After four Covid-19 jabs Helen Simmonds, who takes immunosuppressant drugs to treat her multiple sclerosis, had not produced any antibodies to protect her against coronavirus.
The 46-year-old hairdresser, who lives near Norwich, is nervously awaiting the results of a privately-obtained antibody test in the faint hope she has responded to a fifth dose, administered in April.
Simmonds is one of more than half a million people in the UK, with conditions ranging from MS to blood cancer and kidney problems, who have severely compromised immune systems and are at heightened risk of severe coronavirus but who gain less protection from vaccination than healthy people.
As the UK government pushes ahead with its “living with Covid” strategy, undeterred by stubbornly high infection rates, immunocompromised people, their clinicians and the charities who represent them, fear they have been forgotten.
“I feel like I’m trapped in March 2020 and everyone has moved on,” said Simmonds. “I don’t want people to go around in hazmat suits for my benefit but there’s more this government can do. There’s just no political gain in caring about the immunocompromised.”
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Immunocompromised individuals have access to a number of Covid counter-measures that are unavailable to the general population: they are eligible for five vaccine doses when most can only obtain three; they can test for free while infection rates remain high; and they have rapid access to antibody or antiviral treatments if they test positive.
But these measures have proved imperfect. An Imperial College London study published on Sunday found that 19 per cent of 239 kidney transplant recipients who had received four vaccine doses had not had any immune response.
Patients have also complained of “bureaucratic hurdles” in obtaining a fifth vaccine dose and difficulties in getting timely access to treatment through the NHS’s Covid Medicines Delivery Unit, according to Fiona Loud, policy director at Kidney Care UK.
Loud said patients told her that the CMDU was “oversubscribed, if not overwhelmed” by people looking to obtain antiviral treatments, such as Pfizer’s Paxlovid pill, within the five-day window after testing positive. The NHS said more than 40,000 vulnerable people had benefited from a Covid treatment at home.
She added that some people had been “turned away” from their fifth doses because vaccinators were unaware of the rollout. Simmonds was left in tears after initially being denied her fifth dose.
Alex Richter, professor of immunology at the University of Birmingham, said the government’s Covid strategy amounts to “a game of Russian roulette” for these patients — most of whom are unaware of their response to vaccination as antibody tests are not available on the NHS.
“The government has decided that there’s one strategy and one strategy alone: vaccination. Anyone who vaccines don’t work on has been hung out to dry,” she said.
Nearly nine in ten people in England had been infected at least once with Covid by late April, around half of them since late last year when Omicron emerged, according to an FT analysis of official figures.
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Despite this, behavioural caution among the general public has fallen in recent months, as mandatory self-isolation and mass testing have come to an end.
A YouGov poll of around 2,000 people, commissioned by three main health charities and shared exclusively with the FT, found that only 55 per cent of people in England were aware they should avoid contact with vulnerable people if they have Covid, and just 63 per cent realised they should work from home if they have symptoms.
Meanwhile, many immunosuppressed people have to severely constrain their lives to defy the odds of getting infected.
Simmonds closed her hairdressing salon last year because of fears over the virus and now works from home with a select group of clients, most of whom have tested and are masked up. “For the vast majority of people in this country, everything is all good and life is all OK, and I do feel a bit resentful,” she said.
Miranda Scanlon, a 58-year-old transplant recipient who volunteers at the charity Kidney Research UK, said she rarely leaves her house and her life felt “completely on hold”, despite having produced some antibodies after her fifth dose.
“I live in a way where I basically avoid any situation in which I might catch Covid,” she said. “If in a blaze of optimism I arrange to do something, I inevitably end up cancelling it. You become the person who never turns up.”
Both women said they would feel comfortable returning to normal if masking was more widely encouraged. They also hoped that Evusheld, an AstraZeneca antibody treatment that is used prophylactically, could help them. Studies suggest it reduces the risk of vulnerable people developing symptomatic coronavirus by 77 per cent.
But despite its use in the US, France and other European countries, and its approval in March by the Medicines and Healthcare Products Regulatory Agency, the UK government has not procured Evusheld and says it is awaiting evidence on its effectiveness against Omicron.
“We have a lot more evidence about the worth of Evusheld than we had about vaccines when we bought them,” said Phillip Anderson, head of policy and evidence at the MS Society. “The government’s approach of throwing the kitchen sink of pharmaceuticals at the virus seems to have disappeared for the people who are most vulnerable to Covid now.”
For the time being, with infection rates falling, many immunocompromised people are holding out hope for a lull in the pandemic over summer. Around one in 25 people were infected in the week ending April 23, compared with one in 17 the week before, according to the Office for National Statistics.
“Crossing our fingers and hoping infections fall isn’t a particularly reassuring strategy for people at this stage,” said Anderson. “We do worry that the new normal is going to be quite different for these people than for the general population.”
The Department of Health and Social Care did not reply to a request for comment.
