COVID Vaccine Booster for Blood Cancer Patients?

The website Patient Power has a really nice interview on its site about Covid and blood cancer patients. It tackles a few different issues, and it's worth watching. You can find the video, or read (or translate) the transcript, here.

The video features an interview with Dr. Gwen Nichols, MD, who is the Chief Medical Officer of the Leukemia & Lymphoma Society. The interview is conducted by Andrew Schorr, who founded Patient Power, and is himself a blood cancer patient (with CLL, another indolent blood cancer).

One of the big questions on blood cancer patients' minds is, should we get a booster shot -- a third vaccine, to make sure our immune systems are able to handle it, should we be unfortunate enough to get Covid-19?

The question is particularly important because there is a chance that the FDA will approve this kind of booster shot for immunocompromised people in the U.S. sometime soon. Other countries are doing the same thing. And the U.S. may have a policy for everyone to have a booster shot sometime later in the year.

(And I recognize that there are many places in the world where a "booster" still isn't an issue because lots of people haven't even had the opportunity to get a first or second shot. I hope that happens very soon for everyone, if it hasn't happened yet.)

But back to the question -- should blood cancer patients get a booster shot, if they have already been vaccinated?

According to Dr. Nichols, the answer is complicated. The first part of the answer is, we don't know. There really hasn't been a lot of research on research on blood cancer patients to show how they will react to a booster -- whether it will be effective, or safe. There is some research going on, in the U.S. and other countries, but not specifically focused on blood cancer patients. Some blood cancers can suppress B lymphocytes (that's the white blood cell that becomes cancerous for Follicular Lymphoma and some other lymphomas), and treatments can also suppress B lymphocytes. That can cause problems for people who get Covid-19. However, B lymphocytes are only one part of the immune system. If they don't work, other immune cells might take over. But it's really hard to know that.

There is a lot that we don't know. There's a lot of data that we still need.

So, says Dr. Nichols, the thing you should not do is take things into your own hands. She hears stories of people who lie about having been vaccinated, and get a third vaccine by saying they have only gotten one or two. That's understandable, but also potentially dangerous. Maybe if the booster is approved by the FDA, there will be enough data released to make the choice obvious. At the very least, talk the option over with your doctor if or when the booster becomes available, and get their opinion on whether it is a good option.

In the meantime, if you do suspect that you have been exposed to someone with Covid-19, Dr. Nichols says to get tested right away, and then speak with your doctor about treatment. There may be monoclonal antibodies available, but they work best soon after exposure to Covid. It's the same advice my oncologist gave me a few months ago.

And finally, Dr. Nichols has this advice for the LLS for blood cancer patients: Get vaccinated, and behave as if you were unvaccinated. That means get the vaccine when it becomes available, or get it now if it available and you have hesitated. But be careful anyway -- wear a mask, avoid large crowds indoors, keep your distance outdoors, and get tested if you suspect exposure. I've been doing my best to follow this advice.

I see a lot of information online about Covid-19 and blood cancer, and I usually don't write about it because I'm afraid I'm going to cause someone to panic. That's the last thing I want to do. I also now that I am lucky to have been vaccinated already, and not everyone is so lucky. 

But the advice here is good, and I hope you'll watch the video or read the transcript. Like everything else, it comes down to trusting experts -- ask your doctor about vaccinations, about booster shots, and about treatment, if necessary.

Stay safe, everyone.