Ask the Doctor Question:
I am Stage 0 right now and have had a stable WBC count for a few years. About six‑months after my second dose of the Pfizer vaccine, my WBC went up about 20%. Since then, I’ve also had the recommended booster shot and now looking at a flu vaccination, and the shingles vaccinations near term. I’m wondering if all these vaccinations (stimulating of my immune system) can have a negative effect on my WBC counts and drive them up faster than otherwise with the normal course of the disease. Seems to me that if they stimulate the production of more WBCs and our WBCs don’t die off as normal, this could be the case. This is especially concerning to me since it looks like we may be getting semi-annual boosters for the foreseeable future.
Answer: While any vaccine can increase the inflammatory response since it is stimulating the immune system (thus an increase in your WBC production), usually the increase directly related to the vaccine is transient and will subside shortly. With CLL, upward long-term trends in your lab results are more concerning than any one elevated result. That is why it is very important to have repeat labs drawn over time so a pattern can be established. Generally, no one lab result is going to lead to beginning a new treatment.
So, it is much more important to go ahead and become fully vaccinated as much as possible, and not be too concerned about the transient spikes in WBC’s. Your CLL Specialist will know to take all of that into consideration when looking at your lab values as well. If a reason other than the progression of your CLL can be attributed to the increase in a lab value, then worsening of your CLL can be ruled out and typically will not warrant further action.
There is a good article on all the vaccinations that are needed with CLL that can be found on our website here: https://cllsociety.org/2019/10/vaccines-for-cll-patients/