Jacob Scheier is a Toronto-based poet, essayist and journalist and former winner of the Governor General’s Literary Award.
As an immunosuppressed person, COVID-19 vaccines are not as effective for me as most people. And now that I’ve experienced a summer and fall of patio and backyard hangouts that have felt almost like a pre-pandemic era, it’s hard to imagine going back to a more isolated life. But with the winter here, I worry that taking care of my safety means that I behind.
Gatherings with friends last summer had the celebratory quality of reunions after years apart, and we greeted each other as if the hug had just been invented.
This was very different from the previous year, when After the first lockdown ended and people started congregating in courtyards and parks, I continued to live almost as if I was still locked up.
Since people with autoimmune diseases, like myself (I have Crohn’s disease, an inflammatory bowel disease (IBD)), were not included in the initial vaccine trials, it was not known how effective the vaccine would be for me.
I played pretty safe after my first dose of Moderna. I didn’t change my cautious demeanor much, I just became a little less attentive to things like how close people were to me at the grocery store checkout counter.
A couple of months later I read the initial results of the CLARITY study, led by researchers from several UK universities. The study measured the antibody response in IBD patients with the same immunosuppressive drug as me: infliximab.
Based on the findings of the CLARITY study, it turned out that there was a good chance that my first puncture gave me little or no protection against the virus. I remembered, with a shudder, all the places I’d been lately; the times I found myself, for example, in a narrow grocery aisle with someone who didn’t know or didn’t care how to wear a mask correctly.
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However, according to the study, the vast majority of IBD patients treated with infliximab appeared to have a sufficient antibody response after a second dose of vaccine. It seemed safe to have a social life for the first time in over a year.
In particular, the CLARITY study only measures a particular type of antibody, and it is currently unclear which antibodies and other parts of the immune system are involved in immunity to COVID-19, although the study findings appear to fit well with emerging data from the real world.
A couple of times this summer and fall, during gatherings with friends, when it was raining or a little cold, the small group moved inside. I felt a bit nervous when this happened. Inevitably, someone would say something like, “We are all completely baffled, it will be fine.” I tried to let that calm me down.
In mid-fall, after seeing a headline that said immunosuppressed people in Ontario, including those taking infliximab, were being prioritized for the third dose of vaccine, I immediately went to see the most recent data from the CLARITY study: About three months After the second dose of vaccine, the antibody response of the patients with infliximab had rapidly declined to almost nothing. The graph they used to represent this showed a line sloping sharply downward. The image reminded me of a stock market crash.
To my horror, I realized that I had spent most of the summer and fall, meeting and hugging, probably with very little immunity to the virus.
In hindsight, I was in some denial. A part of me must have suspected that the good news from the CLARITY study was too good to be true (or rather to remain true), and that’s probably why, unconsciously, I did not search for the latest scientific information. I suspect that what I wanted, even more than a sense of security, was to feel a sense of “fitting in” with my friends, a desire that dates back to when I was first diagnosed with Crohn’s disease as a teenager, some 30 years ago. .
When I was 12 years old, my mother put me on a very restrictive diet, although the role of diet in Crohn’s disease is a source of contention between conventional and alternative medicine.
The social glue of teenage life, before it turns to sex and drugs (in my experience) is junk food, especially fast food. I remember one afternoon going to a McDonald’s. While my friends were enjoying their Big Macs, I had tuna salad from a Tupperware container (tuna salad made with olive oil; even mayo was a diet smuggle). The staff told me that I could not eat “food from outside”. My friends, who weren’t the most sensitive at that age, ignored the situation. I sat alone on the patio on that cold and windy day, separated by the window, watching them savor their food, that is, enjoy their disease-free lives, from the other side of the glass.
But there is good news for me: the CLARITY study findings suggest that with a third dose of the vaccine, my immunity should be stronger and last longer than after the second dose.
Or there was good news for me. Enter Omicron.
CLARITY Study Principal Investigator Dr Tariq Ahmad tells me that while he can now confirm that “antibody responses after a third primary dose are robust” (although it takes more time to measure durability), “it seems likely than TNF [i.e. drugs such as infliximab] will also affect the antibody responses to this new [Omicron] variant.”
I’m getting pretty tired of this movie: just as I think my level of protection against the virus is the same as most people’s, I happen to be just as vulnerable as before.
I really wanted to connect with friends and family this winter. I imagine that once the healthy people get the boost, the little in-person meetings will continue, temporarily halted by the new variant. But for better and for worse, I am too informed to, in blissful ignorance, join the party this time.
I find myself reminiscing about junk-free birthday parties I had as a kid. My mother tried to convince my friends that the unsweetened peanut butter in a rice cake was as good as a real cake, as if I wasn’t unpopular enough.
I’m envisioning my second zoom birthday party: all my healthy, triple-mood friends thinking the same thing; if it weren’t for me or rather my illness, the two sometimes feel inseparable, they could be having a party in real life, sharing bottles of wine and of course junk food.
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