Tag Archive for: COVID vaccines

Is the COVID Vaccine Effective for CLL Patients?

Is the COVID Vaccine Effective for CLL Patients? from Patient Empowerment Network on Vimeo.

Is the COVID vaccine effective for chronic lymphocytic leukemia (CLL) patients? Dr. Paul Barr shares insight about mRNA-based COVID-19 vaccine effectiveness in CLL patients – both for those in remission and those in active treatment.

Dr. Paul Barr is Professor of Hematology/Oncology at University of Rochester Medical Center. Learn more about Dr. Barr, here.

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An Expert’s Perspective on CLL Research Advances

Transcript:

Katherine:

I understand that researchers have been looking into whether the COVID vaccination is as effective in people with CLL. What can you tell us about that? The research?

Dr. Barr:

Sure. Everyone knew this was going to be an important question. We’ve known for a long time that riff CLL responses to vaccines in general aren’t as good as some of the normal population. So, there’ve been a whole host of studies over the years where patients didn’t quite respond as well to flu vaccines or pneumonia vaccines. Nonetheless, we typically recommend standard vaccinations, because there’s can be some degree of response. And our testing isn’t always perfect in terms of how well vaccines work.

So, when it typically, is felt to be a relatively safe procedure, is something we typically recommend.

More recently, we looked at studies on the shingles vaccine, and actually that works better than perhaps the flu shot, for example. Because patients probably were previously exposed to that virus earlier in life when they get vaccinated. So, recall response, which is a little bit easier for the immune system.

So, that brings us up to the COVID vaccines, which is obviously critically important ever on everyone’s mind. And the data’s still early. But what we’ve learned so, far is that, like what we might have predicted, our patients, the CLL patients don’t respond as well to the mRNA-based COVID vaccines.

So, in the media we saw, in the larger 20- and 40,000 patients studies that maybe, 95 percent of patients didn’t experience infection. It looks like in the general population, those vaccines work very well. In a cohort of 160, some CLL patients who are vaccinated early on in Israel, it looked like maybe about 40 percent of patients responded.

For the patients who hadn’t previously been treated but had measurable CLL, maybe about half of patients responded adequately in terms of generating antibodies. So, kind of a flip of a coin. For patients who have been treated and were in remission for more than a year, we’ll say the responses were better, maybe 80 percent or so.

For patients who are on active treatment, even our novel treatments, like the BTK inhibitors or venetoclax (Venclexta), the BCL-2 inhibitor, the responses were pretty poor, 18 or so percent.

So, you can see for patients with active disease, their responses are impaired. For those that are in remission, a little better. For those who are on active treatment, the antibody responses aren’t very good. So, I honestly think this is important information, but tell patients, don’t lose hope.

It’s still important to take the precautions. Some degree of wearing masks and social distancing. They will be better protected if their friends and family around them are vaccinated, and they still may respond to some degree. It’s not like the vaccines aren’t working at all. It’s just that the responses aren’t quite as good as the general population. So, again, another long-winded answer, but hopefully that helps patients understand some of the limitations in vaccinations.

But also that generally things are getting safer in that they still can venture out in society, but still have to take some precautions.

Is the COVID-19 Vaccination Safe for CLL Patients in Treatment?

Is the COVID-19 Vaccination Safe for CLL Patients in Treatment? from Patient Empowerment Network on Vimeo

Are COVID-19 vaccines safe for chronic lymphocytic leukemia (CLL) patients in treatment? Dr. Lindsey Roeker discusses COVID-19 vaccine safety, common symptoms, and the effectiveness in CLL patients.

Dr. Lyndsey Roeker is a hematologic oncologist at Memorial Sloan Kettering Cancer Center. Learn more about Dr. Roeker here.

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Transcript:

Katherine:                  

We have another question from our audience. Eileen is currently in active treatment for her CLL, and she wants to know, “Is the COVID-19 vaccine safe for her?”

Dr. Roeker:                 

Great question. So, here is my take on COVID vaccines. We have great data on the safety of these vaccines, so the risk of a life-threatening allergic reaction is very, very low, less than one in a thousand. We know that it can cause some irritation at the injection site, so pain in your arm. We know that it can cause some kind of flu-like, blah symptoms for a couple of days, totally fine to take ibuprofen and kind of get yourself through that period.

But from a safety perspective, I don’t have concerns about these vaccines. There’s a lot of social media coverage on long-term implications that are either not based on data, at all, and just speculation, and people who are trying to raise alarm, or people who are really bringing up bad things that are happening to people really far out from the vaccine. And I think it’s really hard to attribute that to the vaccine. Obviously, any time there is a new technology, there’s the possibility of things happening, and we’re going to know more with time, but I think, overall, from a scientific perspective, there is no data that makes me worried about the safety of this vaccine.

The efficacy question, I think, is more of an open question, and the reason I say that is two-fold. The first is, we know that patients with CLL who get other vaccines, some get 100 percent coverage, some get zero percent coverage, and some are somewhere in between.

And it’s hard to predict who is going to fall where. So, that’s the first piece. The second piece is, we’ve looked at patients who had CLL and got COVID, and we saw if they made antibodies, which is kind of a marker of an immune response, and it’s not consistent that every patient who got COVID makes antibodies.

So, the combination of those two pieces of data makes me question exactly how well they’re going to work. So, what I’m telling my patients is, “Definitely go ahead and get it. I think it’s safe. And then pretend that you didn’t get it.” So, I know that’s hard advice to hear, but continue wearing a mask, continue social distancing, and continue to wash your hands. And then, every interaction you have is a risk-benefit discussion or decision. So, that’s different for every person, but in general, I recommend that people continue being cautious.

Once the whole population around you is vaccinated and we have less virus circulating in the community, that’s when it’s going to be substantially safer. So, definitely, I recommend that people get it, regardless of whether you are on watch and wait, getting treatment, have just finished treatment, whatever it is, but I do think there’s reason to be cautious even after getting vaccinated.

Katherine:                  

Are there symptoms or issues CLL patients should be looking out for, post-vaccine?

Dr. Roeker:                 

Not particularly, beyond what people are getting in kind of the general population. If you’re having a lot of those kind of flu-like symptoms, just talk to your provider to make sure that ibuprofen (Advil, Motrin) is safe, because if your platelets are really low, that can cause bleeding. But acetaminophen (Tylenol) is typically pretty safe and talk to your doctor about which medicines are kind of best for you to take in that situation, but no particular concerns in patients with CLL.