Thursday, July 29, 2021

To booster or not to booster?

Dr. Gwen Nichols, Chief Medical Officer at Leukemia & Lymphoma Society (LLS) states that blood cancer patients are at increased risk of serious illness and death from Covid-19. She recommends avoiding poorly ventilated indoor spaces, wearing masks, social distancing, and staying away from crowds. When others get vaccinated and wear masks, they are protecting those people with compromised immune systems.

But what if you are a cancer patient and you have been inoculated? After taking the antibody test, many inoculated blood cancer patients found out that they do not have protection against the Covid-19 virus.

The Leukemia & Lymphoma Society examined the safety of the Covid-19 vaccine and they also tested the number of antibodies produced by blood cancer patients who had been vaccinated. The results showed that the Covid-19 vaccine is safe, but according to the results of the clinical study (NCT04794387), a number of blood cancer patients do not produce detectable antibodies. They were found to be seronegative.

Thirty-six percent of CLL participants were found to be seronegative after being vaccinated; however, a much higher percentage were found to have no antibodies in the sub-group of CLL patients who within the last two years had taken BTK inhibitors such as ibrutinib, a BCL2 inhibitor such as venetoclax, anti-CD20 antibodies or combination therapies.

Why is that so? We know that B-cells help to make antibodies when a person is vaccinated. Each of these blood cancer therapies affects B-cells. This leads us to deduce that the possibility exists that these cancer drugs could be preventing Covid-19 antibodies from multiplying. And will there be clinical trials with patients on these therapies?

July 8, 2021 Pfizer and Moderna publicly stated that boosters may be in the future. Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, recently indicated that that booster doses may be authorized in the USA for the immunocompromised patients.

July 28, 2021 Pfizer/BioNTech announced that a third dose of the Covid -19 vaccine can boost protection against the Delta variant. Data suggests that if you are 18 to 55 years of age, a third dose can boost your antibody protection five times greater than your second dose (Howard, J., CNN). If you are 65 to 85 years of age, a third dose can boost your antibody levels against the Delta variant 11-fold following your second dose. In addition to the Delta variant protection, the third dose also increases protection against the original coronavirus variant and the Beta variant.

The CDC is in discussion about recommending booster doses for patients with compromised immune systems. Emerging data in two studies have reported an increase in antibody numbers after being given a booster shot following the full vaccine dosage. One study consists of solid organ transplant participants and another consists of blood cancer participants.

Last week, the CDC's Advisory Committee on Immunization Practices (ACIP) met and discussed immunocompromised individuals receiving a third booster dose. Its members seemed to be supportive of allowing this if recommended by their doctors; however, as of July 28, 2021 the official stance of the CDC and FDA is that a third booster of Covid-19 vaccines are not needed.

Earlier this month Israel and France began to give third booster doses of the Pfizer-BioNTech vaccine to some immunocompromised individuals. France is also including hospital staff over the age of 50 and older individuals.

Another 200 million doses of the Pfizer vaccine have been purchased by the United States. Are these future boosters?