COVID and CLL: An Update

Our recent CLL Global Research Foundation Town Hall featured CLL Global President, Dr. William Wierda, and Dr. Constantine Tam from Monash University in Melbourne. CLL patient advocate Jeff Folloder moderated the event. Watch the full webinar.

Transcript

Jeff Folloder:                          

We’re getting near the end of our Q&A session. I have a last question for Dr. Wierda. COVID is still a thing. What is the current recommendation for CLL patients in terms of getting COVID boosters? Once a year? Twice a year? Only when things rage? Tell us what the plan is.

Dr. William Wierda:               

We’re getting into a period probably where if you ask several different doctors, you might get different recommendations. My recommendation is if you’ve had a prior vaccination, and/or you’ve had an infection that you have recovered from, you do have some immunity. And so, we’re not in a situation today like we were in the beginning of the pandemic, where we had patients who had no protection, and their immune system doesn’t work. And we were losing patients at that time with COVID.

So, we do have a population where many or most patients have had either an infection and they’ve recovered, or they’ve had a vaccination. We also have drugs that treat COVID, like nirmatrelvir (Paxlovid). And so, that’s a new tool, and is a tool that also has helped prevent patients from getting sick, very sick, and succumbing from their disease. There are other drugs that we use. We have vaccines for COVID that are mRNA-based vaccinations. And we have a protein-based vaccine – or we’ve had a protein-based vaccine.

One of the concerns I have is that we don’t have a long-term understanding of the side effect and toxicity profile from the mRNA vaccines. If you’re giving one every six months in perpetuity, I don’t know that that’s as important as it would have been in the very beginning of the pandemic. So, that’s not really my recommendation these days. Maybe at most once a year, a COVID booster. If a new one comes out and they’re covering strains that have not been identified, and are emerging as important new strains, then that would be – and it’s a once-a-year time.

If you’ve had a recent infection and recovered from that within the last six months, I don’t think there’s a need for reboosting. Because, in fact, an infection itself is a boost to the immunity once you’ve recovered. Because your immune system has been exposed to a recent COVID virus and is reactivated against the COVID virus.

So, I would say once a year. And if there’s a new strain particularly, get the booster. I don’t usually, for my patients, recommend more than that. Like every six months. And we do have monoclonal antibodies for prophylaxis. And there are very rare patients that I think I have recommended that for. Patients who can’t get a vaccine and patients who haven’t had a COVID infection and recovered would be probably the small group of patients that I would think about recommending the monoclonal antibody for.