I almost titled this “All I want for Christmas is a Covid19 Vaccine”, but very few readers if this article will be fortunate enough to get that wish. As 2021 begins, however, we can expect a rapid role out of millions of vaccine dose.

Tomorrow the UK will become the first county to vaccinate members of its population with an authorised and fully-tested vaccine against Coronavirus. Considering most of us had not even heard of coronavirus a year ago this is a remarkable feat of modern science. Other countries seem likely to be following very shortly. And two other vaccines (Moderna and the Oxford/Astra-Zeneca) also appear likely to be approved soon.

I have written a number of posts about this issue over the months, including this one which reported on the Pfizer study results, but thought today I would answer a couple of questions. Some of this is based on the information related by the UK’s MHRA (our version of the FDA and EMA) aimed at Health Care Professionals and Patients.

1. Is it safe? Will I get side effects?

Some people worry about the rapid rate of producing this vaccine, but the approach of using mRNA has been studied for a while, allowing Pfizer, Moderna, and Astra-Zeneca/Oxford to all rapidly produce vaccine candidates. The studies themselves have been accelerated by using many research sites and because of the availability of large amounts of finances necessary. But that does not mean safety has been short-circuited.

So in the case of the Pfizer study, at the time of the UK’s approval packet being submitted, 19,067 patients who took the vaccine had been. followed and compared to 9536 who took placebo and their safety information was compared at two months post study. Here is a direct quote:

The most frequent adverse reactions in participants 16 years of age and older were pain at the injection site (> 80%), fatigue (> 60%), headache (> 50%), myalgia (> 30%), chills (> 30%), arthralgia (> 20%) and pyrexia (> 10%) and were usually mild or moderate in intensity and resolved within a few days after vaccination. If required, symptomatic treatment with analgesic and/or anti-pyretic medicinal products (e.g. paracetamol-containing products) may be used.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/941452/Information_for_healthcare_professionals.pdf

Thus, if you take the vaccine you may well feel a bit sick. But compared to catching COVID19 which has a not inconsiderable risk of DEATH if you have Blood Cancer, this list of side effects do not sound very serious to me. In fact such responses are surely simply an indicator that your immune system is responding to the vaccine, and can be seen as a good sign! Some people do respond to a vaccine without such symptoms. Crucially, There is NO mechanism by which these vaccines could give you COVID19.

2. Does it work in those with lower immunity?

These vaccines are NOT considered “live” and there is no specific contraindication against those with lowered immunity taking it, although it is noted that it is to be expected that it might not be as effective.

The efficacy data for the Pfizer study suggests really good efficacy of over 90% even in older patients (who have lower immune responses), and patients who had various conditions that increase the risk of severe COVID-19 disease (e.g. asthma, BMI ≥ 30 kg/m2, chronic pulmonary disease, diabetes mellitus, hypertension).

Patients with blood cancer were not studied with this or so far any other COVID19 vaccine. There is, however, no reason to expect that blood cancer patients would experience a different set of adverse events. Some of us may not respond to this or any other vaccine, however.

As such, it would seem sensible for us to be tested after vaccination with an antibody test to assess our response. I am not clear if that is part of the plan, but hope it may be. Not least because this would alllow us to be considered for other potential “passive” methods of protection such as the forthcoming monoclonal antibody cocktails or perhaps IVIG.

It is reasonable to hope that some people with blood cancer will respond to this vaccine, just as some of us do respond to other vaccines.

UK CLL experts have commented on the release of the COVID19 vaccines and in the UK anyone with a blood cancer will be among early groups who are prioritised. The leading patient charity Blood Cancer UK have also released a helpful article.

There may be some patients with blood cancer (for example shortly after stem cell transplant ) who would be advised by their expert team not to take this vaccine, but in general it seems that there is no specific reason why most of us cannot take this.

The UK is including those of us with blood cancer in one of the early priority groups (those in care homes, NHS and social care staff and the very elderly will be ahead of us). The priority groups aim to cover over 90% of those who have been dying from COVID19 so should make a rapid impact on the impact of the pandemic. It is being suggested that the vast marjory of those of us who are most vulnerable will have been vaccinated here in the next few months.

3. What if it doesn’t work?

It seems a reasonable request for those of us who receive one of these vaccines to also be tested for antibodies a few weeks after the second dose of vaccine. Failure to produce would be an indicator that we were not protected, and as well as continuing to take extra care to avoid catching the disease in such a situation, this may also be an indicator that we should be considered for IVIG which at some stage may begin to offer some protection against COVID19.

The much maligned phrase “herd immunity” will also hopefully come into play. It appears that infection with COVID-19 does appear to offer at least some protection against re-infection, although this is not absolute since some people have caught the disease twice. This natural immunity, coupled with a growing pool of vaccinated individuals will hopefully form a human shield for those who do not respond to the vaccine.

Over time, the hope will be that the incidence of COVID19 will dramatically reduce in the general population. As this happens, hopefully we will begin to feel safe to emerge from our cocoons, though perhaps the use of masks and certain other precautions will continue for many of us since we have found that other infections are also less frequent as a result.

4. But what about….?

No the vaccine does not contain a chip, nor are you injecting aborted baby body parts, nor will this vaccine sterilise you, and in humans injecting RNA cannot change your DNA!

This page from the BBC debunks some of this dangerous anti-vaccine fake news.

I urge all who read this article to think twice before they share misguided fear mongering about vaccines, or indeed other lies abut the COVID19 pandemic.