Guidelines for COVID vaccination of Cellular Immunotherapies and Transplant patients
The availability of effective COVID-19 vaccines is a welcome development in this pandemic. However, special consideration should be given to anyone having undergone autologous transplant, allogeneic transplant or CAR T-cell therapies. The timing, clinical characteristics and the type of vaccine must be considered before you are vaccinated. Before getting the vaccine, first consult with your Cellular Immunotherapies & Transplant provider at VCU Massey Cancer Center by contacting your post-transplant coordinator through the My VCU Health Patient Portal or by calling (804) 628-7290.
While research on the COVID vaccine in those who have had transplants and CAR T-cell therapies is limited, there is some data as well as prior experience with vaccination protocols for other agents that can serve to set an effective and safe COVID vaccine process. The following are the guidelines suggested for post-transplant patients.
CAR-T, autologous, and allogeneic transplant patients should only receive Pfizer/BioNTech and Moderna/NIH COVID-19 vaccine products at this time. This guidance only applies to these two vaccine products and may be subject to updates. While AAV/Adenoviral-based vaccines with simpler deployment logistics may soon be approved and available, they are currently untested and potentially unsafe for CIT patients.
Timing of vaccination
Recipients of autologous transplant, allogeneic transplant or CAR T-cell therapy should be evaluated for COVID-19 vaccination at Day +180 post transplant and not before then.
COVID-19 vaccination should be delayed for:
- Relapse or progression of underlying disease receiving therapy-strength chemotherapy
- Grade 3-4 acute GVHD
- Prednisone at a dose >5 mg/kg/day
- Receipt of anti-CD20 monoclonal antibody within 6 months (e.g., rituximab, obinutuzumab, ofatumumab)
- Receipt of anti-thymocyte globulin or alemtuzumab within 6 months
- Temperature > 100.4 oF/38 oC in the last 48 hours
Consult with us before getting vaccinated
- Before scheduling a COVID vaccine, please consult with your Massey post-transplant coordinator through the My VCU Health Patient Portal or by calling the CIT Program’s dedicated vaccine telephone line at (804) 628-7290.
- Please contact the CIT Program when you receive your second dose, if it is performed outside of the VCU Health system, so that we can measure your post-vaccination COVID antibodies.
- If you experience any adverse events from vaccination, please report them to the CIT Program through the dedicated telephone line at (804) 628-7290.
Logistics of vaccination
- Administration of the vaccine in Massey and VCU Health clinics is based on available vaccine supply. Initial supply of these vaccines is severely limited and is made available to Massey and VCU Health by the Virginia Health Department.
- Because the vaccine has a short shelf life and requires special storage, advance planning for administration is needed.
At VCU Massey Cancer Center, our intention is to ensure that all post-transplant patients will receive COVID vaccine protection. We also will provide coverage for the critical caregiver of patients who are ineligible for vaccination. Please contact us at (804) 628-7290 with any questions regarding the COVID vaccine.