I am a patient with multiple myeloma IGA. I had the fourth dose of the Covid vaccine last July, after contracting the virus in October 2021. Do I need to take the fifth dose?
The currently available recommendations, including those in force in Italy, confirm for all cancer patients, including those with multiple myeloma, the need to apply booster doses to optimize protection, regardless of the stage of the disease and any active treatment.
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Multiple myeloma patients are particularly at risk of developing COVID-19 infection, with an increased risk of developing severe symptoms and potential mortality compared to the general population and other types of cancer, as evidenced during the early stages of the pandemic. As shown by various studies, in which I took part with my IRST IRCCS Institute of Meldola (FC), there is also an increased risk of severe post-Covid sequelae, and the risk factors certainly include age, male gender, disease control and high disease risk, multiple comorbidities (especially cardiovascular, pulmonary and renal), inflammatory response, development of a severe form of Covid-19, need for intensive care and count of lymphocytes.
I am under 60 but I am a frail patient. Can I take the fifth dose of the anti-Covid vaccine?
Of course, the vaccination status of the patient makes a difference, regardless of the type of myeloma, the stage and the recent systemic therapies practiced. The booster doses, also including the Omicron variant, made it possible to induce sero-conversion and increase the cellular and humoral immune response against Covid-19 in the majority of patients with an undetectable or suboptimal response after one or two doses.
Can I do my own vaccine adverse event reporting?
The rapid emergence of new and more widespread variants has kept the incidence of SARS-CoV-2 infection significantly high. Robust studies confirm that in patients with hematological malignancies including multiple myeloma (particularly if relapsed/refractory and multi-treated), the virus – especially the Omicron variant – could be associated with increased morbidity and mortality, which however appear significantly reduced in patients vaccinated with one or two booster doses.
I have had autoimmune thrombocytopenia and have a genetic predisposition to lupus. Can I get the anti-Covid vaccination?
Unfortunately, there are some categories of patients (particularly those receiving targeted therapies against BCMA) who respond poorly to vaccine therapy and who remain at greater risk of severe infection. For patients who develop infection despite prophylactic therapies, the importance of rapid access to currently available antiviral therapies is underlined, which significantly reduce the risk of developing severe forms and mortality related to the Covid-19 infection. Both new generation vaccines and increasingly specific anti-viral therapies, aimed at the most severe variants, are currently in an advanced stage of development.
* Claudio Cerchione is Chief Medical Researcher in Hematology at the Romagna Institute for the Study of Tumors “Dino Amadori” – IRST IRCCS of Meldola (FC)