Ask a doctor on the topic of Other questions to doctors

Congenital immunodeficiency and double vaccination. Still at risk for Covid19?

July 17, 2021 | 75,00 EUR | answered by Dr. med. Frauke Gehring

I am 32 years old and in December 2019 I was diagnosed with a congenital immunodeficiency. During my annual check-up with my immunologist in December 2020, I was informed that my values had further deteriorated and that I would likely "crash to the ground" in 1-2 years. I am supposed to receive injections to boost my immune system accordingly.
Since my immunologist is currently not reachable and due to the fact that I now see my career and mental health as massively endangered because of Corona, I have decided to seek a second opinion in this way.

I was sick with a cold from mid-April for 7-8 weeks (multiple Corona tests were negative and there was white and yellow mucus). After 7-8 weeks and taking antibiotics, the cold disappeared after 3-4 days. After 10 days of antibiotics, I had cold symptoms again after a few days, which have since been recurring or more severe and have been bothering me. I only took one day off sick during this period, even though I also had 2 weeks of vacation during that time. Just to provide a current insight into my health situation.

I received my first Biontech vaccination on 05/05/2021 and the second on 06/16/2021. A value of 11.7 or 24.6 according to the WHO scale was determined in an antibody level test before the second vaccination. A value of 162/340 WHO was determined in a second test, 14 days after the second vaccination.

The results of the blood tests from 05/18/2020 and 12/02/2020 from my immunologist are attached.

To be honest, the situation is slowly overwhelming me, I feel strongly uncertain because I cannot assess how I should behave and what perspectives I still have. Due to a certificate from my immunologist, I have been working from home for 8 months. I would like to change employers. However, without security regarding my current situation, I find it difficult to apply for a job in an office.

Therefore, my questions are as follows:
1. What is your opinion on my health condition based on the information/values provided (please see attachment)?

2. Do I now have effective protection against a severe course of the Delta variant due to the good antibody results after the second vaccination, even though according to the Israeli study, Biontech only offers 63% effectiveness against infection? Are antibodies essentially the trump card, and is a weak immune system not problematic with sufficient antibodies, or should I still expect a potentially severe course in case of infection with Delta?

3. If there is still a greater risk for me due to Delta: If I understood my doctor correctly, the injections that would improve my situation are very expensive and are therefore only prescribed by the health insurance company when the situation no longer allows otherwise. This may still be understandable for me if one is "only" sick for 6 months of the year and has some other minor infections. With Corona and the constant fear of infection, in my opinion, it is inhumane to isolate someone for 1-2 years just to save some money. Is it possible to improve my situation medically now? If yes, what is your assessment regarding an application to the health insurance company, considering that Corona may present a corresponding risk?

Thank you in advance.

Dr. med. Frauke Gehring

Good day,

I am happy to reply to you, but I would like to know which immune deficiency was found; in the attached values, there is a slight deficiency of immunoglobulins, but it does not suggest that it will become dramatic in one to two years.

1.) For this, we would need to have the current blood values. A viral infection does not improve with antibiotics, so you may have had a superinfection with bacteria. I would suggest rechecking the leukocytes and CRP value. If they are still elevated, I would look for any source of inflammation within you: teeth? bronchi (smoker)? sinuses? heart valves?

2.) The BioNtec vaccine also provides very good protection against severe illness with the Delta variant, which I do not fear with this level of antibodies. We also have a second line of defense, T-cell immunity, and your T-cells were not even reduced in your blood test. You may still get infected, but the risk of a severe illness is only in the low percentage range.

3.) From this, I conclude that I no longer want to isolate you so severely! This is inhumane, especially for someone so young, and in my opinion, is no longer justified after vaccination. The administration of immunoglobulins also does not seem necessary in the current situation, as you are capable of producing sufficient antibodies.

Sincerely, Dr. Gehring