Immunocompromised

[OldDisneyFan]

Hello all,

Long time poster (old account hacked, so new log in) with a DAS question. DH is a transplant recipient and is on a cocktail of drugs that suppress his immune system. Pre-Covid, he always managed to get sick from our WDW trips. To protect himself, he always wore masks in the airports, on the planes, and in elevators, but there's always lots of coughing and sneezing going on in the parks.

Now we're planning a trip in December. DH has been vaccinated for Covid, but the drugs he takes means the vaccine will have little effectiveness, if any. Given their earlier messaging, I figured Disney would still be requiring masks to some degree through the end of year, but I now doubt that will be the case. Obviously, DH will try and help himself by wearing a mask at all times.

So after all that, my question is do you all think he would benefit from a DAS to keep him out of crowded situations as much as possible? Would he even qualify? If FP+ is back, we will utilize that as much as possible and we will pay for Disney After Dark events, if they're available. A couple of years ago, coming home with a cold was one thing, but now the stakes are much higher.

 

[OurBigTrip]

He can certainly ask, and he may well receive one, but I’m not sure how much it will keep him out of crowded situations...he’ll avoid the standby line, but still be in the FP line, food lines, etc.

best of luck for your trip and his continued good health!

 

[sparky68]

He can certainly ask, and he may well receive one, but I’m not sure how much it will keep him out of crowded situations...he’ll avoid the standby line, but still be in the FP line, food lines, etc.

best of luck for your trip and his continued good health!

The lines to get into the parks, the lines to check into the hotel, transportation.
A Disney vacation is just a series of crowded lines.
What does his doctor say? Even the fast pass lines are going to be crowded. With the reduction in social distancing rules they are going to be pushing people in tight again.
I've had the express pass at universal and been stuck in the express line for rides for long crowded waits on busy days.

 

[OldDisneyFan]

With COVID, length of exposure matters. At least FP lines should lessen the amount of time in the queue. If FP lines are long, he skips the ride. I’m the runner for quick service meals, stuff in stores, etc.
We do not take crowded transportation—we stay at the Boardwalk, so we walk to Epcot and HS. If the buses are crowded, we take a cab to the other parks. We might rent a car this trip. We have pre check for the TSA line and fly first class so there’s a bit more space between passengers.
The trip won’t be risk-free, but I’m trying to minimize it as much as possible.

 

[OldDisneyFan]

Forgot to say—thanks for the replies

 

[Madteaparty001]

DD has EoE, masks and frequent hand sanitizing is your best defense. Glasses/sunglasses can help as well. The main point of entry for viruses and bacteria are mouth, nose, and eyes. In the winter when it's cold use gloves that are leather like material so they can be wiped down. Also changing out of your clothes as soon as you get back to the hotel room and keeping them separate (such as in a laundry bag in the closet) then getting them washed before rewearing, bringing your own pillowcases, taking a shower before bed and using slippers in the hotel room (if the room has those nice vinyl/wood floors you can spray them down with cleaner and a rag just make sure not to wear shoes past the entryway).

Defense boosters such as vitamin c and zinc can ward off symptoms or shorten sickness duration, I like using cold eeze. We also bring a pack of Clorox wipes and wipe everything in the room down when we first arrive and refuse housekeeping (they are often overworked and thus will work while sick).

Honestly, cross contamination is the biggest way people inadvertently spread illness. There's some good videos on YouTube done by nurses and a few I've seen of buffets where they used glow in the dark hand sanitizer or washable ink to show how one person can spread a virus just through touch.

When we visit next year (after she has the vaccine) we'll definitely be thankful for the DAS, before her diagnosis she was almost on cold medicine constantly to help her breathe during flu season. Now since virtual schooling and being mindful of how susceptible she is we've managed to go over an entire year without a cold. (And that's with weekly to biweekly trips for testing and therapies at the children's hospital).

 

[kwdietrich1]

Hello all,

Long time poster (old account hacked, so new log in) with a DAS question. DH is a transplant recipient and is on a cocktail of drugs that suppress his immune system. Pre-Covid, he always managed to get sick from our WDW trips. To protect himself, he always wore masks in the airports, on the planes, and in elevators, but there's always lots of coughing and sneezing going on in the parks.

Now we're planning a trip in December. DH has been vaccinated for Covid, but the drugs he takes means the vaccine will have little effectiveness, if any. Given their earlier messaging, I figured Disney would still be requiring masks to some degree through the end of year, but I now doubt that will be the case. Obviously, DH will try and help himself by wearing a mask at all times.

So after all that, my question is do you all think he would benefit from a DAS to keep him out of crowded situations as much as possible? Would he even qualify? If FP+ is back, we will utilize that as much as possible and we will pay for Disney After Dark events, if they're available. A couple of years ago, coming home with a cold was one thing, but now the stakes are much higher.

Good afternoon,
I am also a (2x) transplant recipient and I am also on many meds that suppress my immune system. I’ve been lucky that I haven‘t contracted an illness while at Disney World. My transplant team prescribes me a prophylactic antibiotic for any trips I take. I would have DH ask his transplant team about this. I’m also highly discourage from flying because that is the more dangerous time to contract an illness or blood clot in the legs. I am on blood thinners to help mitigate this. And I don’t fly anymore.

Is your husband mobile? Does he tire easily? I used to have to travel with my power wheel chair, but now use a rollator in the parks so if I am fatigued I can sit in the queues. Consider renting/using a mobility aide if desired.


Also, I’m curious as to why you were told that the covid vaccine would not be as effective with those whose immune systems are suppressed. One of my doctors’ main role this year has been to research the effectiveness of the vaccines in transplant recipients and it has been reported as highly effective. Now, if the patient has neutropenia that is a different story and the patient is advised to neither leave their house nor travel at all.

Just take the precautions as already mentioned and I think he will be fine.

 

[OldDisneyFan]

Good afternoon,
I am also a (2x) transplant recipient and I am also on many meds that suppress my immune system. I’ve been lucky that I haven‘t contracted an illness while at Disney World. My transplant team prescribes me a prophylactic antibiotic for any trips I take. I would have DH ask his transplant team about this. I’m also highly discourage from flying because that is the more dangerous time to contract an illness or blood clot in the legs. I am on blood thinners to help mitigate this. And I don’t fly anymore.

Is your husband mobile? Does he tire easily? I used to have to travel with my power wheel chair, but now use a rollator in the parks so if I am fatigued I can sit in the queues. Consider renting/using a mobility aide if desired.


Also, I’m curious as to why you were told that the covid vaccine would not be as effective with those whose immune systems are suppressed. One of my doctors’ main role this year has been to research the effectiveness of the vaccines in transplant recipients and it has been reported as highly effective. Now, if the patient has neutropenia that is a different story and the patient is advised to neither leave their house nor travel at all.

Just take the precautions as already mentioned and I think he will be fine.

My husband is on low dose antibiotics and has been for more than a year. He’s also on blood thinners. Yes, he is mobile and does not need a mobility device.
We have to fly since we’re on the west coast.
Vaccine effectiveness for immune compromised folks has been in the new a lot lately. It seems the anti-rejection meds interferes with the vaccine.

 

[kwdietrich1]

I guess I need to have a conversation with my doctors about the effectiveness. I was led to believe I would be fine. I’ll need to read up on this as I don’t want to put myself at risk. Thank you.

 

[Jmljasmine]

Just wanted to add, I was able to fine N95 masks on Amazon again. That may help.

 

[SueM in MN]

From what I’ve been reading, the effectiveness of COVID vaccine in immunocompromised people appears to depend on what is causing the immunocompromise.
Johns Hopkins researchers are recommending organ transplant recipients to continue to follow COVID Safety Measures, even after a 2nd dose of vaccine. Although the vaccine does provide some immunity, it may not be enough to be totally protective.
Johns Hopkins COVID recommendations
There are studies being done on how well the vaccine may work in other people with immune deficiency, but none that I know of that are completed. Based on research done on other vaccines, it is recommended COVID vaccine should be completed at least 2 weeks before immunosuppressive therapy is given. That is how a family member of mine had his done at direction of his specialist doctors.
Based on current research and what is known about past vaccines in immunocompromised patients, the vaccine is expected to show less protection than in immune competent people. So, in general it’s still recommended for those people to continue precautions.

 

[Starwind]

From what I’ve been reading, the effectiveness of COVID vaccine in immunocompromised people appears to depend on what is causing the immunocompromise.
Johns Hopkins researchers are recommending organ transplant recipients to continue to follow COVID Safety Measures, even after a 2nd dose of vaccine. Although the vaccine does provide some immunity, it may not be enough to be totally protective.
Johns Hopkins COVID recommendations
There are studies being done on how well the vaccine may work in other people with immune deficiency, but none that I know of that are completed. Based on research done on other vaccines, it is recommended COVID vaccine should be completed at least 2 weeks before immunosuppressive therapy is given. That is how a family member of mine had his done at direction of his specialist doctors.
Based on current research and what is known about past vaccines in immunocompromised patients, the vaccine is expected to show less protection than in immune competent people. So, in general it’s still recommended for those people to continue precautions.

There have been a handful of other studies, too, most involving small numbers of patients with the resulting caveat of "more research needed".

One made the mainstream headlines recently. I found it interesting because it looked at healthy controls, IMID patients on biologic treatments (mostly on tumour necrosis factor blockers), and IMID patients on methotrexate. As you can see from the titles and the articles, the specific medication made the difference in this study: Medpage article: "Methotrexate Impairs COVID Vax Response" https://www.medpagetoday.com/rheumatology/arthritis/92777 Actual study: "Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease" https://ard.bmj.com/content/early/2021/06/07/annrheumdis-2021-220597 The full study is worth the read if you have an interest in the topic (see "PDF" icon in upper right on the BMJ page).

I find it quite interesting that the research being done now and previous research with previous vaccines (eg influenza) has shown that the specific medical condition, the specific treatment medication, and even the specific combo of the two, can all have an impact, and even then there aren't a lot of universals. There is still so much that is not understood.

I know for us, this type of research, in consultation with our doctors, are having an impact on things like which vaccine we get as our second dose, ongoing precautions we will take as restrictions are lifted in our jurisdiction, and our future travel plans.

We already took precautions when traveling, but will be more stringent when traveling in the future. Our next Disney trip is a DCL Alaska cruise in summer 2022 and we are hopeful that the risk level will be much lower then -- though to be honest I don't think our personal precautions while traveling will lessen for many years, if at all.

For the OP, I have been wearing high filtration masks at Disney for many years now. I don't know what the reception will be like post-covid, but I can say that for the most part pre-pandemic most people just ignored it. I had one memorable idiot adult that ran/jumped in front of my face and made a comment, but he also came close enough to me that I shoved my arms out to push him out of my physical space [he was within inches] and as I did that be backed off and went on his way. I have no idea if he was drunk or is just an absolute jerk, but that is the only *problem* I had. I have had a number of curious kids come up to me and ask why I am wearing a mask - usually to the embarassment of their parents trying to stop them from asking - and depending on how I am feeling I will reply "I have bad allergies" or "so I don't get sick", both of which are true. "I have bad allergies" gets a better recption because I think kids probably understand it easier. Either way, once they get an answer they are happy and go back to what they were doing Now, on the buses people did tend to not want to sit near you [on public transit in my home city this was especially true!!] if they had the choice. Same in the airport... I figured good for me, a natural little buffer !

SW

 

[sparky68]

Just wanted to add, I was able to fine N95 masks on Amazon again. That may help.

Those may or may not be real N95 masks. Amazon has a problem with bogus N95 masks.

 

[DisneyOma]

For the OP, I have been wearing high filtration masks at Disney for many years now. I don't know what the reception will be like post-covid, but I can say that for the most part pre-pandemic most people just ignored it. I had one memorable idiot adult that ran/jumped in front of my face and made a comment, but he also came close enough to me that I shoved my arms out to push him out of my physical space [he was within inches] and as I did that be backed off and went on his way. I have no idea if he was drunk or is just an absolute jerk, but that is the only *problem* I had.

SW

Or he could have been on the spectrum. I have a few adult students who would be able to "pass" as a drunk or jerk, but they are actually special needs adults with some "interesting" behaviors.

 

[AGirlAndHerDog]

Those may or may not be real N95 masks. Amazon has a problem with bogus N95 masks.

If they're shipped by Amazon they're probably real. I get mine at Lowe's. Though they seem to be disappearing soon.

 

[Evita_W]

From what I’ve been reading, the effectiveness of COVID vaccine in immunocompromised people appears to depend on what is causing the immunocompromise.
Johns Hopkins researchers are recommending organ transplant recipients to continue to follow COVID Safety Measures, even after a 2nd dose of vaccine. Although the vaccine does provide some immunity, it may not be enough to be totally protective.
Johns Hopkins COVID recommendations
There are studies being done on how well the vaccine may work in other people with immune deficiency, but none that I know of that are completed. Based on research done on other vaccines, it is recommended COVID vaccine should be completed at least 2 weeks before immunosuppressive therapy is given. That is how a family member of mine had his done at direction of his specialist doctors.
Based on current research and what is known about past vaccines in immunocompromised patients, the vaccine is expected to show less protection than in immune competent people. So, in general it’s still recommended for those people to continue precautions.

There are also studies that are showing promise for immunocompromised individuals that indicate that it might work well for them to be fully vaccinated twice, with each being from different manufacturers a couple of weeks to a month apart. So in other words two shots of moderns followed by two shots of Pfizer or a shot of J&J or vice versa. Preliminary findings are showing that antibodies are almost non existent in many after the first round and off the charts a couple of weeks after the second round. These are very preliminary studies I have seen, but there are people working on them, but in the meanwhile, you should always follow your doctor's advice.

 

[Little E]

@Madteaparty001 My DS has EoE too! It's so rare to find others with this. I hope your DD is well and healthy!

 

[Starwind]

Or he could have been on the spectrum. I have a few adult students who would be able to "pass" as a drunk or jerk, but they are actually special needs adults with some "interesting" behaviors.

Noted. However, given the particular context, I am pretty sure the person was being a jerk, possibly aided by alcohol.

 

[Starwind]

If they're shipped by Amazon they're probably real. I get mine at Lowe's. Though they seem to be disappearing soon.

Even shipped by Amazon can be dicey if they are "sold by" a third party. "Sold and shipped by Amazon" should be safe if the product is a known brand name.

However, both Home Depot and Lowes are again selling 3M N95 masks through their website and in (some) stores. They are authorized 3M retailers. Costco in Canada has 3M N95 as well, but I couldn't find them on the Costco USA website - you might want to check in their stores though.

For anyone looking for quality surgical masks, Armbrust USA is a Texas-based manufacturer of high quality US-made surgical masks (ASTM Level 3 Certification). They sell them through their website and have been in the media quite a bit in recent months - they have links on their website to quite a few of the articles/reports.

 

[Madteaparty001]

@Madteaparty001 My DS has EoE too! It's so rare to find others with this. I hope your DD is well and healthy!

HF Autism, EoE, Dysphagia, hypotomia, ARFID, difficulty with articulation, underweight, and sensory issues. She has a ridiculous amount of specialists but just looking at her you would never know, she's charming, has a high IQ, pretty, silly, and could debate a politician to death. When she has a meltdown it's honestly enough to make my head spin trying to figure out what issue is causing it.

Her GI put her on a high dose of omeprazole for the past 6 months and we've seen good reduction in swelling on her last EGD. Next month she's going to be taken off it and at her follow up EGD we'll see if she regresses, if so it's down to elimination diet . Pray for me lol. Have you figured out what sets your DS off? Her allergist can't find anything that shows up on blood tests.