“What Exactly Is the Plan for Us?”
Mary Baliker, a 58-year-old kidney transplant recipient living in Middleton, Wisconsin, is no stranger to blood tests. But this one was different. As part of a clinical study on antibody responses, she has been periodically FedEx-ing her blood to Johns Hopkins, where doctors have been looking for immune responses to the Moderna vaccine. Because she takes immunosuppressive drugs so her body doesn’t reject the donated organ, it wasn’t very likely that the vaccine would prompt the immune response it is supposed to. Nevertheless, she held out hope. When the final results came back—negative, no antibodies—she was heartbroken. “I guess all my fear of not building antibodies had just been proved,” she said. “I was discouraged. I just tried not to think about it.”
Baliker is one of many Americans whose immune systems are weakened either because of disease or because of the medications used to treat disease. It’s tricky to tally the exact number of the immunocompromised, which includes people with a wide range of conditions—not only transplant patients but also people with arthritis, HIV/AIDS, multiple sclerosis, inflammatory bowel disease, and cancer. A recent estimate puts the proportion of privately insured adults ages 18 to 64 on immunosuppressives at 2.8 percent, or some 3.6 million Americans. But Dr. Beth Wallace, a rheumatologist at the University of Michigan Medical School who authored the study, said this estimate didn’t account for those on Medicare or Medicaid, nor did it count innately immunocompromised adults not on immunosuppressives. She noted pinning down the true number of Americans with weakened immune systems is surprisingly difficult, but some experts I spoke with thought it could be as high as 10 million or even 15 million.