CLL Advocates Newsletter Issue 8

Dear Friends of CLLANZ

New Zealand’s Covid 19 national vaccination programme kicked off last week.

For people with CLL, Covid 19 has additional risks above those of the general population.

There is an increased risk of infection, and, in particular, an increased mortality for CLL patients who get severe disease. Some of this relates to the age group typically affected by CLL, and some to the intrinsic immunodeficiency that is part of CLL.

In a recent study from the European Research Initiative on CLL (ERIC), about 80% of patients in a study on Covid 19 in CLL patients had severe disease. Over a third of these patients died of Covid 19 infection. Being on ibrutinib seemed to have a protective effect, reducing the severity of the disease.

Vaccination immune responses are reduced in people with CLL, so vaccination likely will not provide as good a level of protection in this group as in the general population.

There is much that has been found so far from vaccination programmes in other countries, and from the research that has been done, and that continues to be done.

There are many vaccines in development for Covid 19, and three of those have been approved for public vaccination programmes.

There are the mRNA vaccines of Pfizer/BioNTech, and Moderna; and the AstraZenica/Oxford vaccine that uses a chimpanzee cold virus as a vector. The latter, I am told, is considered safe to use in CLL patients by most UK haematologists.

Some other information to look out for:

  • Studies are in progress regarding using more than one vaccine in the same individual.
  • There was a study that used half the recommended dose for the initial vaccine and then a full dose for the second, which seemed to have been associated with a better outcome than the orthodox vaccine recommendation.
  • The interval between vaccine doses when the vaccine is orthodoxly given in two doses is the source of some debate, and a longer interval seems OK.
  • Response rates for vaccines in use has been high, with some variation in subgroups, but the duration of vaccine protection seems to be variable, and still being studied.

So, vaccination is recommended for people with CLL, and you should seek medical advice regarding getting your “jab”

Best wishes

Neil Graham