My Vaccine Didn’t Work. Now What?

I double-masked. I socially distanced. I got vaccinated as soon as I could. Then the door to New York’s reopening party abruptly shut in my face.

In my mid-fifties I was diagnosed with psoriatic arthritis, meaning that my immune system was attacking my joint cartilage. My left hip had already been replaced, and I hoped to avoid further surgery.

My rheumatologist prescribed Enbrel, and Methotrexate; medications that suppressed my overactive immune response. During the five years I have been taking these powerful drugs, I have lived an active lifestyle, including a daily regimen of three-mile walks, and lap swimming.

As COVID ripped through the city my wife, Brenda, and I lived a monkish existence. Our biggest risk was sending our ten-year-old daughter, Marta, to in-person school.

Brenda worked remotely from our Brooklyn home, and I had recently retired, after a public service career. The most difficult part of the pandemic was being unable to visit our siblings and elderly parents, all of whom lived far away.

Marta also missed our relatives. “How much longer until the vaccines?” she constantly asked.

After being vaccinated in April I joyfully luxuriated in my pre-pandemic activities: haircuts, gym workouts, bookstore shopping sprees. I even flew to Los Angeles, for a long-delayed family reunion.

Brenda was also vaccinated, but Marta was not, limiting our family activities. I fantasized about family trips, and going out for a “date night” with Brenda.

Last month my rheumatologist told me that one-third of Methotrexate patients had an insufficient response to COVID vaccines.“Two-thirds of people taking Methotrexate have a perfectly good response,” he said, cheerfully.

He took a blood sample to measure my antibodies. They barely registered.

My doctor said there was good evidence that a third shot raised anti-bodies to an acceptable level in immunocompromised people. But the FDA prohibited booster shots.

I felt like a football player who scored a winning touchdown, only to have it negated by a penalty.

After a year of feeling the sense of camaraderie that comes with a traumatic communal experience, I was suddenly an outsider. Stores were busy. People were planning long-delayed vacations. Facebook friends posted photos of themselves eating inside restaurants. I felt as though I was looking in on an impenetrable bubble.

My discomfort peaked whenever I walked into a supermarket and saw nearly everyone unmasked. It was impossible to know who was vaccinated, and who was not.

I reverted to a cautious mindset, making me self-conscious. At a July Fourth party I was the only masked person (except for Benda, who wore a face-covering in solidarity.) When everyone gathered around a table filled with food, I stood aside. “C’mon,” people said, pointing to the food, as I reluctantly kept my distance.

I had spent little time considering what the world looked like to people with health issues that kept them from fully participating in day-to-day life. Now I had a sense of what it felt like to be watching the parade, rather than marching in it.

Being relegated to the sidelines made me feel abandoned by health agencies that were going all out to convince vaccine-hesitant Americans to get their shots, while paying little attention to people like myself, who were desperate to be immunized. It was also frustrating to learn that Israel and France had already green-lighted boosters for people with weakened immune systems.

But the black hole people like me found ourselves in may soon be filled with light. On July 22 a CDC advisory panel will consider updating recommendations regarding boosters, for the estimated 10 million Americans who are immunocompromised.

With the Delta variant spreading and infection rates rising, this policy change can not come soon enough. Allowing a third shot would also make everyone safer, by adding to the number of inoculated Americans.

My hope is that I will receive a booster no later than the fall. Marta should be vaccinated by then, allowing me to take her to Los Angeles, for the first time in two years. We also have winter-break reservations to see Brenda’s family in Israel, and it would pain me to be left behind.

In the meantime I will have to be ever-vigilant; maintaining my spirits by remembering the sweet taste of normality I temporarily savored this spring.