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.
Lymphoma Canada, with the help of our Scientific Advisory Board comprised of leading hematologists /oncologists from across Canada, created a brief report addressing important questions from patients related to COVID-19 and the vaccine, to provide guidance from the clinician and policy levels.
In August 2021, provinces began to approve the administration of a third COVID-19 vaccine to individuals with two prior vaccinations. Provinces differ in their roll-out plan and eligibility criteria. For best guidance, please speak with your clinician to determine your eligibility and review your provinces roll-out plan for details on how to access the vaccine.Read More
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.
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.
- 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.
- 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.
- 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.
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. Research published on the antibody response to the COVID-19 vaccine in hematology patients (different subtypes grouped together) and other solid tumour patients.
Benda, M. et al. (August 3, 2021). Serological SARS-Cov-2 antibody response, potential predictive markers and safety of BNT162b2 mRNA COVID-19 vaccine in haematological and oncological patients. Br J Haematol. Access article here.
2. Treatment with anti-CD20 treatment and active disease are negative predictors for a negative antibody response to the COVID-19 vaccine. Differences in CD20 treatments (obinituzumab vs rituximab) can play a role in response.
Gurion, R. et al. (July 29, 2021). Humoral serologic response to the BNT162b2 vaccine is abrogated in lymphoma patients within the first 12 months following treatment with anti-CD20 antibodies. Heamatologica. Access article here.
3. Research confirming that the first dose of both BNT162b2 and AZD1222 vaccine leads to lower production of antibodies against SARS-CoV-2 in patients with Waldenstrom Macroglobulinemia/Chronic Lymphocytic Leukemia/Non-Hodgkin Lymphoma compared to controls of similar age and gender and without malignant disease.
Gavriatopoulou, M. et al. (July 20, 2021). Low neutralizing antibody responses in WM, CLL and NHL patients after the first dose of the BNT162b2 and AZD1222 vaccine. Clin Exp Med., 1–5. Access article here.
4. Research on the antibody response to the COVID-19 vaccine in lymphoma subtypes. Importantly looks at timing of treatment and types of treatment received.
Herzog Tzarvfati, K. et al. (June 29, 2021). BNT162b2 COVID-19 vaccine is significantly less effective in patients with hematologic malignancies. AJH. Access article here.
5. Research showing that COVID-19 vaccine administration can cause vaccine-associated hypermetabolic lymphadenopathy (swelling of your lymph nodes) close to the vaccine site which can mimic progression of disease on PET imaging scans.
- Clinician’s should ask their patient when they received their vaccine(s) when interpreting the results of imaging scans.
Cohen, D., Krauthammer, S.H., Wolf, I. & Even-Sapir, E. (June 2021). Hypermetabolic lymphadenopathy following administration of BNT162b2 mRNA COVID-19 vaccine: incidence assessed by [18F]FDG PET-CT and relevance to study interpretation. Eur J Nucl Med Mol Imaging. Access article here.
6. 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.
7. 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.
8. 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.
If you have any questions regarding these clinical studies, please contact us at firstname.lastname@example.org.
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 email@example.com
- Cancer Patient Resources
- COVID-19 and Vaccines Report
- Information for Lymphoma and CLL Patients
- Self Care and Mental Wellness
- How to Protect Yourself
- Federal Resources
- Provincial Resources
INFORMATION FOR LYMPHOMA AND CLL PATIENTS
|COVID-19 and Vaccines Report||Lymphoma Canada|
|COVID-19 and Cancer Patients (Webinar Recording)||Canadian Cancer Society|
|COVID-19 Cancer Patient Support||All.Can|
|Anxiety & Stress Management webinar||Lymphoma Canada|
|Mental Health and the COVID-19 Pandemic||Centre for Addiction and Mental Health|
|Mental health and psychosocial considerations during the COVID-19 outbreak||World Health Organization|
|Self-care Guide||Government of Quebec|
|Tips for Managing Anxiety During the COVID-19 Pandemic||The Globe & Mail, March 16, 2020|
|How to Meditate||Mindful.org|
|Mental Health Tips for Working from Home||Government of Canada|
|Coronavirus disease and food safety||Government of Canada|
|Wellness Together Canada||Federal Mental Health and Substance Use Support|
|Resource Hub: Mental health and wellness during the COVID-19 pandemic||Mental Health Commission of Canada|
|BounceBack Ontario free mental health program||Canadian Mental Health Association|
|Know the Difference: Self-Monitoring, Self-Isolation and Isolation for COVID-19||Government of Canada|
|Hand washing guide||Government of Canada|
|When and how to wear medical masks||World Health Organization|
|How to protect yourself from coronavirus when grocery shopping||Consumer Reports|
|Coronavirus disease (COVID-19) advice for the public: Myth busters (WHO)||World Health Organization|
|Sanitizing the home if someone is sick||Centers for Disease Control and Prevention|
|Caring for family members with COVID-19||Government of Canada|
|Coronavirus disease (COVID-19) outbreak updates, symptoms, prevention, travel, preparation – Canada.ca||Public Health Agency of Canada|
|Vaccines and treatments for COVID-19: Progress – Canada.ca||COVID-19 Vaccine Information|
|Recommendations for Prioritization of Key Populations for COVID-19 Immunization||Government of Canada|