COVID vaccine and chemo

[kiwiCanuck]

Does anyone have any experience with B cell targeting chemotherapy and COVID 19 vaccine? As far as I understand it, the chemo wipes out your vaccine based immunity.

[AussieNeil Partner Administrator]

Welcome to our community. I see that you've just recently joined.

You haven't specifically stated the treatment you are concerned about. In general, B-cell targeting therapies do not affect the mature B-cells/ plasma cells, which produce our antibodies, or we would all need to repeat our childhood vaccinations after treatment.

While we are in treatment, targeted therapies do unfortunately also reduce our counts of healthy B-cells, so we are unlikely to produce much in the way of new plasma cells specific to the coronavirus, unless we take a break of at least 3 weeks (a week beforehand and two weeks afterwards) so we might make some new, healthy B-cells and allow them time to mature into plasma cells. Most specialists wouldn't recommend that approach unless we had been on maintenance therapy for some years.

Anti-CD20 monoclonal antibody treatments are particularly long lasting in the blood. If your treatment includes one of these, (rituximab, obinutuzumab, ofatumumab), you are unlikely to produce any antibodies for at least 6 to 12 months after your last infusion.

The above is specific to antibody production. The degree of T-cell cellular immunity that we can develop during treatment is still being assessed in clinical trials.

Neil

[kiwiCanuck in reply to AussieNeil]

Wow. Thanks for that. I'm on rituximab, so the likelihood of effectively losing my vaccine protection is high and will stay high after chemo completes.

[gardening-girl]

kiwiCanuck, I've been on the B-cell BTK targeting drug ibrutinib for 7 years and did respond to Moderna's vaccine with anti-Spike antibody titers of 5.6 U/ml and 25.9 U/ml after the first two shots, and >2500 U/ml after the third.

[kiwiCanuck in reply to gardening-girl]

Thanks for that. My haematologist recommended ibrutinib but then figured FCR (fludarabine cyclophosphamide rituximab) fit my driver's better.