worked for. His wife, Dr. Jill Glasspool Malone, paced the room and pulled up articles on her laptop that she said supported his complaints.

The example he points to more frequently is from his time at the Salk Institute for Biological Studies in San Diego. While there, he performed experiments that showed how human cells could absorb an mRNA cocktail and produce proteins from it. Those experiments, he says, make him the inventor of mRNA vaccine technology.

“I was there,” Dr. Malone said. “I wrote all the invention.”

What the mainstream media did instead, he said, was give credit for the mRNA vaccines to the scientists Katalin Kariko and Drew Weissman, because there “is a concerted campaign to get them the Nobel Prize” by Pfizer and BioNTech, where Dr. Kariko is a senior vice president, as well as the University of Pennsylvania, where Dr. Weissman leads a laboratory researching vaccines and infectious diseases.

But at the time he was conducting those experiments, it was not known how to protect the fragile RNA from the immune system’s attack, scientists say. Former colleagues said they had watched in astonishment as Dr. Malone began posting on social media about why he deserved to win the Nobel Prize.

The idea that he is the inventor of mRNA vaccines is “a totally false claim,” said Dr. Gyula Acsadi, a pediatrician in Connecticut who along with Dr. Malone and five others wrote a widely cited paper in 1990 showing that injecting RNA into muscle could produce proteins. (The Pfizer and Moderna vaccines work by injecting RNA into arm muscles that produce copies of the “spike protein” found on the outside of the coronavirus. The human immune system identifies that protein, attacks it and then remembers how to defeat it.)

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Covid-19 Misinformation Goes Unchecked on Radio and Podcasts

On a recent episode of his podcast, Rick Wiles, a pastor and self-described “citizen reporter,” endorsed a conspiracy theory: that Covid-19 vaccines were the product of a “global coup d’état by the most evil cabal of people in the history of mankind.”

“It’s an egg that hatches into a synthetic parasite and grows inside your body,” Mr. Wiles said on his Oct. 13 episode. “This is like a sci-fi nightmare, and it’s happening in front of us.”

Mr. Wiles belongs to a group of hosts who have made false or misleading statements about Covid-19 and effective treatments for it. Like many of them, he has access to much of his listening audience because his show appears on a platform provided by a large media corporation.

Mr. Wiles’s podcast is available through iHeart Media, an audio company based in San Antonio that says it reaches nine out of 10 Americans each month. Spotify and Apple are other major companies that provide significant audio platforms for hosts who have shared similar views with their listeners about Covid-19 and vaccination efforts, or have had guests on their shows who promoted such notions.

protect people against the coronavirus for long periods and have significantly reduced the spread of Covid-19. As the global death toll related to Covid-19 exceeds five million — and at a time when more than 40 percent of Americans are not fully vaccinated — iHeart, Spotify, Apple and many smaller audio companies have done little to rein in what radio hosts and podcasters say about the virus and vaccination efforts.

“There’s really no curb on it,” said Jason Loviglio, an associate professor of media and communication studies at the University of Maryland, Baltimore County. “There’s no real mechanism to push back, other than advertisers boycotting and corporate executives saying we need a culture change.”

Audio industry executives appear less likely than their counterparts in social media to try to check dangerous speech. TruNews, a conservative Christian media outlet founded by Mr. Wiles, who used the phrase “Jew coup” to describe efforts to impeach former President Donald J. Trump, has been banned by YouTube. His podcast remains available on iHeart.

Asked about his false statements concerning Covid-19 vaccines, Mr. Wiles described pandemic mitigation efforts as “global communism.” “If the Needle Nazis win, freedom is over for generations, maybe forever,” he said in an email.

The reach of radio shows and podcasts is great, especially among young people: A recent survey from the National Research Group, a consulting firm, found that 60 percent of listeners under 40 get their news primarily through audio, a type of media they say they trust more than print or video.

unfounded claim that “45,000 people have died from taking the vaccine.” In his final Twitter post, on July 30, Mr. Bernier accused the government of “acting like Nazis” for encouraging Covid-19 vaccines.

Jimmy DeYoung Sr., whose program was available on iHeart, Apple and Spotify, died of Covid-19 complications after making his show a venue for false or misleading statements about vaccines. One of his frequent guests was Sam Rohrer, a former Pennsylvania state representative who likened the promotion of Covid-19 vaccines to Nazi tactics and made a sweeping false statement. “This is not a vaccine, by definition,” Mr. Rohrer said on an April episode. “It is a permanent altering of my immune system, which God created to handle the kinds of things that are coming that way.” Mr. DeYoung thanked his guest for his “insight.” Mr. DeYoung died four months later.

has said his research has been “misinterpreted” by anti-vaccine activists. He added that Covid-19 vaccines have been found to reduce transmissions substantially, whereas chickens inoculated with the Marek’s disease vaccine were still able to transmit the disease. Mr. Sexton did not reply to a request for comment.

Vaccines Won’t Protect Millions of Patients With Weakened Immune Systems

For more than a year, Dr. Andrew Wollowitz has mostly been cloistered inside his home in Mamaroneck, N.Y.

As chief of emergency medicine at Montefiore Medical Center in the Bronx, Dr. Wollowitz, 63, was eager to help treat patients when the coronavirus began raging through the city last spring. But a cancer treatment in 2019 had obliterated his immune cells, leaving him defenseless against the virus, so he instead arranged to manage his staff via Zoom.

A year later, people in Dr. Wollowitz’s life are returning to some semblance of normalcy. His wife, a dancer and choreographer, is preparing to travel for work at Austria’s National Ballet Company. His vaccinated friends are getting together, but he sees them only when the weather is nice enough to sit in his backyard. “I spend very little time in public areas,” he said.

Like his friends, Dr. Wollowitz was vaccinated in January. But he did not produce any antibodies in response — nor did he expect to. He is one of millions of Americans who are immunocompromised, whose bodies cannot learn to deploy immune fighters against the virus.

as high as 55 percent.

Most people who have lived with immune deficiencies for a long time are likely to be aware of their vulnerability. But others have no idea that medications may have put them at risk.

“They’ll be walking around outside thinking they’re protected — but maybe they’re not,” said Dr. Lee Greenberger, chief scientific officer of the Leukemia and Lymphoma Society, which funds research on blood cancers.

The only recourse for these patients — apart from sheltering in place until the virus has retreated — may be to receive regular infusions of monoclonal antibodies, which are mass-produced copies of antibodies obtained from people who have recovered from Covid-19. The Food and Drug Administration has authorized several monoclonal antibody treatments for Covid-19, but now some are also being tested to prevent infections.

Convalescent plasma or gamma globulin — antibodies distilled from the blood of healthy donors — may also help immunocompromised people, although a version of the latter that includes antibodies to the coronavirus is still months from availability.

compassionate use program. (Regeneron released trial results this week showing that the cocktail reduces symptomatic infections by 81 percent in people with normal immune systems.)

It’s unclear how many immunocompromised people don’t respond to coronavirus vaccines. But the list seems at least to include survivors of blood cancers, organ transplant recipients, and anyone who takes the widely used drug Rituxan, or the cancer drugs Gazyva or Imbruvica — all of which kill or block B cells, the immune cells that churn out antibodies — or Remicade, a popular drug for treating inflammatory bowel disease. It may also include some people over age 80 whose immune responses have faltered with age.

“We’re extremely concerned and interested in trying to see how we might be able to help those particular patients,” said Dr. Elad Sharon, an immunotherapy expert at the National Cancer Institute.

As the pandemic spread, doctors who specialize in treating blood cancers or who care for immunocompromised people expected at least some of their patients to encounter difficulties. Dr. Charlotte Cunningham-Rundles, an immunologist at Icahn School of Medicine at Mount Sinai in New York, has about 600 patients who are almost entirely dependent on getting regular doses of gamma globulin to stay safe from pathogens.

Even so, 44 of her patients became infected with the coronavirus; four died, and another four or five had long-term illnesses. (Chronic infections may offer opportunities for the virus to evolve into dangerous variants.)

registry to provide information and antibody tests to people with blood cancers. And several studies are assessing the response to coronavirus vaccines in people with cancer, autoimmune conditions like lupus or rheumatoid arthritis, or who take drugs that mute the immune response.

In one such study, British researchers followed nearly 7,000 people with Crohn’s disease or ulcerative colitis from 90 hospitals in the country. They found that less than half of patients who took Remicade mounted an immune response following coronavirus infection.

were protected after a single dose of the Pfizer vaccine and only 27 percent after a single dose of the AstraZeneca vaccine. (In Britain, the current practice is to delay second doses to stretch vaccine availability.)

Likewise, another study published last month indicated that fewer than 15 percent of patients with cancers of blood or the immune system, and fewer than 40 percent of those with solid tumors, produced antibodies after receiving a single dose of the Pfizer-BioNTech vaccine.

And a study published last month in the journal JAMA reported that only 17 percent of 436 transplant recipients who got one dose of the Pfizer-BioNTech or Moderna vaccine had detectable antibodies three weeks later.

Despite the low odds, immunocompromised people should still get the vaccines because they may produce some immune cells that are protective, even antibodies in a subset of patients.

“These patients should probably be prioritized for optimally timed two doses,” said Dr. Tariq Ahmad, a gastroenterologist at the Royal Devon and Exeter NHS Foundation Trust who was involved in the infliximab studies.

He suggested that clinicians routinely measure antibody responses in immunocompromised people even after two vaccine doses, so as to identify those who also may need monoclonal antibodies to prevent infection or a third dose of the vaccines.

Wendy Halperin, 54, was diagnosed at age 28 with a condition called common variable immunodeficiency. She was hospitalized with Covid-19 in January and remained there for 15 days. But the coronavirus induced unusual symptoms.

“I was having trouble walking,” she recalled. “I just lost control of my limbs, like I couldn’t walk down the street.”

Because she was treated for Covid-19 with convalescent plasma, Ms. Halperin has had to wait three months to be immunized and has made an appointment for April 26. But despite her condition, her body did manage to produce some antibodies to the initial infection.

“The take home message is that everybody should try and get the vaccine,” said Dr. Amit Verma, an oncologist at Montefiore Medical Center.

The gamble did not pay off in Dr. Wollowitz’s case. Without antibodies in his system to protect him, he is still working from home — a privilege he is grateful for. He was an avid mountain biker and advanced skier, both of which carry risk of injury, but with the coronavirus, he is playing it safe.

In anticipation of returning to his normal lifestyle, Dr. Wollowitz is tuning his bicycles. But he said he foresaw himself living this way till enough other people are vaccinated and the number of infections in the city drops.

“I’m not exactly sure what that date is,” he said. “I’m really waiting to get back out.”

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