Multiple Myeloma Patients Hope For Vaccine Boost
- Clinical recommendations from the CDC state that patients with hematologic cancers like multiple myeloma should get a third COVID booster shot.
- A July study in Nature found that only 45% of those being treated for the disease had enough antibodies to fight COVID after two doses of the Pfizer or Moderna vaccine.
- Multiple myeloma patients have a weakened immune system which makes them more susceptible to infections and viruses like COVID.
A recent study determined that less than half of those who have been diagnosed with multiple myeloma produced the necessary number of antibodies needed to protect themselves from the virus, even after receiving two doses of the Moderna or Pfizer vaccines.Read More
There is now some hope, however, with the availability of a booster shot for any immunosuppressed persons.
Can Multiple Myeloma Patients Get the Booster Shot for COVID-19?
A panel comprised of the nation’s leading medical experts on immunizations recommended on Aug. 13 that all individuals who are receiving treatment for hematologic cancers such as multiple myeloma seek out a third booster shot of the COVID-19 vaccine.
That decision was made a little over 12 hours after the Food and Drug Administration granted emergency use authorizations for a third dose of the Moderna and Pfizer COVID-19 vaccines in immunosuppressed persons.
Once the additional dosage was approved, it fell to the members of the Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) to determine for whom it was approved.
After a four-hour meeting, the group recommended that moderately to severely immunocompromised people should seek out a booster shot.
The group then gave six examples of patients who would be classified as moderately to severely immunocompromised, starting with those who have “been receiving active cancer treatment for tumors or cancers of the blood.”
COVID vaccines have proven to be far less effective in cancer patients receiving chemotherapy, immunotherapy, biological therapy, or any combination of the three; and at times ineffective in those being treated for hematologic cancers.
This came just days after a pair of studies published in The Journal of the American Medical Association also determined that cancer patients have fewer antibodies than individuals who are not immunosuppressed when they first receive the vaccine, and after their second dose.
Why Do Multiple Myeloma Patients Need a Booster?
In July, a study published in Nature found that only 45% of multiple myeloma patients achieved antibody levels high enough to effectively protect them from COVID-19 after receiving two doses of the Pfizer or Moderna vaccines.
Another 22% of study participants showed an increase in antibody levels but not to the level needed to fight the virus, while 33% failed to register any antibodies both before and after receiving the vaccine.
Old age, impaired renal function, low lymphocyte counts, reduced uninvolved immunoglobulin levels, and those participants not in complete remission were more likely to have lower antibody counts
Researchers were working with a small sample size of just 103 multiple myeloma patients for that study, half of whom were given the Pfizer vaccine while the other half received the Moderna shot.
These participants will have their antibody levels measured at least one more time for an update on how the booster impacted their levels.
These individuals need protection more than many others because of the way multiple myeloma weakens a person’s immune system.
A weakened immune system combined with damaged white blood cells makes it far easier for infections to develop in the body, or viruses such as COVID-19.
Those individuals with multiple myeloma who have contracted COVID-19 have often been far sicker for far longer than the general public.
Prolonged sickness can also become a problem for the population as a whole as this is when variants of viruses are able to develop, which are often far more contagious and over time more resistant to vaccinations.
Can Multiple Myeloma Survivors Who Are Not in Active Treatment Get a Booster?
In its recommendations, the Centers for Disease Control Advisory Committee on Immunization Practices was very clear that it considers patients “receiving active cancer treatments” as immunocompromised.
Those are the only cancer patients that the ACIP cites in its recommendations, but the group makes it very clear that any person who is immunocompromised can and should receive a booster shot if their doctor approves of the measure.
When Are Multiple Myeloma Patients Eligible For a Booster?
A booster shot may be administered to any immunocompromised person four weeks after completion of the initial two-dose vaccination.
This means that most multiple myeloma patients are long overdue for that booster, having been the first approved for vaccines in January.
Can Multiple Myeloma Patients Get the Booster From Their Doctor?
Doctors are now able to administer a third dose of the COVID vaccine to any immunocompromised person they believe qualifies for a dose.
It is not until the FDA approves a drug or treatment that doctors and medical providers have liability protection. This is why so many doctors who were urging the FDA to speed up approval for a booster shot were also refusing to provide patients with a third dose.
Doctors are only allowed to provide a third dose at this time, but will soon be able to administer the vaccines as they see fit once full approval has been given to the Pfizer and Moderna vaccines by the FDA.
What Do Multiple Myeloma Patients Need to Bring When Getting a Booster?
The CDC has opted to go with the honor system in laying out the clinical regulations for those immunocompromised persons seeking a booster shot.
Multiple myeloma patients who are currently in treatment need only go to a vaccine site or their doctor’s office to get their booster, as they fall under those six groups highlighted by the CDC.
All other immunocompromised persons who have or had multiple myeloma simply need to get the approval of the doctor before they too can get a booster, either at a vaccine site or right there in their doctor’s office.
Patients should bring their vaccine card but will not be required to show proof of identification, a doctor’s note, or a prescription to get a booster.
Can Multiple Myeloma Patients Mix and Match Vaccines
Yes. But only if it is absolutely necessary.
Those who received the Pfizer vaccinations should get a third dose of the same vaccine while those innoculated with Moderna should once again receive that for their booster.
However, any site that runs out of the Pfizer or Moderna vaccines is allowed to administer either of the mRNA formulas to those seeking a booster.
How Can Multiple Myeloma Patients Protect Themselves?
Multiple oncologists tell SurvivorNet that wearing a mask is still the best way for cancer patients to avoid contracting or spreading the virus.
Dr. Paul G. Richardson, clinical program leader and director of clinical research at the Jerome Lipper Multiple Myeloma Center at Dana-Farber Cancer Institute, previously explained to SurvivorNet that getting vaccinated is just one of many steps cancer patients should be taking at this time.
“The key is the success of vaccinations, but other strategies in my [multiple myeloma] patients focus on continued precautions, and attention to therapeutics – not least as the variants are such a concern,” explained Dr. Richardson.
“We are moving from pandemia to endemia and as such long-term adjustments and continued caution are inevitable in terms of treatments for underlying and supportive care. Fortunately, however, we are moving towards a more manageable paradigm of therapy/care, although the danger of SARS CoV2 remains clear and present.”
Individuals with cancers of the blood are the most vulnerable due to the increased risk that their bodies may not produce any antibodies against COVID-19 even after receiving two doses of the vaccination.
That is why masks are so important for individuals with cancer.
“The problem with a lot of the variants, especially the delta variant and others, is that if you have a low immune response or low antibody titer, which many of these (cancer) patients would have, it may not be protective against getting an infection,” explained Dr. John N. Greene, chief of infectious diseases at the Moffitt Cancer Center.
“So for these immunosuppressed cancer patients, there is no guarantee that their vaccine is effective because [antibody testing] is not recommended outside of a research setting to actually measure their immune response or their antibody levels. And therefore, since it remains a mystery, they should continue to wear a mask and not go into large crowds where people could infect them and others visiting them.”
He continued: “I think that’s pretty sound logic because these immunosuppressed patients and people are at higher risk of serious illness if they were to catch COVID-19.”
Dr. Amrita Krishnan, director of the Judy and Bernard Briskin Center for Multiple Myeloma Research at City of Hope, told SurvivorNet that she continues to urge her patients – many of whom are at a high risk of not producing antibodies – to wear a mask and social distance.
Dr. Jana Dickter, also from City of Hope, said that it is not just those with cancer who need to be careful.
“I would also suggest that patients advocate for themselves by having close relatives, family members, and household contacts get vaccinated,” Dr. Dickter told Survivor Net.
There may also be a third option in the near future, as a special vaccine is currently in development.
The National Cancer Institute is sponsoring a trial for a vaccine that is specifically designed to protect individuals with cancer from contracting COVID-19. That trial is still in the recruiting stages.