NPR's Nurit, Aizenman explains. Dr. Laura McCoy is an infectious disease researcher at University College London. The group of people that I'm particularly interested in are those living with HIV. She's been studying how well their immune systems respond to vaccines against Covid 19. Specifically the Pfizer vaccine. So far, it's worked quite well for HIV positive people. But there's a catch in her studies. All of our participants had really quite well controlled HIV. Normally HIV attacks the immune system. That these patients were on anti HIV medications that were suppressing HIV is impact. What we hadn't yet seen was how people's immune response was affected when they're HIV was effectively out of control because they weren't on medication. Then in a clinic she was working with an HIV positive patient came in who was not on any meds. The HIV virus had decimated this person's immune system. For instance, there were very few functional B cells, or T cells, crucial players in the immune system and as it happened just 16 days earlier. This person had gotten their second dose of the Pfizer vaccine. Typically, two weeks after the second dose, a person's blood is teeming with antibodies against covid. But with this person we actually couldn't see Any measurable levels of anti Corona virus antibody in the blood. Even after 44 days once this person had been put on HIV meds, and their immune system had recovered. They still have not produced any covid antibodies in response to the vaccine that's really quite extraordinary. These results published in the journal The Lancet this month match similar recent findings that the vaccines may not be effective for people who are immuno compromised for other reasons, cancer patients and organ transplant recipients on immuno suppressing drugs. Doctor Salim Abdelkarim directs South Africa's Center for the AIDS program of research, he says this suggests in countries around the world. A lot of people are at risk. Most countries will have immuno suppressed individual and he says it's time to connect the dots to a wider problem. Specifically, Abdul Karim and his collaborators recently followed the case of a woman in South Africa who was infected with the coronavirus at a time when her HIV was uncontrolled. It took her body seven months to clear the coronavirus. In the course of that train, the virus undergoes multiple mutations. And step by step, These mutations morphed the virus into a version of the variance of concern that have fueled new surges across the world. HIV positive woman became a call. It has been for the creation of a whole lot of new variance. She literally has recreated the steps. And that finding echoes a handful of similar studies. Abdul Karim, who also co chairs South Africa's advisory committee on Covid, 19 says his takeaway is this immune suppressed individuals are really important in this pandemic. Protecting them needs to be made a top priority for their own sake and to slow the emergence of variance. And there are potential solutions. For instance, a recent study of organ transplant patients who were on immunosuppressant drugs found that giving them a third dose of either the Pfizer or Moderna vaccine did have some effect. Similarly, McCoy's work on HIV positive patients suggests if you make sure a person's HIV has been treated before you give them a covid vaccine. The vaccine will work. The keys is Abdul Karim will be to ramp up research on all this. This is a new scientific puzzle, he says. And we've only just begun putting the pieces together. Jarrett, Aizenman NPR news As negotiations continue to lift US sanctions on Iran and revive the 2015 nuclear deal. Iranians wonder if and when the long promised economic rebound might ease their hard times. On a visit to Iran, NPR's Peter Kenyon found people struggling with rampant inflation. In.