MD’s Saturday COVID lunch


Learning from other coniditons. Anti-CD20 increases COVID-19 risks

Predictive factors for a severe course of COVID-19 infection in myasthenia gravis patients with an overall impact on myasthenic outcome status and survival. Eur J Neurol 2021

Myasthenia is a conditon associated with antibodies against the junction between the muscle and the peripheral nerves and this has been treated with rituximab. In MS there was an increase in hospitalisation and ICU use although not death, and increased risk of death occurs in myasthenia. This rather suggests the worsening effect in MS is real as it is seen in other conditions. Steroids were also a risk factor and this was reported in MS too.

“MG patients treated with rituximab were observed to have a high risk of death caused by COVID-19 (OR 35.143, 95% CI 3.216 – 383.971, P = 0.004)”.

In kidney transplantation depletion T and B cells risks poor COVID-19 vaccine B cell response but half of Antibody-negative people make a T cell response


Kidney Transplant paptients show that immunosuppressive agents T and B cell depleting antibodies block COVID-19 vaccine response.

“Factors that were associated with vaccine no-response included diabetes treatment with anti-thymocyte globulin (similar specificity to alemtuzumab in action) during the last year (OR 7.23, 95% CI 1.12-46.51, = 0.037).Importantly “half of antibody-negative patients had actually developed a positive ELISpot (T cell response)”

Your vaccination related adverse events is not a reflection of how good the antibody response is

Does reactogenicity after a second injection of the BNT162b2 vaccine predict spike IgG antibody levels in healthy Japanese subjects?Takeuchi, M., Higa, Y., Esaki, A., Nabeshima, Y., Nakazono, A.10.1101/2021.06.08.21258444 — Posted: 2021-06-10

Adverse reactions are more common after the second injection of messenger RNA vaccines such as Pfizer/BioNTech’s BNT162b2. We hypothesized that the degree and severity of reactogenicity after the second injection reflects the magnitude of antibody production against the SARS CoV-2 virus spike protein (spike IgG).

Just read we know this is not the case in other people so it wouldn’t be expected to be different in Japanese people]

The adverse events scores after the second injection were not significantly associated with spike IgG (antibody response) Reactogenicity (response to the vaccine) after the second injection may not accurately reflect antibody production.

Vaccination may keep you out of hospital…Just Do It!

Vaccination reduces need for emergency care in breakthrough COVID-19 infections: A multicenter cohort study Amit Bahl, Steven Johnson, Gabriel Maine, Martha Hernandez Garcia, Srinivasa Nimmagadda, Lihua Qu, Nai-Wei Chendoi:

The title says it all…..A Jab one Day, keeps the Hospital Away

and finally…..Is ProfG……Davros?

Every now and then we need a light-hearted moment, and looking at I recent tweet posted by a reader and I wondered “what’s under the table?”. We are seeing ProfG doing webinars and whilst some of you think it is a special chair and head set to deal with his injuries, it is clear to me that he is now bionic and has been turned in to a Dalek, since his accident.


Once he takes his mask off, he can use the extra eye to look into the future, but now you know what lurks beneath

Davros - Doctor Who Series 9' Cardboard Cutouts |

Here he is, with my Uncle Tom and some Prototypic Henry’s:-)..If you are Britsh and Old enough you will get it:-)

Davros - The Daleks - The Doctor Who Site

General Disclaimer: Please note that the opinions expressed here are those of the author and do not necessarily reflect the positions of the Barts and The London School of Medicine and Dentistry nor Barts Health NHS Trust.

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  • Nice work
    Reactogenicity (response to the vaccine) after the second injection may not accurately reflect antibody production

    Maybe production of intererons ???

    adverse effects are flu-like symptoms: increased body temperature, feeling ill, fatigue, headache, muscle pain, convulsion, dizziness, hair thinning, and depression. Erythema, pain, and hardness at the site of injection are also frequently observed. IFN therapy causes immunosuppression, in particular through neutropenia and can result in some infections manifesting in unusual ways.[41]

    Well yesterday night i fell a bit like this

    Feel sorry for all off pwms taking this drug longterm


  • There are lots of studies on healthy subjects saying reaction doesn’t matter for protection, but it seems focused on reassuring people with lower reactions.

    My question, particularly for PwMS, is what fraction of people with strong adverse vaccine reactions DON’T have strong protection after?

    If this % is small, which seems likely, at least people with strong reactions should have some comfort.

  • I also sent in a blood spot test for Covidence yesterday (QMUL, as well same sort of equipment). Covidence asked what time of day I got vaccinated and whether I took anything afterwards. (4pm and I didn’t) as “there is evidence that the time of day you’re vaccinated and whether you take medications (Ibuprofen, Paracetamol etc.) influences the vaccination response. They haven’t said how. Pronbably insufficient data gathered yet. What do you know MD? Can you ask your QMUL colleagues whether we’ll learn about this?

    • Sorry to say I know nothing, maybe they will give us a seminar but often work is submitted before hear anything

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