The risk group is at great risk – Newspaper Kommersant No. 61 (7506) dated 04/10/2023

The All-Russian Union of Patients (VSP) conducted an analysis of the impact of coronavirus infection on people with weakened immune systems. More than half of the respondents refused to be vaccinated, while over the past year, almost every second person in this risk group had the disease, and almost every third was treated in a hospital. WHO reminds that it is these people who should be revaccinated against coronavirus.

VSP experts interviewed 542 people over the age of 18 with immunoinflammatory, autoimmune, oncological and oncohematological diseases, as well as on dialysis and after organ transplantation. It turned out that over the past year, almost every second such patient was diagnosed with COVID-19 (48%). At the same time, there are relatively more coronavirus survivors among patients on dialysis and after transplantation (59.4%). Less recovered, according to the study, among patients with autoimmune diseases – 41%.

Approximately one in three patients with secondary immunodeficiency were treated inpatiently for coronavirus last year. More often, patients on dialysis and after transplantation (55%), as well as oncological patients (39.4%) ended up in the hospital. In other groups, about a third of the sick patients were hospitalized.

53% of immunocompromised patients are not vaccinated against COVID-19 for various reasons. Of these, 23% of the respondents were not vaccinated due to their convictions, and 43% of them do not do any vaccinations at all. About 30% had the coronavirus and refused to be vaccinated for this reason. Approximately 27% were recommended not to be vaccinated by a doctor.

26% have a double vaccine, but only 12.6% have been revaccinated, and 2.4% have been vaccinated with monoclonal antibodies. There are more vaccinated patients among patients with immunoinflammatory rheumatic diseases – almost every second (47.5% of respondents). And there are comparatively more unvaccinated among cancer patients (30%) and patients with autoimmune diseases (28.7%).

Epidemiologist, director of the Institute for Interdisciplinary Research at the European University at St. Petersburg Anton Barchuk says that patients with secondary immunodeficiency are one of the main risk groups for coronavirus. In particular, studies show that people on dialysis have higher risks of both infection and complications – up to and including death – than the general population. For them, in terms of preventing severe consequences, vaccination is the most effective. “Therefore, it is good that half were vaccinated,” continues Mr. Barchuk. “As for the rest, the problem here is more in the medical community, which believes that secondary immunodeficiency is a contraindication to vaccination.”

Elena Savinova, co-founder of the Collective Immunity ANO for the development and support of vaccine prevention, agrees: among Russian health workers, there remains a significant proportion of those who are skeptical about both vaccination in general and vaccination against covid in particular. Therefore, to expect educational work, according to her, it was possible only from those who understand why the vaccine is needed. In contrast, Olga Shuppo, scientific director of the Grand Clinic network of immunorehabilitation and preventive medicine clinics, says that patients with chronic diseases tend to have many restrictions against vaccination. Ms. Schuppo recommends that they pay more attention to other preventive measures. At the same time, according to the study, the vast majority of patients on immunosuppressive therapy today do not discuss additional options for protection against COVID-19 with their doctor (65.6% of respondents).

44% of respondents are inclined to believe that the impact of coronavirus on their lives is minimized today. To a greater extent, they are convinced that the coronavirus infection does not affect their lives, cancer patients – 56.7%. In other groups, the share of rather consonants was 30–45%.

“The feeling of continuing distance, of being cut off from the rest of the world, which was able to return to normal life after the pandemic,” is more characteristic of 31.2% of respondents; another 24.6% agree with the statement in part. The decrease in the availability of basic treatment due to pandemic restrictions in 2022 was somehow felt by about every second patient (25% of respondents agree more with the statement; 22.3% agree somewhat). More than 40% of respondents experienced the loss of their jobs in the same “pre-pandemic” volume and a decrease in income in one way or another.

According to Elena Savinova, this shows people are tired of the topic of the coronavirus and the pandemic. In addition, close monitoring of the pandemic, which was typical in the first two years, has been curtailed in a number of countries: “If we take into account the first influenza pandemic of 1918-1920, it can be assumed that the pandemic is coming to an end.” Anton Barchuk recalls that coronavirus as an infectious agent has not gone away. And people from risk groups are most susceptible to it, as to any infectious diseases. According to him, the attitude to the coronavirus should now be the same as to other infectious diseases: “You need to know about it and remember that there is a way to prevent it in the form of vaccination.” Ms. Savinova recalls that on March 29, the World Health Organization stated that revaccination against covid is recommended only for high-risk groups. Note that 59.4% of patients with reduced immunity are interested in receiving information about protection against COVID-19. And every second patient with secondary immunodeficiency (55%) considers important notifications with a reminder of the expiration of vaccination.

Natalia Kostarnova