Ask the Doctor Question:
I have had CLL for 12 years, currently starting my fifth year on Ibrutinib and faring very well at this point. However, I am one of the unfortunate individuals who did not develop any antibodies after two Pfizer covid vaccine shots. I have heard that some people have had a response after a third shot. My two doctors (Dr. Kanti Rai and Dr. Syali) cannot legally recommend a third shot until the CDC approves it.
Do you know of anyone who has received a third shot – and – was it successful? Have you heard if the CDC is considering approving a third shot for immunocompromised people like me?
Answer: Glad you are doing well with your CLL on ibrutinib. Regarding your question, as you know the FDA/CDC just recommended a third dose for immunocompromised. We just wrote up an article on that here:
There have been several studies that show varying degrees of response for those with CLL. If you are on ibrutinib, the chances are low that you will have a response; however, it is possible. The studies show that if you have not yet received treatment before, you have the best chance of getting a “boost.” Also, if you had any response at all to the first two vaccines, even if it was extremely low, but detectable at all, you can experience an increase in antibody levels too. Essentially, it does not hurt to get a third dose and give it a try. Although it sounds like you are in the same boat as many other CLL patients, and COVID monoclonal antibody treatments may be our best bet. CLL Society is working hard on trying to get studies going in the immunocompromised communities with these preventative monoclonal antibody therapies, so they can get pushed across the finish line at some point with the FDA should the data read out as well as we think it will.
In the meantime, regardless of your decision, please have a COVID plan in place. We just put out a detailed checklist that you and your family can go through to have in place just in case. Please read through the plan and print out the worksheets at the bottom of the page. You can find that information here: