CSN Login
Members Online: 8

You are here

RITUXAN AND COVID VACCINE

Unbreakable1
Posts: 9
Joined: Jul 2021

Has anyone had rituxan and had the covid vaccine and told that the vaccine may not be effective because of rituxan? I had my last chemo treatment on August 2 and I  asked my specialist about the covid booster shot. She said that because I took rituxan, the booster will not have be effective. I got my first covid vaccine on January 15 and second one on Feb. 8. I was diagnosed with cancer on March 12 (my 43rd birthday) and had my first chemo middle of August. I was told that I may not have the antibodies because of rituxan, but I should take an antibody test to see if I have the antibodies from the vaccine. Anyone been told the same thing or have any info on this?

ShadyGuy
Posts: 709
Joined: Jan 2017

I have asked the same questions of my physicians and LLS but received no definitive answer. It seems they just simply do not know.

po18guy's picture
po18guy
Posts: 1222
Joined: Nov 2011

Any drug that ends with "mab" is a Monoclonal AntiBody. That is the drug naming convention. Rituximab is one of them. I received only two infusions of Arzerra (Ofatumumab) in a clinical trial. 3+ years later, I am still B-cell depleted. I am also actively immune suppressed due to transplant rejection issues. Neither doctor nor I were expecting a significant response to any vaccine (I have not yet even had my "baby shots" after a 2015 stem cell transplant wiped that protection out.

More recently, after my second Pfizer injection, I developed a very prolonged and unusual immune system response. It 'seems' that the reaction alone does not guarantee the production of antibodies. We simply do not know. What I do know is that it is almost 6 weeks post the second vaccination and my immune system is still upset. Mild fevers on an almost daily basis. Will this continue? What this all means is currently unknowable. But, I do hope to be tested for anti-spike protein antibodies, which would indicate at least some level of protection against the virus. 

The entire world is in an unprecedented experimental phase, with data being collected in an ongoing basis. In the years ahead, we will know much more than we do now, and some of the current opinions may be altered or overturned. No one knows.

I do know that the Leukemia and Lymphoma Society is collecting data regarding response to the various vaccines. In some cases, they cover the cost of drawing and testing blood for the presence of antibodies. From their site: "LLS has reported data from more than 1,400 blood cancer patients enrolled in its LLS National Patient Registry showing that up to 25% of blood cancer patients produce no antibodies against COVID-19 more than two weeks after their second mRNA vaccination."   

Therefore, it seems that only by being tested for the presence of antibodies can one have some knowledge or assurance of protection. 

ShadyGuy
Posts: 709
Joined: Jan 2017

And at least 2 other regulars on here are participating in the LLS testing. It is free and painless and the draw can be done at any Labcorp site. I signed up online and they sent me a coupon for a free test with no Doctor prescription required. My insurance only pays if there is a Doctor's prescription. It is not definitive but it is better than nothing.

Lym999
Posts: 43
Joined: Feb 2020

I am also part of the study. It is scary that 1 in 4 who had Lymphoma and got the vaccine aren't protected even though they think they are. Mine did come back positive for antibodies along with that I had Covid previously. I was extremely lucky because when I got Covid in March of 2020, it was right as my treatment had ended. It looks like my smell and taste will never come back the way it once was, but it could have been a much worse situation.

po18guy's picture
po18guy
Posts: 1222
Joined: Nov 2011

Shouldn't we at least get a purple heart or something for all we've been through? I consider myself to be part of the walking wounded. Smell and taste may not return to  what they were, but I suspect that the brain has the ability to readjust our perception so that we are acclimated to the new normals. 

ShadyGuy
Posts: 709
Joined: Jan 2017

In the end we are all alone.

Yeah, you got to walk that lonesome valley
You got to walk it by yourselves
Ain't nobody else gonna go there for you
You got to go there by yourselves

Joan Baez

Lym999
Posts: 43
Joined: Feb 2020

I wish I could adjust my smell and taste, but that can be rather difficult. I know there are studies being done on trying to retrain the brain, but there are certain foods and smells that I used to love that I can't tolerate anymore.

 

ShadyGuy is right, in the end, we are all alone. I don't think that we ever change.

Sal0101's picture
Sal0101
Posts: 136
Joined: Sep 2015

Hello!!   I was recently at my Oncologist and she of course highly recommends the vaccine Booster.  She mentioned a study about antibodies and the booster shot. Participants would have their antibodies tested, then booster, then antibodies tested again. i was a bit excited to be part of the study until she pulled up the CDC website and realized for stem cell transplant participants you would have to be within 2 years Of transplant.  I didn't qualify because I'm coming Up on 5 years. I'm 63 so it looks like I'll have to wait on a booster. Sure would like to know if I have antibodies! 

Sharon

po18guy's picture
po18guy
Posts: 1222
Joined: Nov 2011

"What the world needs now,

is another folk singer,

like I need a hole in my head"

 

David Lowery - Cracker, ex Camper Van Beethoven

ShadyGuy
Posts: 709
Joined: Jan 2017

Along with his silver star my Dad had a purple heart. He was a POW and lost an eye in Sicily. It represented bravery resulting in injury, something he did consciously without being forced to do. My younger brother was wounded in VietNam before his 19th birthday and received a purple heart. Getting a disease, while sad, is not the same thing at all. I found your comment troubling. And by the way, "Lonesome Valley" was written by George Jones who was NOT a folk singer. I consider it to be more of the bluegrass genre. Baez and several other folk singers made some good renditions and changed the lyrics slightly. Good luck in your struggles and I sincerely hope you continue to do well. And thanks for the occasional useful info. I mostly enjoy reading your posts.

po18guy's picture
po18guy
Posts: 1222
Joined: Nov 2011

Why find my posts "troubling"? Because of opposition to my worldview? Rather, "challenging" is the intent. I firmly believe that I am never alone, as a sense of loneliness can lead to depression. There is enough of that running around these days. 

PBL
Posts: 329
Joined: Jul 2016

Sal0101, have you checked with LLS whether you could still be enrolled?

Sal0101's picture
Sal0101
Posts: 136
Joined: Sep 2015

PBL,

No not yet.  I just joined (or refreshed my old password from years ago) LLS and will have to do some research.  I know for a fact that I will get the booster as soon as I'm eligible.

po18guy's picture
po18guy
Posts: 1222
Joined: Nov 2011

I began to sign up for the antibody testing, but was concerned with the wording. Will clear it up with a contact at LLS. It almost gacve the impression that you were crearting an access portal to your health information and asked which potential info you did not want to be included. Hmmm.

Sal0101's picture
Sal0101
Posts: 136
Joined: Sep 2015

I agree Po.  I started the questionnaire and backed out part way through. 

Evarista's picture
Evarista
Posts: 320
Joined: May 2017

I am another currently enrolled in the aforementioned LLS study.  Early results were published this summer and are summarized here:  https://www.lls.org/news/study-leukemia-lymphoma-society-shows-covid-19-vaccine-safe-25-blood-cancer-patients-do-not

Rather than wading through the whole thing, you might find last month's webcast by the Study Coordinator helpful in terms of understanding "what it all means". Note that the last section was added recently and discusses the booster issue.  (Some of the earlier information is dated because the video was made prior to FDA approval for immunocompromised people.) AFAIK, you can still join the study, which is part of the LLS National Patient Registry: https://www.ciitizen.com/lls/?utm_source=LLS&utm_medium=Partner%20Marketing&utm_campaign=Referral&utm_content=Landing%20Page&utm_channel=LLS&utm_vehicle=Referral It is my understanding the the medical records sharing is voluntary and revokable at any time, but you should ask them specifically about that if you are uncomfortable about it.

Video link: https://www.lls.org/patient-education-webcasts/lls-covid-19-antibody-research-study-your-questions-answered

Bottom line is that a signifcant percentage of blood cancer patients do not mount a detectable antibody response to the Pfizer or Moderna Sars-CoV-2 vaccines.  Importantly, the fraction of responders varies with disease type and with treatment.  As your oncologist has shared with you, Unbreakable, Rituxan (rituximab) is one of the treatments associated with non-responsiveness. This makes sense, given that the target of Rituxan is B-cells, which are the cells that produce antibodies.  Hopefully more fully parsed data will be available in the not too distant future.  

Your oncologist is probably your best guide in how to approach your vaccination status.

My personal view is that there is still much to be learned, particularly because 1) most of the early data in "cancer patients" is not specific to blood cancer and 2) the early data on "immunocompromised" focused mostly on solid organ transplant recipients.  As mentioned in the video, LLS will be doing T cell analyses and hopefully that will give a fuller picture of our collective immunocompetence.  In the meantime, I have gotten my 3rd Pfizer and am very much on board with "Get vaccinated. Act unvaccinated." I continue to mask in public, avoid crowds, and keep my social distance. 

Additional note:  limited data set on booster studies published by the LLS group:  https://www.sciencedirect.com/science/article/pii/S1535610821004906?via%3Dihub

ShadyGuy
Posts: 709
Joined: Jan 2017

I think the biggest issue is what level of antibodies offers protection and what stage of treatment the patient is in. By that I mean does Rituxan affect the antibodies after treatment has ended or only while undergoing treatment? My last Rituxan was about 18 months before the first jab. I showed spike protiens but only got a number - 8. I do not know how that compares to people undergoing treatment, those never treated etc. I am still considering whether or not to get the booster. I am traveling internationally which requires loads of testing and so far no issues. Gotta live my life and life involves risks. I have always known we all eventually die, a fact which I suppose makes me more comfortable with risk.

Evarista's picture
Evarista
Posts: 320
Joined: May 2017

You raise an excellent point, Shady, and I expect that the answer will be that results vary.  If you download the Excel spreadsheet (Supplemental Data) from that second study that I linked, you can see some indication of that, as the data includes time from last treatment. I am 4.5 years out from my last Ritux and remain wimpy in the antibody production department (~9 on the anti-Spike).  I do not expect that to change for me.  But you can see pretty clearly from that data set that others do see improvement with a 3rd shot. 

ShadyGuy
Posts: 709
Joined: Jan 2017

I will probably get it some time after I arrive back in country on October 7. I did not go thru the data. You have always been so thorough and precise. When you talk I listen! Thank you!

Max Former Hodg...
Posts: 3699
Joined: May 2012

Medical science knows little to nothing about how well, or when, the current vaccines work in the general population (estimates vary pretty much monthly), so the liklihood of them knowing how they will work in blood cancer patients (current or former) seems most likely near zero to me.  Today's breaking news will be tomorrows laughed-at speculation.

I have noticed that I have essentially no sense of taste for about a year now, but I had no sense of taste during chemo 12 years ago, and for approximately a year thereafter.  An old friend has in essence wandered back home....  I have never been tested for Covid, but neither have I ever met the requirements to suggest testing.   But, of course, well over 85% of those who have tested positive for it have never had symptoms, or only very minor symptoms easily attributable to other issues.   I have now known a dozen or so close friends or relatives who have tested positive at some point, but not one of them ever had symptoms, or if they did, symptoms no worse that a minor bout of the cold. 

I have received both doses of Pfizer, and will get the booster soon.  Beyond that, it seems not worth researching or fretting over.  The refrain to the following, magisterial hit is:

Some gotta win/ Some gotta lose/  Good Time Charlie's got the blues.        A better refrain would be:  

Some gotta win/ Some gotta lose/  But neither one gets to chose     

Some will have the vaccine benefit them greatly; others will die on a ventilator.   Most will never have an issue either way.

 

Dwight is just soo old-school smooth.  He has been acting, very successfully in recent years also.  He had an important character in Billy Bob Thornton's series Goliath, for instance.

DWIGHT YOAKAM GOOD TIME CHARLIE'S with LYRICS - Bing video

Galrim
Posts: 308
Joined: Apr 2013

In Denmark there has already been a large study done on this (I live here and is DLBCL patient). I will spare you the details, but all patients who has received Rituximab in parallel with their Covid vaccinations are now getting a third booster shot. Requirement, they have found out, for it to work is a treatment gap/pause of 4 weeks on either side of the booster shot.

Unbreakable1
Posts: 9
Joined: Jul 2021

Hi Galrim,

I received my Pfizer vaccines on Jan 15, 2021 and February 8, 2021. I had my first chemo on April and Last one in early August which included Rituximab. I took an antibody test recently and was negative for igM and positive for igG which means i have had the virus recently or in the past. If that is the case I am ost likely asymptomatic. I have never had the symptoms. But I was told by a specialist that the booster will have zero effect on me. I am confused. Do I get the booster or not?

 

po18guy's picture
po18guy
Posts: 1222
Joined: Nov 2011

Go with doctor on this one. Tests will reveal how strong or weak your immune system is.   

Subscribe to Comments for "RITUXAN AND COVID VACCINE"