COVID-19 Vaccine Updates and FAQs

Updated: 10/20/21

Frequently Asked Questions

The Lymphoma Research Foundation (LRF) encourages patients, survivors, and their caregivers to take information and questions back to their individual health care providers as a way of creating a dialogue and partnership about their lymphoma and treatment.

COVID-19 VACCINE BASICS

What is the COVID-19 vaccine?

As of August 23, 2021, the has U.S. Food and Drug Administration approved the first COVID-19 vaccine: Comirnaty (formerly known as the Pfizer-BioNTech COVID-19 Vaccine) for individuals 16 years or older; and approved Janssen and Moderna COVID-19 vaccines for use in the United States under the Emergency Use Authorization (EUA). Comirnaty continues to be available under EUA for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals.

These are commonly called the “Pfizer,” “Moderna,” and “Janssen” vaccines, which refer to the respective vaccine manufacturers. The Pfizer and Moderna vaccines are referred to as messenger RNA (mRNA) vaccines. mRNA vaccines teach our cells how to make a protein to trigger a response from the immune system. The Janssen vaccine is manufactured using a specific type of virus called adenovirus type 26 (Ad26), which is used to deliver a piece of the DNA, or genetic material, to trigger a response from the immune system.  Unlike other vaccines, the COVID-19 vaccines do NOT use the live virus that causes COVID-19. All vaccines have undergone rigorous testing to ensure safety and efficacy.

What does the efficacy rate mean and how effective is the COVID-19 vaccine?

Vaccine efficacy measures how well vaccines work to prevent diseases among vaccinated people when compared to unvaccinated individuals. The Pfizer and Moderna vaccines demonstrated 95 percent efficacy in clinical trials. Studies thus far suggest that receiving two doses of the vaccines is important for achieving the immune response to provide lasting protection. Even in those of us who are vaccinated, however, following social distancing protocols, handwashing, and use of masks remains important to maximize safety and avoid the spread of infection.

The Janssen vaccine demonstrated 67 percent efficacy in preventing moderate to severe/critical COVID-19 occurring at least 14 days after vaccination and 66 percent efficacy in preventing moderate to severe/critical COVID-19 occurring at least 28 days after vaccination.  Additionally, the Janssen vaccine demonstrated 77 percent efficacy in preventing severe/critical COVID-19 occurring at least 14 days after vaccination and 85 percent efficacy in preventing severe/critical COVID-19 occurring at least 28 days after vaccination.  Unlike the Pfizer and Moderna vaccines, the Janssen vaccine is administered as a single dose.

How are the COVID vaccines distributed?

The Comirnaty (Pfizer-BioNTech) vaccine is approved for anyone 16 years or older; and authorized for use in anyone 12 through 15 years, while the Moderna and Johnson & Johnson vaccines are authorized for anyone 18 and older. Be sure to speak with your oncologist or primary care provider about whether a COVID-19 vaccine might be appropriate for you and details of availability at your medical center or elsewhere in your community.

Does the vaccine have side effects?

Thus far, it has been rare to experience any severe side effects as a result of either vaccine. You may experience mild reactions after receiving the vaccine that is in keeping with similar symptoms after receiving a flu shot. The most common side effect is soreness at the injection site. Other reactions may include fatigue, headache, muscle aches, joint aches, and, less commonly, fever. These reactions are temporary and may be a sign that your body is building immunity.  It is important that any individuals with a history of severe allergic reactions alert the medical team prior to receiving a vaccine, as such reactions can occasionally occur with COVID-19 vaccination.  In general, given the risk of exposure to COVID-19 in the community and the potential for severe consequences of infection (including in patients with lymphoma), it is felt that the benefits of vaccination far outweigh the risks.

COVID-19 VACCINES AND LYMPHOMA/CLL

Do lymphoma patients fall into the high-risk group category?

The Center for Disease Control (CDC) has an Advisory Committee on Immunization Practices (ACIP) that has made recommendations for a phased rollout of the vaccine. For more information on the rollout plan, please visit the CDC’s website. ACIP has prioritized initial supplies of the vaccine to be allocated to healthcare personnel and long-term care facility residents. People with certain underlying medical conditions, such as cancer, are among the groups being prioritized for earlier access to the COVID-19 vaccine. Both before and after you receive the vaccine, it is important to continue to follow public health guidelines such as those relating to social distancing and wearing masks in many public settings.

Should lymphoma patients and survivors receive the COVID-19 vaccine?

Most lymphoma patients should receive the COVID-19 vaccine as soon as it is available because studies have shown that blood cancer patients may be at higher risk for negative outcomes from COVID-19 infection than the general population.  However, given that some lymphoma treatments might affect the efficacy of a vaccine (by impacting the immune system), lymphoma patients and survivors should consult their oncologist or healthcare team prior to receiving the COVID-19 vaccine – particularly if they are in the midst of lymphoma treatment or have had it recently (e.g. within the last 6-12 months). Some healthcare providers may suggest that some patients wait a period of time after their last treatment before receiving the vaccine. Studies at this point suggest that the COVID-19 vaccines are safe for even those who have underlying health conditions (with the rare exception of some of those with a history of severe allergic reactions).

COVID-19 VACCINES AND TREATMENTS

How may medication or treatment for lymphoma affect the efficacy of the vaccine?

Lymphoma and lymphoma therapies can be associated with a diminished immune system.  An immune response to the vaccine, which then also acts against the virus if infection occurs, is the key way vaccines provide protection.  It is expected that certain lymphoma therapies, particularly rituximab (Rituxan) and obinutuzumab (Gazyva), may diminish the immune response to vaccines due to their effects on normal B cells.  This observation has been noted in some patients with other vaccines.  It is possible that chemotherapy and other treatments, including targeted therapies, may also affect immune responses to vaccines.  However, since lymphoma patients (and other patients receiving cancer therapies) were generally not included in clinical trials of COVID-19 vaccines, we do not presently know for certain if or how much lymphoma treatments would affect the efficacy of a vaccine.  It may also be that some patients might have a diminished immune response, but that may nonetheless provide some meaningful but lower efficacy.  These issues are under active study by researchers and likely depend on the details of the nature and timing of lymphoma therapies relative to vaccination.  In general, it seems appropriate for lymphoma patients to receive COVID-19 vaccinations when available given the possibility of at least some efficacy, but it is a good idea to speak with one’s physician/healthcare provider for specific guidance on this issue.

Can the vaccine have negative effects on treatments for lymphoma?

There is no evidence (or expectation) at this time that the vaccine will have any impact on lymphoma therapy, nor should lymphoma patients have an increased risk of side effects.  As mentioned before, COVID-19 vaccines are NOT live virus vaccines (which would be a type that in some cases may not be appropriate for lymphoma patients). It is always best to consult with your physician regarding any concerns you may have in receiving the vaccine.

AFTER VACCINATION: WHAT HAPPENS NEXT?

Should caregivers or loved ones get the COVID-19 vaccine? If so, how soon?

It is encouraged for caregivers and all members of the patient’s household to be vaccinated as soon as possible. Since the vaccines are now widely available, caregivers and loved ones should consult with their healthcare providers, local pharmacies, or state agencies for locations of vaccination sites.

Are lymphoma/CLL patients fully protected against COVID-19 after being fully vaccinated?

It is important to note that being fully vaccinated with a COVID-19 vaccine does not necessarily mean that individuals are therefore fully protected. The CDC recently updated their COVID-19 Vaccine Guidelines because data suggest that immune responses to COVID-19 vaccination might be reduced in some immunocompromised individuals. According to the CDC, this includes, but is not limited to, people receiving chemotherapy for cancer, people with blood cancers such as leukemia or lymphoma, people receiving stem cell or organ transplants, people receiving hemodialysis, and people using certain medications that might blunt the immune response to vaccination. We suggest that you consider consulting your oncologist or primary care provider about your COVID-19 vaccine immune response and your own diagnosis.

Should I get antibody testing after I’ve received my vaccine to confirm if I’ve had a response?

Antibody testing is not recommended to assess the immune response to a COVID vaccine. The presence of an antibody response does not ensure that an individual has “protection” and the absence of an antibody response does not mean that a patient has “no protection.” Lymphoma patients who may be immunosuppressed due to their underlying lymphoma and/or their treatment may in fact have a broad range of potential “immune status” regardless of whatever test results might be observed. It is also not recommended that lymphoma patients (or others) change their behavior (one way or another) based on any such test results. There are a number of ongoing research studies ongoing that are assessing this issue further.

What can I do to continue protecting myself after being vaccinated?

Since individuals can experience an impaired immune response to the Covid-19 vaccine, lymphoma/CLL patients should continue practicing preventative measures such as using face coverings and social distancing when interacting with members outside their households. In some individuals, prophylactic infusions of anti-SARS-CoV-2 monoclonal antibodies may be beneficial. Patients should speak to their doctors to determine if this could be another protective option for them.

Should I get a booster shot if I received a third shot of the vaccine?

The CDC recommends that moderately and severely immunocompromised people over the age of 18 who received a 2-dose mRNA primary series and an additional mRNA additional dose (3 total mRNA vaccine doses) are eligible for a single COVID-19 booster dose (Pfizer-BioNTech, Moderna or Janssen) at least 6 months after completing their third mRNA vaccine dose.

Approved Vaccines

January 31, 2022, The FDA approved a second COVID-19 vaccine. The vaccine has been known as the Moderna COVID-19 Vaccine; the approved vaccine will be known as Spikevax for the prevention of COVID-19 in individuals 18 years of age and older. Spikevax has the same formulation as the EUA Moderna COVID-19 Vaccine and is administered as a primary series of two doses, one month apart

January 3, 2022, The FDA revised the EUA for the Pfizer-BioNTech COVI-19 Vaccine to:

• Expand the use of a single booster dose to include use in individuals 12 through 15 years of age.
• Shorten the time between the completion of primary vaccination of the Pfizer-BioNTech COVID-19 Vaccine and a booster dose to at least five months.
• Allow for a third primary series dose for certain immunocompromised children 5 through 11 years of age.

December 9, 2021, The FDA revised the EUA for the Pfizer-BioNTech COVID-19 Vaccine, authorizing the use of a single booster dose for administration to individuals 16 and 17 years of age at least six months after completion of primary vaccination with the Pfizer-BioNTech COVID-19 Vaccine. On Nov. 19, the FDA authorized the use of a single booster dose of the Pfizer-BioNTech COVID-19 Vaccine for administration to all individuals 18 years of age and older after completion of primary vaccination with any FDA-authorized or approved COVID-19 vaccine. This new action expands the use of a single booster dose of the Pfizer-BioNTech COVID-19 Vaccine for administration to individuals 16 and 17 years of age at least six months after completion of a primary series of the Pfizer-BioNTech COVID-19 Vaccine.

November 19, 2021, The FDA revised the EUA for both the Moderna and Pfizer-BioNTech COVID-19 vaccines authorizing the use of a single booster dose for all individuals 18 years of age and older after completion of primary vaccination with any FDA-authorized or approved COVID-19 vaccine. Prior to this authorizations, a single booster dose of the Moderna and Pfizer-BioNTech COVID-19 vaccines was authorized for administration to individuals 65 years of age and older, individuals 18 through 64 years of age at high risk of severe COVID-19, and individuals 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2. Today’s action expands the use of booster doses of both vaccines to include all individuals 18 years of age and older at least six months after completion of the primary vaccination series of the Moderna COVID-19 Vaccine or Pfizer-BioNTech COVID-19 Vaccine or at least two months after completion of primary vaccination with the Janssen COVID-19 Vaccine.

On October 20, 2021, the FDA authorized the use of Covid-19 boosters from Moderna and Johnson & Johnson. The use of a single booster dose of the Moderna COVID-19 Vaccine that may be administered at least 6 months after completion of the primary series to individuals 65 years of age and older, 18 through 64 years of age at high risk of severe COVID-19 and 18 through 64 years of age with frequent institutional or occupational exposure to SARS-CoV-2. The use of a single booster dose of the Janssen (Johnson and Johnson) COVID-19 Vaccine may also be administered at least 2 months after completion of the single-dose primary regimen to individuals 18 years of age and older. The use of each of the available COVID-19 vaccines as a heterologous (or “mix and match”) booster dose in eligible individuals following completion of primary vaccination with a different available COVID-19 vaccine.

For more information about this approval, click here.

On September 22, 2021, the FDA updated the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine to allow for use of a single booster dose, to be administered at least six months after completion of the primary series in individuals 65 years of age and older; individuals 18 through 64 years of age at high risk of severe COVID-19; and individuals 18 through 64 years of age whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk of serious complications of COVID-19 including severe COVID-19.

For more information about this approval, click here.

On August 23, 2021, the U.S. Food and Drug Administration approved the first COVID-19 vaccine. The vaccine has been known as the Pfizer-BioNTech COVID-19 Vaccine, and will now be marketed as Comirnaty, for the prevention of COVID-19 disease in individuals 16 years of age and older. The vaccine also continues to be available under emergency use authorization (EUA), including for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals.

For more information about this approval, click here.

On May 10, 2021, the U.S. Food and Drug Administration expanded the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to include adolescents 12 through 15 years of age. The FDA amended the EUA originally issued on Dec. 11, 2020 for administration in individuals 16 years of age and older.

For more information about this authorization, click here.

On February 27, 2021, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the third vaccine for the prevention of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The EUA allows the Janssen COVID-19 Vaccine to be distributed in the U.S. for use in individuals 18 years of age and older.

For more information about the Janssen COVID-19 Vaccine, click here.

On December 18, 2020, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the second vaccine for the prevention of coronavirus disease 2019 (COVID-19) for individuals 18 years of age or older. The emergency use authorization allows the Moderna COVID-19 Vaccine to be distributed in the U.S.

For more information about the Moderna COVID-19 Vaccine, click here.

On December 11, 2020, the U.S. Food and Drug Administration (FDA) issued the first emergency use authorization (EUA) for a vaccine for the prevention of coronavirus disease 2019 (COVID-19) for individuals 16 years of age or older. The emergency use authorization allows the Pfizer-BioNTech COVID-19 Vaccine to be distributed in the U.S.

For more information about the Pfizer-BioNTech COVID-19 Vaccine, click here.

Helpful links:

FDA Coronavirus Disease 2019 (COVID-19) landing page
Health and Human Services COVID-19 Vaccines landing page

Sources:
U.S. Food and Drug Administration
Centers for Disease Control
U.S. Health and Human Services

LRF Helpline

The LRF Helpline is available to help patients and their loved ones better understand their lymphoma diagnosis so that they can feel empowered to make the most informed decisions about their treatment and long-term care.  The Helpline can also connect patients to financial assistance resources, legal, and insurance help.

Feel free to contact the LRF Helpline with any of your lymphoma-related questions, Monday through Friday from 9:30am – 7:30pm Eastern Standard Time (ET). Call (800) 500-9976 or email at helpline@lymphoma.org.