COVID-19 Information Hub

Dear lymphoma community,

In an effort to protect our community and our staff from potential exposure to COVID-19 our office is closed until further notice.  All staff will be working remotely to provide our services in the areas of education, support, advocacy, and research.  We continue to respond to all inquiries via phone and email.  We are here to help as always, so please do not hesitate to contact us.

The worldwide battle against the COVID-19 virus continues.  Within Canada, our federal and provincial governments are responding with legislation and guidance to help protect Canadians as well as to provide regular updates on the impact of the virus in Canada.  Topics addressed include: vaccines, financial and economic support, travel, your health, limiting the spread, and other daily updates about COVID cases in the country.  This information is constantly evolving. Below we have provided links to the federal and provincial/territorial COVID-19 webpages and websites dealing with cancer patient-specific resources related to COVID-19.  We recommend that you consult these pages often and follow the guidance provided therein.

**IMPORTANT UPDATES**

On May 28, 2021, the National Advisory Committee on Immunizations updated their immunization statement and recommendations for the COVID-19 vaccines. Based on limited clinical trial data, NACI previously recommended that authorized COVID-19 vaccines may be offered to immunosuppressed patients due to disease or treatment in some circumstances, and on a case-by-case basis, if the benefits outweighed the risks and with transparency about the limited evidence available. Additional evidence is now available from real world use of COVID-19 vaccines, primarily mRNA vaccines, in these populations. In May 2021, NACI reviewed safety data, as well as COVID-19 risks for these groups and updated their recommendation below:

Updated recommendation: NACI preferentially recommends that a complete two-dose vaccine series with an mRNA COVID-19 vaccine (Pfizer-BioNTech, Moderna) should be offered to individuals in the authorized age group, including those who are immunosuppressed and have an autoimmune condition.

Updated Recommendation: With the increase of COVID-19 vaccine supply in Canada, second doses should be offered as soon as possible, with priority given to those at highest risk of severe illness and death from COVID-19 disease after or concurrent with first doses for all remaining eligible populations.

For the full update, please visit the government of Canada website here.

Advocacy Efforts

The COVID-19 landscape in Canada is constantly changing with new information from the latest research. Because of the evolving nature of information surrounding COVID-19, different guidelines have been released by the provincial, territorial, and federal governments. Some guidelines take into account new research and provide specific guidance for cancer patients and their treatments, while many guidelines leave questions unanswered. To address challenges faced by the lymphoma community regarding COVID-19 and vaccine access, Lymphoma Canada continues to advocate on behalf of patients and caregivers.

1. With the support of many organizations including Lymphoma Canada, a letter was sent on February 1, of this year to the National Advisory Committee on Immunization (NACI), the Federal Minister of Health, Health Canada, and other provincial health bodies. This letter provided recommendations for dosing schedules to meet the required clinical trial timelines and advocated for the development of a pan-Canadian strategy for the collection and distribution of research and data on COVID-19 and the vaccine to guide decision-making.

Access Letter Here

2. Following these efforts, NACI continued with its 4-month dose delay schedule. With recent research published, addressing the safety and immune response in cancer patients, real evidence was provided to counter NACIs decision. Our Scientific Advisory Board felt strongly that continuing our advocacy efforts to address this issue was important. With this information, Scientific Advisors and clinicians affiliated with patient groups added their support. A second follow-up letter was sent on April 1, to Provincial/Territorial Health Ministers, Chief Medical Officers, Premiers, and Public Cancer Agencies, along with Health Canada and NACI about three important challenges facing the lymphoma and cancer community.

Access Letter Here

3. On April 7, NACI released a statement re-affirming their decision to continue with the 4-month dose delays. However, jurisdictions may choose to shorten the time between the first and second dose for specific populations. Certain provinces such as Ontario and Manitoba have adopted provincial guidelines to ensure normal dosing is scheduled for specific high-risk individuals. It is important to stay up-to-date with your province’s immunization plan as it could change to include your eligibility! After hearing from patients and caregivers about continued advocacy efforts, it was decided that a national awareness campaign was the next best step. Lymphoma Canada along with other patient organizations will be launching an article in the Globe & Mail that is addressed to the Prime Minister and Provincial/Territorial Health Bodies focused on the continued dose delays for cancer patients. This was published on April 28, 2021.

Access Article Here

4. Further advocacy efforts were taken in British Columbia, publishing a similar advocacy article in the Victoria Times Colonist on May 12, 2021, alongside in Quebec.

More advocacy work to come. We hear you; we support you!

Important Research Published on the COVID-19 Vaccine in Lymphoma Patients

The following are important scientific studies published on the safety and efficacy of the COVID-19 vaccines in lymphoma patients. As lymphoma patients were not included in the original vaccine clinical trials, research is currently underway to better understand the immune response in lymphoma subtypes. Few studies have been published thus far.

1. Interim research looking at the immune response to the COVID-19 vaccine in hematological patients.

Monin-Aldama, L. et al. (March 17, 2021). Interim results of the safety and immune-efficacy of 1 versus 2 doses of COVID-19 vaccine BNT162b2 for cancer patients in the context of the UK vaccine priority guidelines. MedRxiv. Access article here.

2. Research determining the immune response to the COVID-19 vaccine in Chronic Lymphocytic Leukemia patients.

Herishanu, Y. et a. (April 16, 2021). Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia. Blood 2021011568. Access article here.

3. Study that measured the antibody response to the COVID-19 mRNA vaccines in hematology patients.

Agha, M. et al. (April 7, 2021). Suboptimal response to COVID-19 mRNA vaccines in hematologic malignancies patients. MedRxiv. Access article here.

If you have any questions regarding these clinical studies, please contact us at info@lymphoma.ca.

Resources for Cancer Patients

We suggest you visit these COVID-19 Cancer Specific Resources:  Support for cancer patients – COVID-19 Cancer Patient Support Hub (covid19oncologyresources.ca)

This website is intended for people in Canada living with cancer, caregivers, their families, and anyone else affected by cancer.  It is regularly being updated as new developments, resources, services and assistance relating to COVID-19 and oncology change or become available.

If you are a patient with lymphoma or CLL, please do not hesitate to reach out to us for support at info@lymphoma.ca

Additional resources are available as follows:

World Health Organization: Coronavirus (who.int)

Canadian Pharmacists Association: CPhA – COVID-19: Information for Pharmacists – English

Lymphoma Canada’s COVID-19 Action Plan is sponsored by Merck.

Financial support has been provided by Gilead.