Health

Third dose of mRNA vaccines brings new hope to immunocompromised Oregonians

By Crystal Ligori (OPB) and Jenn Chávez (OPB)
Aug. 30, 2021 1 p.m.

Portland cartoonist, educator and kidney transplant recipient Jonathan Hill just got his third shot. “It’s not like I can just go and have a cocktail party in my house,” but he’s grateful for the added layer of protection.

Earlier this year, things were looking up for Portland cartoonist and educator Jonathan Hill. The pandemic had been especially precarious for Hill: He’s an immunocompromised person who received a kidney transplant in 2015 and takes immunosuppressants so his body won’t reject the kidney. Because of his condition, he’d stayed under extra-strict lockdown for months on end. But in March 2021, after he and his wife were finally vaccinated, they were excited to see friends again and start living life out in the world.

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That sense of possibility lasted about ... a week. Before long, Hill started seeing research that suggested that, as an immunocompromised person, his body likely wasn’t able to build up the same amount of virus-fighting antibodies that other people typically get from two doses of a mRNA vaccine. After talking with his doctor, he realized that for the time being, he’d have to revert back to living like he hadn’t been vaccinated at all.

Fast-forward to August. With research and data collection progressing in real time, the Food and Drug Administration approved the use of a third dose of the mRNA vaccine for moderately or severely immunocompromised people. That includes people who’d received solid organ transplants, like Hill. The Centers for Disease Control and Prevention, as well as the Oregon Health Authority, said people with compromised immune systems should get a third vaccine dose as soon as medically possible.

So, Hill didn’t wait. He just got his third dose of the vaccine in mid-August. It’s not a moment too soon, as Oregon experiences one of the nation’s worst surges of the highly infectious delta variant of COVID-19. Hill joined OPB’s All Things Considered the week after his third shot, to talk about his experience with vaccines and navigating the pandemic as an immunocompromised Oregonian. Here are some highlights from the conversation:

Jenn Chávez: Like many Oregonians, you received two doses of the COVID-19 vaccine this spring. What was life like after you were fully vaccinated for the first time?

Jonathan Hill: I was really excited, I’m sure like everyone was excited, to be able to see people, to be able to go out. We were being extremely careful, because we didn’t want to take any unnecessary risks. I basically never left the house. And then we got the shots, and then there was a week where we just had a lot of fun. We had friends over to watch Blazers games, to play board games, to just hang out. A week after that is when we started to read articles about how immunocompromised people did not have that same level of protection, and we had to kind of shut it all down again.

Chávez: How has it felt to you to be watching others begin to act a little more freely in the past few months after getting their vaccines, while this whole time you’ve had to be concerned and live with more caution and restrictions than many of the people around you?

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Hill: If I’m being honest, it was frustrating. But to be fair, I think I’ve been frustrated throughout this whole process. Even before the vaccines were a thing — I have to go every month and get an infusion of my immunosuppressant medicine. I live by David Douglas [High School in east Portland] and the hospital where I get my infusion is [Good Samaritan in Northwest Portland]. I’m basically going from one end of town to the other. You know, I would just bike by restaurants and coffee shops and things, and even before the vaccine came out, it just seemed like there was this ... like people just wanting to do normal things. I mean to be fair, this has sucked for everybody. Nobody has wanted to do this. But to me it’s just like, it just keeps prolonging it. And we’re seeing that now, right?

Chávez: When you started hearing that many immunocompromised folks may not be producing antibodies, how clear were things to you, in terms of even figuring out what your own antibody response was, and if you were going to need a third shot?

Hill: Everything has just been really difficult, trying to find information. Because a lot of the information that we found, that sort of spurred us to calling my doctor and asking about it, was just articles that we would see online. But they all kind of say the same thing, but they also all kind of say nothing at the same time. You know, I think that’s been the hard part: weeding through the information. And then of course everyone wants an easy fix, where they’re like, “well can’t you just test your antibodies?” “Just get that crazy antibody treatment that Trump got,” or, “can’t you do these things?” In reality though, the antibody tests aren’t readily available, and they don’t test the antibodies as a result of the vaccines. So that’s why there’s kind of no way for us to know. And so, that’s why we have to just continue to be careful.

Jonathan Hill is a cartoonist and educator in Portland. He's also immunocompromised and just last week, received his third COVID-19 vaccine dose.

Jonathan Hill is a cartoonist and educator in Portland. He's also immunocompromised and just last week, received his third COVID-19 vaccine dose.

Courtesy of Jonathan Hill / OPB

Chávez: Recently the government did recommend a third dose for immunocompromised folks. You did just go ahead and get your third shot last week. What was that like? And what does that mean for you now?

Hill: To be honest, it was kind of anticlimactic. With the difficulty of getting the first two doses of the vaccine, and how there was a scarcity and all this bureaucracy and red tape and everything. I saw my doctor at the beginning of July and she had mentioned that data was starting to come out and she had a concern, what is it going to be like? Is the insurance going to cover it? Is she going to have to prescribe it? What are the checks going to be? Etc, etc. And, when I actually got the shot, I literally was able to schedule an appointment at a Rite Aid to just go get it that day. And it was just so anticlimactic compared to everything else. It was sort of like... is that all there is? But I got it, and the thing is, it’s important to remember that me getting a third vaccine just makes me safer. I think the data suggested at first, with the two doses, only 17% of immunocompromised people develop antibodies. I think the third shot ups it to 54%. Those aren’t great odds, 54 is better than 17 but it’s not as good as 97, or whatever it is. So even though I have it, it’s just another layer of protection. It’s not like I can just go and have a cocktail party in my house or anything like that. We’re still just being careful and we’re still having to hunker down.

Chávez: What would you tell people, or want people to keep in mind, about how immunocompromised folks — or people who can’t get vaccinated, like kids under 12 for example — how you are experiencing the pandemic?

Hill: It’s so heartbreaking that we’ve had the vaccine, and we’re still kind of in a place that we were last summer without it, right? And this is the attitude that I think everyone needs to have, and everyone needs to remember: care about other people, think about other people. Instead of being like, well I want the vaccine so I can do these things, [be] like I’m going to get the vaccine so I can protect these people, like kids under 12, older people, people that don’t have the vaccine, can’t get it, for whatever reason. We are all in this together, and we have been in this together and I think that attitude of everyone for themselves has kept it at this plateau. It’s so devastating that we have the science to get closer to being on the other end of this, but we’re not.

Chávez: You’ve had to remain more isolated than most people during the pandemic. What are some ways that you have found to help you continue to engage with the world and feel connected with the people around you even while you’re physically isolated.

Hill: You know, it’s a weird thing. I mean, we’re all sick of Zoom, right? But having check-ins, where I can just work with friends and have it on and it’s almost like we’re at a coffee shop. We’re not having to look at each other and engage, which is the biggest awkward part of Zoom, but just working on our own thing and talking and catching up. I feel like I have a love-hate relationship with social media, but it’s been nice to be like, what are my friends doing, how are they doing? I also have been playing a lot of video games online as another way to connect with friends. I don’t want to make it seem like I’m Rapunzel or something in a tower — I mean I’m also bald, so I’m not like Rapunzel at all — but I’m not completely isolated. We can have friends over outside and be careful, you know, wear masks, be six feet away. Or, some friends have been very kind and have volunteered to isolate for two weeks so that they can come over. We can do those things, we just have to be conscientious of how we’re doing things. I think my wife and I both have real strong introverted tendencies, even though I can also be very extroverted, so I think that helps. I also think being a cartoonist, where I’m basically by myself drawing for hours and hours — it’s almost like I’ve been training to make it through this my whole life, you know?

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