I wanted to know if anyone had some insight into which vaccine they would take if they had a choice in the following circumstances.
Where I am located they are spacing out the first and second doses between 90-120 days.
I may have no choice but to take the AZ vaccine if the Pfizer is not available which I will do.
Does anyone have any insight if extending the second dose makes one of them better to take than the other if I do have a choice.
Thanks
I read that spacing out the AZ proved to provide even better protection but in any case not worse than administering the second shot after 3 or 4 weeks. That's the british experience, so I hear. No such news regarding the other vaccines. In SVK the second AZ shot is given 10 weeks after the first one, while the other vaccines 28 days after the first one.
UCLA, where I got my first Pfizer dose, is being very strict about the timing of the second dose. That seems to be the thinking most places I’ve read about (US - specifically California).
When you say quite strict, presumably UCH is following UK Govt guidelines and giving everyone the second shot 3 months after the first. I guess they have no choice.
For Pfizer in U.S. , I believe the time is 21 days between--mine will be 23 days.
21 days for me.
That's interesting as both my wife and I have had 1st Pfizer doses at Stanford -- and they make everyone wait 34 days whether it's Pfizer or Moderna.
Now Stanford (IMO) doesn't do dumb things. Regardless, I have my #2 on Saturday.
More questions than answers! UCLA ( just down the coast for those not familiar) would go up to 28 for those of us juggling schedules, but no more when I scheduled.
The first one you can get, I think is the advice. Here in UK... my wife and I have same GP. I had AZ, she Pfizer 2 weeks after me at a different centre too. We both have 2nd shot dates. Both 12 weeks after the 1st shot.
Jig
Thanks for the reply’s. I have no choice in having to wait the 3-4 months for the second shot so will see if I have a choice in vaccines and make a choice if I do. It seems the AZ is better if I wait the 3 months but it is not as efficient as the Pfizer vaccine and does not protect from some of the new variants from what I have heard.
You're saying exactly what I believe is true. Can't understand how I've not seen comments here about fact there has been no hair tearing among us in UK regarding the yet unpublished results of the Francis Crick Institute and Kings College. Not that tantrums help.
Interim results of the SOAP study have been published as an unreviewed pre-print, medrxiv.org/content/10.1101...
(to download the full text click on the "Preview PDF" button).
This write-up is of a small study, the blood cancer subjects numbering just 56. Their responses, however, were so clearly different from solid-cancer patients and controls that the results can't be ignored.
From the Discussion section at the end of the pre-print (emphasis mine):
"Patients with haematological malignancies are reportedly at increased risk of adverse outcomes from SARS-CoV-230 and given this vulnerability, there is an urgent need to protect this population expeditiously. Thus, the extremely poor immunogenicity following a single vaccine inoculation of haematological cancer patients is of particular concern. Clearly, this is not an entirely unexpected finding given the immunobiology of the underlying diseases and the fact that many patients with mature B cell malignancies have experienced prior or concurrent B cell depleting agents. Nonetheless, although our interim analysis was insufficiently powered to assess the impact of the day-21 boost in these patients, it is strikingly clear that increased measures are urgently required to confer immunological protection, most likely comprising prompt vaccine boosting and frequent serological monitoring. Until such measures are introduced, it seems important that this population continues to observe all COVID-19-associated measures such as social distancing and shielding when attending hospitals, even after vaccination. Moreover, whereas cancer patients in the UK were assigned vaccination priority level 4, no prioritisation was given to non-professional carers and/or immediate social contacts, who may potentially transmit virus to incompletely protected patients and/or be infected by them. Possibly these groups should be considered as priorities in future pandemic planning, in part to limit nodes of increased transmission and VOC emergence".
Thanks for this report. I find it a bit hard to understand. Am I right interpreting it to say it is important to take the vaccine?
What they advocate for cancer patients is to get vaccinated with two shots in 3 weeks, as in this study antibodies increased markedly after the second shot. They say that the current UK protocol, a 12 week interval between shots, leaves cancer patients with little protection for too long, especially blood cancer patients. The blood cancer subgroup gained less than the solid cancer subgroup from the second shot, so for us it's back to the old adage: don't expect much protection from vaccine, but some is better than none.
Thank you
3 to 4 mths for shot 2!
Why?
I have seen no data to say that a delayed 2nd vacc dose will give less enduring protection post 2nd shot. Just that there may be a couple or 3 weeks after the 3 mths is up when 1st shot benifits lapse, a bit.
We don't know. Remember it's IgG and T cells that get "educated".
...and of course us CLLers must expect a lesser vaccine response. At the moment no way of telling. But, and I stand to be corrected, I heard 11 studies afoot in the UK to look at CLL immunity post C19 vaccination.
I predict, cos of Covid, we will know more about immune function in CLL soon. That's exciting. For us the risk is infection, and not just to SARSCoV2.
So it's super important. Who knows, we may all get better protection in the long run.
Stay safe over in Canada.
Jig. 🇬🇧
Jig, just to draw your attention to the two phases of the SOAP study, looking in depth at the immune responses of patients - including those with blood cancer - 1. to Covid infection and 2. to the Pfizer vaccine.
Results from 1 were published in January cell.com/cancer-cell/pdf/S1... and results of 2 in March as an unreviewed pre-print medrxiv.org/content/10.1101...
Taken together these show that the immune responses of blood cancer patients are in stark contrast to those of solid cancer patients and the rest.
As you say, other studies are in progress.
Jig, There are results from a trial/ result project carried out by the highly respected Francis Crick Institute and King's College in London, indicate that in general blood cancer and solid tumour cancer patients, getting the Pfizer 2nd dose 3 weeks after 1st dose, developed good immunity to Corona 19. BUT in the cancer patients who got the second vaccine 12 weeks after first (which is what happens in the UK) there was dramatically, distressingly less protection. Seriously poorest results for blood cancer patients. Quite dramatic results , but this seems to have been buried.
I'd like to make clear that my post above these lines is not critical of Pfizer. They have repeatedly said that it is important not to extend the timing of their second vaccine beyond the recommended 3 weeks and when our Government extended this period to 12 weeks they said it is not a good idea but that extending to 5 weeks between the two shots is the absolute limit that should be done.
I've heard the reverse, the truth will come out evenually one hopes
Here's what the BCC reported on vaccine efficacy against variants, see bbc.co.uk/news/health-55659820
Early lab results, however, suggest the Pfizer vaccine can protect against the new variants, although slightly less effectively.
Two new coronavirus vaccines that could be approved soon - one from Novavax and another from Janssen - appear to offer some protection too.
Data from the Oxford-AstraZeneca vaccine team suggests it protects just as well against the new UK variant. It offers less protection against the South Africa variant - although it should still protect against severe illness.
Early results from Moderna suggest its vaccine is effective against the South Africa variant, although the immune response may not be as strong or long-lasting.
IMO though, CLL patients should take all these generalisations with a pinch of salt. We are a special case, see my reply to BluMts above.
If you have a choice, go for the vaccine you can get 2 shots of soonest, preferably with maximum 3 weeks between.
You can't rely on vaccination-interval data for the general population. Most blood cancer patients probably need frequent repeat shots. Ref SOAP study ongoing in UK.
Whichever, don't drop your guard.
If given a choice . . . . . the Moderna. That effective vax requires less in terms of the complexity of refrigeration logistics than the Pfizer, so a bit less that can go wrong. However the best advice is to get the one that is offered to you. My guess is that boosters will be along shortly. I rcvd both doses of the Moderna but would have taken the Pfizer if it was offered. I don't think Azn is offered in the US and J&J single shot is now being offered here.
I don't know the science to answer that question nitram120. From what I've read I think the AZ vaccine will prove to be one of the best at the end of the day. When I went to get my AZ jab the nurse said that it seems to cover more conditions than Phiser. There appears to be lots of politics involved with these two Vaccines, as the recent EU fiasco shows, compounded by the unfounded reports that AZ is unsafe. It looks like Political mischief to me and is affecting the rollout in several EU countries, which will ultimately cost lives. If I were you I would try and get both AZ jabs if possible. Entirely a matter for you of course, which ever you choose I wish you all the best with them.
No real answers - just more questions. In the US they have added J and J to Pfizer (21 day spacing) and Moderna as options. I’m hoping to see good boosters in the not too distant future.
I got the Pfizer yesterday and the protocol is 21 days, no exceptions, in one state healthcare system. When you book your first dose, the second appointment is automatically booked.
I had the second Pfizer yesterday: Not reaction, maybe a bit warmer then usual and a bit more tired. The second Pfizer is given 3 weeks after the first. Maximum protection of 95% is reached two weeks after second. But new variants are a question for level immunity.
Thanks to all for your input. I got the Pfizer vaccine and besides my arm hurting woke up the next morning feeling fine. Hope that does not mean that it won’t work well but I am hopeful. Now I have to wait almost 4 months for the next dose. Stay safe everyone!
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