COVID-19 FAQ #35: What should myeloma patients know about antibody testing and booster shots?
Multiple myeloma patient vaccine antibody response and COVID-19 booster shots
In This COVID-19 FAQ episode, myeloma expert Dr. Brian G.M. Durie discusses myeloma patient antibody response and the potential need for a booster shot.
The BOTTOM LINE:
A booster will likely be considered by the FDA and may become available to myeloma patients. For the time being, continue to wear a mask and practice social distancing.
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This week’s “Ask Dr. Durie” comes from a patient who is very confused about neutralizing antibody testing and the possible need for a booster vaccine.
Well, this is very important to understand. First, the neutralizing antibodies are antibodies that attack the COVID-19 virus infection. The antibodies are important to be checked, but the testing must be the correct test.
Unfortunately, there are many, many antibody tests on the market and readily available. The important thing is to talk carefully with your doctor about the specific neutralizing antibody test. The very best testing is only available in a few reference labs across the country, for example, in California, there’s a reference lab in Sacramento, where samples can be sent.
And so, it’s very, very important just to talk to your doctor rather than just searching the internet, yourself. Talk to your doctor and jointly identify the correct testing so you can see if testing can be done in your case. Testing can be done after the first dose or preferably, two weeks after the second dose of your vaccination, Moderna or Pfizer.
The not so good news is that we have learned for myeloma patients on active treatment, the antibody levels, the neutralizing antibody levels that are achieved, are less than optimal. Many patients will have maybe not sufficient antibodies to be sure or secure that any infection will be fought off. And so, this is the unfortunate reality in the current situation.
And so, the first thing to be aware of is that standard precautions need to be continued because of that. Patients need to continue to wear masks, avoid crowds, and be careful about social distancing.
Well, how about getting a booster vaccination to get a better neutralizing antibody level? This has been very much in the news recently, and the Pfizer pharmaceutical company just announced that they will seek FDA approval for a third, or booster vaccination, in the six-to-12-month time frame after the original double vaccination.
And so, it seems that maybe this booster vaccine will be available if the FDA does approve this type of booster. It seems that both Pfizer and Moderna will seek this type of approval. What we will need to understand is if this booster is sufficient to get the antibody levels into the safe range that we want to see.
And so, BOTTOM LINE is that for the time being, information is incomplete in terms of the exact levels of neutralizing antibodies that can be achieved in myeloma patients, except that we do know that they may be much lower than we would like. There is a chance that booster vaccination will become available, and maybe a way to get those antibodies to a level that we would like to achieve. In the meantime, stay safe, wear your mask when you’re out and about, and when you may be exposed to an uncertain circumstance.
Dr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.