The vaccine schedule for the immunocompromised, including all those with chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL), has been updated again by the CDC. The new guidance was mentioned in a press release by the CDC but has not yet been clearly explained. And the CDC has not yet had time to update the immunocompromised section on its website. Frankly, the guidance once again is quite confusing!
CLL Society has received many questions from our community on this subject. The graphic below from the Health Department’s website for the state of Michigan found here is the most precise representation that we have found on the subject.
To put it simply, if one has received either of the mRNA vaccines, namely Pfizer and Moderna, the “primary series” of COVID-19 consists of three full-strength shots for CLL/SLL patients, NOT two (as is the case for those with normal immunity).
Then, an additional two “booster doses” are recommended after those three doses of the primary series shots. The first booster (also referred to as the fourth shot) is recommended at least three months after the primary series shots. Then the newly recommended second booster (also referred to as the fifth shot) is recommended fourth months after the first booster.
Some important things to remember when it comes to COVID-19 vaccinations and CLL/SLL:
- One’s COVID-19 antibody response to previous doses of the vaccine should not determine whether or not you should adhere to the recommended COVID-19 vaccination schedule.
- Even if you have never had a robust antibody response to previous doses of the COVID-19 vaccines, you should still adhere to the recommended schedule. The vaccines are known to stimulate other parts of our immune systems that are also important in fighting off infection.
- Those with CLL/SLL should still receive Evusheld, regardless of their vaccination status, treatment status, or if they are still in Watch & Wait.
- Additional COVID-19 vaccination doses are best if received before starting any new CLL/SLL treatment regimens since several CLL therapies will diminish the body’s ability to respond to vaccines.
- COVID-19 vaccines can be received two weeks before Evusheld or two weeks after Evusheld.
We only know for sure that COVID continues to keep us guessing. So eventually, these recommendations will also change. We hope the graph below helps. It was accurate as of the time this article was written.
Stay strong. We are all in this together.
Brian Koffman, MDCM (retired) MS Ed (he, him, his)
Co-Founder, Executive VP and Chief Medical Officer
CLL Society, Inc.