COVID -19 Vaccinations for CLL patients ?

[lankisterguy]

Here is an opinion from my CLL expert doctor copied from groups.io/g/CLLSLL/message/...

with permission from the writer Richard Furman MD

Date: Thu, 26 Nov 2020 12:51:33 EST

We don't know if they are effective nor whether there will be unanticipated side effects in CLL patients, but overall, from the perspective of these not being live vaccines, they are safe for CLL patients. Given what information I have seen, I am going to recommend vaccination for my patients.

Rick Furman

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Len

[Justasheet1]

Thanks Len. Coming from such an expert, those words will carry a lot of weight with me when I speak to my own CLL expert. Jeff

[Cheltman]

Hi Len. Thanks for your post. I was wondering if there would be implications with the vaccines. I’ve just had my 4th round of B&R and had no issues and numbers going in the right direction m👍 Hope you are well. Jon

[lankisterguy Volunteer in reply to Cheltman]

Hi Cheltman, -

My wife and I love to save quoteable quotes from Dr. Furman, they are often very simple yet profound. One of his favorites is "We just don't have enough data, yet"

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And another recent comment from him, is that to get accurate data requires a placebo control group for comparison and that once a vaccine is approved it would be unethical and unthinkable to allow high risk patients like those of us with CLL to be given a placebo instead of a vaccine that might work - due to the risk of more deaths.

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So I suspect we will never see a Phase 3 trial for CLL patients or other immune compromised, unless someone funds a trial that compares two vaccines, with no placebo. Then we may only know which of the two vaccines is slightly better, but no way to know if it would be better for us to wait until herd immunity takes over after several years. (I am not willing to wait for that data- I would be dead from quarrantine boredom by then)

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Len

[Cheltman in reply to lankisterguy]

I agree with that Len. Stay safe and hope things are improving in America. 👍

[Ballet50]

Thank you for the info Len. This matter has been high on my list of concerns. Yes, I would take the vaccine rather than waiting on "herd immunity". That is if my CLL doc, Kerry Rogers @ The James approves. Will see her in February. In the meantime, stay well all.

[Peggy4]

Thanks Len. Good to know.Peggy 😀

[PaulaS Volunteer]

Thanks Len, it's good to hear Dr Furman's view on this.

Dr Furman says "...from the perspective of these not being live vaccines, they are safe for CLL patients...". However, there seem to be different views on whether all the vaccines being produced are non-live, especially the Astra Zeneca one. (As KrisBren01 says in healthunlocked.com/cllsuppo... )

I get confused by this. Do different medics define "live" vaccines in different ways?

Paula

[PaulaS Volunteer in reply to PaulaS]

P.S. I tried to read Dr Furman's full message on the site you mention, but it seems to need registration with that group. Was he actually referring to one specific Covid vaccine, rather than speaking in general?

[lankisterguy Volunteer in reply to PaulaS]

Dr Furman was replying to a question about the Pfizer and Moderna vaccines that are mRNA.

Len

[PaulaS Volunteer in reply to lankisterguy]

Thanks Len. I'm still trying to get my head around these things...

Paula

[lankisterguy Volunteer in reply to PaulaS]

Hi Paula,After digging in further I learned that the Astra Zeneca vaccine is a live Rhino (cold) virus that has been altered / disguised to make the immune system believe it is COVID-19. So it is live.

Len

[Peggy4 in reply to lankisterguy]

So no good to us!Peggy

[CLLerinOz Administrator Volunteer in reply to lankisterguy]

This is a good, up-to-date resource that answers many questions with the caveat that there haven't been any trials on CLL patients to date:

hematology.org/covid-19/ash...

And this is another written for patients with Primary Immunodeficiencies which can probably be extrapolated to CLL:

cslbehring.com/vita/2020/co...

However, I'm not so sure that the Astra Zeneca vaccine won't be ok for some CLL patients: "Oxford-AstraZeneca vaccine: Contains a weakened form of a harmless virus that usually causes the common cold in chimpanzees but doesn’t grow in humans. The virus has been modified to include the gene for the coronavirus spike protein protein. Injecting this virus aims to prime the immune system to attack without exposing the body to the full virus. The vaccine can be stored at fridge temperature." We may need some further clarification about this.

scienceblog.cancerresearchu...

[PaulaS Volunteer in reply to CLLerinOz]

Thanks so much, CLLerinOz . Those links are very helpful.

However as you say, the situation with the Astra Zeneca-Oxford vaccine needs more clarification. It seems that for chimpanzees it is "live", but for Homo Sapiens it should not be!

Paula

P.S. I didn't express that very well. I suppose it's more a case of the Oxford vaccine being technically "live" but it probably won't behave as "live" in human beings. Yes, more clarification definitely needed!

[CLLerinOz Administrator Volunteer in reply to PaulaS]

Yes, that’s my understanding, too.

[AussieNeil Administrator in reply to CLLerinOz]

"but doesn’t grow in humans" needs to be absolute to doesn't grow in any humans, even those with immunodeficiencies. It would be reassuring to know that the ability of the vector virus to replicate has been totally and irrevocable crippled it that's possible.

[CLLerinOz Administrator Volunteer in reply to AussieNeil]

Hopefully, as we get closer to rollout of the vaccines, we’ll know.

[Bar68]

Thanks for posting this, Len.