COVID vaccine while receiving CD-20 (Rituxan)

[Carolinaj]

ncbi.nlm.nih.gov/pmc/articl...

Hello everyone,

I have not been in here in while so my apologies if this was discussed already. My husband is on Venetoclax and Rituxan. He is supposed to get his COVID vaccine this Friday and today he is receiving Rituxan. I came across this article on the lack of effectiveness of the vaccine when receiving CD20 therapies.

I wonder what others in the same situation doing?

Thank you!

Carolina

[cajunjeff]

This is a good question Carolina. It is now well known that being on a CD 20 monoclonal antibody treatment might impact the effectiveness of the vaccine. We have had a few members post that their doctors have advised them to delay the vaccine for that reason.

I have not seen that advice given in blanket fashion by all cll doctors to all people on CD 20 therapies. My question to any doctor against the vaccine for CD 20 efficacy issues would be that if the vaccine is still safe, which I think they all agree it is, what is the harm in taking it just in the hope it provides some protection now? A follow up question would be why not take the vaccine now and then again after CD 20 therapy is complete?

I am curious to hear from those who are on CD 20 therapy and what their doctors have said. I am guessing on this issue we might find some doctors advising their CD 20 therapy patients to wait to take the vaccine and others saying go for it, the worst that can happen is its not effective and you can retake vaccine later.

[Carolinaj in reply to cajunjeff]

Thank you cajunjeff ! This is exactly what we were thinking. My husband will be seeing his hem/onc today and will ask this question. We think he should go ahead and receive it in hopes of any protection even if minimal. Thank you!

[bkoffman CLL CURE Hero]

If possible, it makes sense to delay starting an anti CD20 MAB until after vaccinated or waiting 6 months to get the shot. If not, I would get vaccinated as it is theoretical that it won't work and then push for another booster in 6 months. This is completely off script and not part of any guideline, so please discuss with your team. It just makes sense to me and is what I would personally try to do. Brian CLLSociety.org

[Palmetto in reply to bkoffman]

We were told by Dr.Davids at least 6 months after Rituxan or Gazyva before vaccine may have any effect however our oncology hematologist urged him to get it even though only 4 months after. He felt any protection better than none. I wonder if anyone has had the mRNA vaccine and then waited for the newer adenovirus vaccines instead of mrna

[bkoffman CLL CURE Hero in reply to Palmetto]

Not sure why one vaccine would be better than another if you have no B cells to make antibodies. The MABs would likely have less negative effect on the T cells that may be important in immunity.

[Penkman]

I am receiving exactly the same treatment as your husband. I asked the same question to my haematologist who advised me to have it on the basis that it would not do any harm and any improvement in immunity that it might give, no matter how small would be of benefit. Based on this advice, I had the AZ vaccine two weeks ago.

[ragged]

I received the Moderna vaccine on the advice of my hem-onc team while on the anti-CD20 Obinutuzumab (with Venetoclax) despite the uncertainty as to an antibody response. The plan for me is to obtain a booster at some point, presumably when I complete my treatment late this year. As bkoffman of the CLL Society as previously informed us, a multi-center study is being organized to determine how those of us with CLL are responding to the vaccines.

[PJ60]

I have asked my hematology/oncology team twice about getting vaccinated for Covid. In no uncertain terms they all advised me at different times that there was absolutely no point to being vaccinated until the Rituxan was out of my system six months after my last infusion. So I’m waiting until July . They were quite adamant about it, and told me it would be a waste of time money and pain. Good luck, PJ

[81ue]

Rituximab appears to be one of the drugs that timing is important with vaccines. I was just reading this article creakyjoints.org/living-wit... on the reasons to wait after rituxan dose to get the vaccine based on theories of best flu and pneumonia vaccine timing with rituxan. The wait is for when b cells that create antibodies are recovered . I'm going to have my last rituxan dose in April (yay) . I''m on venetoclax and that drug has no wait precautions

[shmbak]

My husband had two shots of Pfizer prior to his first infusion of Rituxan. He did not make measurable antibodies, so he didn't try to get a third shot when he became eligible in October. However, I asked his oncologist recently if it's worth doing anyway (knowing that he's now getting Rituxan every four weeks and Omicron is circulating in our area) and doc said to do it.