I have CLL and am still on watch and wait. After being extremely careful and escaping Covid for 2.5 years, I had a mild case in mid September. According to CDC guidance, I should wait three months before getting the new vaccine. I am wondering if this recommendation holds true for those of us who are immune compromised. I’m scheduled to receive my next dose of Evusheld on December 20 at the Blood Cancer Center which would be my three month mark after having Covid but now am reading that Evusheld is not effective against some of the new variants. I know there should be at least two weeks between vaccine and Evusheld. I’m trying to decide the sequence for receiving Evusheld and a dose of the vaccine. Any advice or insight would be much appreciated. Thank you.
New Vaccine vs Evusheld: I have CLL and am still... - CLL Support
New Vaccine vs Evusheld
Thanks for the chuckle….. $.02. 😀
Always best to check with your MD. My layperson thinking, I would get the bivalent booster now. You have CLL, unless you had a blood test, you do not know if you made natural antibodies from your covid infection. The odds of having great natural immunity for someone with CLL post infection is not good. Even though Evusheld may not be helpful with future variants, it is still advise to get it now if you can. But best to wait at least two weeks after vaccination. If you cannot get Evusheld until December, it will give you plenty of time to see if it is an option for whatever variants are around at that time.
I just got over covid. Got the booster a couple of weeks after my rapid test became negative, which was last week. Next week I will contact my ID Doctor and ask for Evusheld. Will try to wait at least three weeks before getting Evusheld. I do not want Evusheld antibodies interfering with whatever is happening with the booster that I recently received. Somewhere in there, I will try to fit in the flu vaccine. I am off my zanubrutinib since July. So hoping maybe I will make antibodies from the recent booster. I did not make any antibodies from the previous five vaccines. That is my lay person’s take on it.
BTW, my oncologist is not big on prescribing Evusheld. He said, covid is decreasing now. I am of the mindset that it is going to pick up in a few weeks. In addition, does not matter if there is minimal covid or a ton of covid around. If you are the one that gets it, seems like you should have all the protection possible to help weather through it.
I was told 4 weeks after getting COVID for the bivalent booster, but that was in the UK I had a mild version of COVID in August and had the booster around 21 September. Evusheld is not available in the UK and even if it were I doubt if I would qualify for it being on W and W. It was a bit of s struggle to get Paxlovid
I am also on W&W. I have caught covided twice now, both times I called 111 and both times I was prescribed paxlovid. If your doctor has registered you as high risk it is automatic (so long as your symptoms started less than 5 days before you seeking medical help). I can not fault the NHS in this
When I caught COVID I tried NHS 11. They said call my GP. I did and after several phone
calls they said I couldn't get Paxlovid I then remembered I had the PCR kit sent to clinically vulnerable people in March and did the test sent it off. They got in touch with a CMDU and I got Paxlovid
Tricky decision. Maybe this will help you decide
covid.cdc.gov/covid-data-tr...
Below the coloured bar chart is an inconspicuous box where you can select a region to replace the USA.
These stats are not reliable in some states, but the trends are probably clear enough. Chances are you had Omicron BA.5 in September, and Evusheld has some but not much neutralising activity against it.
Come early January things could look different, with an equally high chance of catching BA.4.6 and/ or other subvariants that are completely resistant to Evusheld. Then you would be better served by whatever protection you had gained from vaccination and previous infection.
unfortunately the variants seem to be outpacing all monoclonals, and the vaccines, as well. The bivalent was geared toward ba5.
Novavax shows some promise, but in the US it was only just now approved as a “first booster.” Other counties have approved it as a full-fledged booster, regardless of booster status.
For me, I didn’t get any antibodies from the vaccines. I rely on limiting exposure as much as possible and we’ll-fitting n95 masks. Still going to get evusheld if available (which hinges both on circulating variants and supply), and will boost— I just don’t put much faith in their protective abilities for me personally at this time
Most of us with CLL are getting some T-cell protection from being vaccinated, if we are to believe the research, and it is much broader and longer lasting than any antibody response (mine was very weak too). I read somewhere that the bivalent vaccines are expected to have only slightly higher efficacy against BA.5 compared with the original mRNA vaccines, and we don't yet know how well they will do against the upcoming subvariants.
I quite like this virologist's summary of the situation, from a couple of weeks ago statnews.com/2022/10/06/bq1...
I’ll try to take a look later this weekend.
My understanding is 1) those of us with CLL have t-cells that aren’t functioning robustly either; 2) Covid is faster to infect than t-cells can react, antibodies are “where it’s at;” and 3) t-cell researcher Anthony Leonardi has been consistently correct about covid and the role of t-cells. Where Covid is concerned there is no t-cell immunity.
I read that the preferred sequence is the Covid vaccination, wait two weeks, then Evusheld. The reasons are:
1) Getting the vaccination before Evusheld increases the chances of the vaccination causing one's body to create Covid antibodies.
2) Two weeks is enough time for those antibodies to develop.
3) Having a two week gap between getting a Covid vaccination and Evusheld will make it more obvious which event was responsible for negative side effects if any negative side effects were to develop,
The usual disclaimer that I am not a doctor and therefore the above is not medical advice. AIso don't have CLL (I have Waldenstrom's Disease).
Good luck.
check is in the mail😂
Agree completely about discussing with an MD, however the comment “Elsewise, there is more muttering about the "uneducated" making their own decisions” hits me a bit wrong. That is the stage of the pandemic we’ve been at for some time. Public health pretty much has left us to our own devices. “It’s up to the individual to assess their risks and respond accordingly.” Then they promptly changed the metrics for reporting, so we haven’t the tools to assess our own risks, messaged mildness, and gaslit us along the way.
I got both recently. I got the Evusheld first on 9/19. Then I was ready to get the new Covid booster on 10/3… but due to work/family/etc, I didn’t get it until 10/15. I need a weekend for the Covid booster because I always have a 2-3 days of blah reactions. I have had zero reactions with the Evu-sheld. Good luck!!
Blue JK -
I think the CDC made a soft recommendation to wait 3 months - longer is better.
cdc.gov/vaccines/covid-19/c...
"In addition, people who recently had SARS-CoV-2 infection may consider delaying a primary series dose or booster dose by 3 months from symptom onset or positive test (if infection was asymptomatic)."
The magic 3 months came from a single study that they cited:
jamanetwork.com/journals/ja...
Durability of Antibody Levels After Vaccination With mRNA SARS-CoV-2 Vaccine in Individuals With or Without Prior Infection
November 1, 2021
That study only looked at vaccination before and after 90 days after infection. The 90 days was arbitrary. I think the 90 day-or-more delay is a way of saying a normal person doesn't benefit much if done any sooner, and to try to stretch things out. See my reference below for more detailed immune system timing.
I'll post some other thoughts I've been gathering in another thread.
=seymour=
our Oncologist is only giving my husband Evushield now ...
due to the fact that “Leukemia patients cannot maintain immunity in their bone marrow. “
Doc said VAX a month post-Evusheld. Last I heard is unknown if Evusheld effective for Omicron& beyond. Evusheld was developed & EAU'd in late-2021, before Omicron.
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