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Ask the Doctor: Should CLL patients receive the COVID vaccine while they are on treatment with BTK inhibitors considering that they have to stay on them indefinitely?
As of January 2021, there are two COVID-19 vaccines that have been approved by the Federal Drug Administration (FDA) for use in the United States under the Emergency Use Authorization. Some lymphoma/CLL treatments might affect the efficacy of a vaccine (by impacting the immune system), and therefore raises questions by patients on whether they should receive the vaccine while in active treatment.
LRF Scientific Advisory Board member Christopher Flowers, MD, MS (The University of Texas MD Anderson Cancer Center) discusses what CLL patients should be mindful of if they are currently in treatment with BTK inhibitors.
Should CLL patients receive the COVID vaccine while they are on treatment with BTK inhibitors considering that they have to stay on them indefinitely?
Patients with CLL and all patients with active or prior cancer have a lower level of immunity to infections in general. This level of decreased immunity is different for different cancers, treatments, and patients, however, in general, they are all at a higher risk of bad outcomes, including pneumonia, hospitalizations, and death, from COVID19 than those who do not have cancer or other significant medical illnesses. We believe all patients will benefit from getting an FDA approved COVID19 vaccine when it is available to them and that these benefits outweigh the risks for the majority of our patients. Both Pfizer and Moderna vaccines are currently FDA approved in the US. Both are safe and effective for use in former and current cancer patients.
Patients who experienced anaphylaxis to prior injectables (such as vaccines), should not take the vaccine currently and discuss further with their physicians when and whether COVID19 is appropriate. Food allergies and other allergies are not a reason for not receiving the vaccine. However, patients who have significant allergies (such as allergies that require the patient to carry an EpiPen), will need to be monitored a little longer after the injection than other patients. After vaccination, we strongly recommend that everyone continues with social distancing, wearing masks in public, and washing hands regularly as previously recommended prior to the vaccine. You still may be able to get and spread COVID-19 to others even after vaccination.
