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LLS Statement on COVID-19 Omicron Variant for Blood Cancer Patients and Survivors

Rye Brook, N.Y., January 4, 2022 – Given the rapid rise in COVID-19 infections caused by the Omicron variant, The Leukemia & Lymphoma Society has developed this page to provide blood cancer patients and survivors with the latest information about this rapidly emerging situation.

Get vaccinated, act unvaccinated
LLS continues to encourage all blood cancer patients and survivors to get vaccinated for COVID-19 according to CDC recommendations. For people with blood cancer and blood cancer survivors, the current recommendation is to get four doses in total—three in a primary series plus a booster dose.

  • Blood cancer patients and survivors should receive 3 shots of Moderna or Pfizer vaccine in their primary vaccine series. This is critically important, because the third dose will greatly increase the likelihood of having a high enough antibody level to reduce the chance of a severe infection with the Omicron variant. 
  • If the Moderna vaccine is requested as a third shot, blood cancer patients should be sure to get the full dose (0.5-milliliter dose containing 100 micrograms). The half (0.25-milliliter containing 50-microgram) dose is for booster shots only, which is the third shot for people with healthy immune systems, but the fourth shot for blood cancer patients and survivors. There is only one dose size for the Pfizer vaccine.

Since research from LLS and other organizations has shown that some blood cancer patients will fail to make COVID-19 anti-spike antibodies even after the 3-shot mRNA vaccine series, they should take additional steps to avoid COVID-19 infection. Avoid large crowds, mask up, maintain social distancing and make sure all people in the household are fully vaccinated (including the third or booster vaccination).

What to do if you get COVID-19 or are exposed to someone with a known infection
Blood cancer patients and survivors are at higher risk of severe COVID-19 outcomes, including hospitalization and death. Do not delay getting care if you test positive for COVID-19, whether or not you have symptoms, or if you come in close contact with someone who is infected. 

IMPORTANT NOTE: As of January 3, 2022, most COVID-19 treatments are in short supply. The federal government is purchasing these treatments directly from the manufacturers and allocating them to states based on population size. State and local health departments are responsible for allocating the treatments locally.

The following treatments and preventive therapies work best if started early: 
*Treatments should be guided by your physician and require a prescription.

Monoclonal antibody therapies are FDA authorized for COVID-19. They are made in a laboratory and are designed to give the body an immediate infusion of “ready-made” antibodies than can immediately work against infection. COVID-19 antibodies work by binding to the spike protein of SARS-CoV-2 virus and blocking its ability to attach to and enter human cells. 

Because Omicron has many mutations in the spike protein, only some of the FDA-authorized monoclonal antibodies retain the ability of block the virus’ ability to infect human cells. Therefore, only certain monoclonal antibody should be considered.

Monocolonal Table

Two oral medications are FDA-authorized to treat patients with proven COVID-19 infections. 

  • Paxlovid (nirmatrelvir and ritonavir tablets) is FDA authorized to treat mild-to-moderate COVID-19 in adults and pediatric patients 12 years and older (confirmed by a positive COVID-19 test) who are at high risk of progression to severe infections, including hospitalization or death. 
    • This oral medication is taken for 5 days only. Paxlovid is not authorized to treat hospitalized patients or to prevent COVID-19 infection.
    • Paxlovid may impair the efficacy and safety of certain cancer medications, and therefore must be used with the guidance of your physician. 
    • In clinical trials, Paxlovid reduced hospitalization or death due to COVID-19 infections in 89% of in high-risk individuals compared to patients on a placebo if taken within 5 days of symptom onset. 
    • Paxlovid is effective against the Omicron variant in preliminary laboratory studies and is likely to be effective in patients.

 

  • Lagevrio (molnupiravir) is FDA authorized for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients 18 years and older (confirmed by a positive COVID-19 test) who are at high risk of progression to severe infections including hospitalization or death. 
    • This oral medication is taken for up to 5 days only. Lagevrio is not authorized for initiation in hospitalized patients or for anyone without a positive COVID-19 test result. 
    • In clinical trials, Lagevrio reduced hospitalization or death due to COVID-19 infections in 30% of high-risk individuals compared to patients on a placebo if taken within 5 days of symptom onset. 
    • Lagevrio is effective against the Omicron variant in preliminary laboratory studies and is likely to be effective in patients.

For more information, check out our COVID-19 Resource Page