3rd covid vaccine

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Koreysue
Posts: 229
Joined: Mon Apr 30, 2018 2:36 pm

3rd covid vaccine

Postby Koreysue » Fri Aug 13, 2021 11:46 am

Does anyone know if cancer survivors in general qualify for the 3rd shot, or is it only for those currently in treatment? I sent a message to my doctor, but am curious what ya’ll have heard.
Ksue
Dx: 6/2017 stage 3 colon cancer
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/2018 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/2019 / CEA : 3.4
CEA 10/21/19: 3.2
CEA 3/9/20: 3.8
CT NED /CEA 6/17/20: 3.8
CEA 11/4/20 4.6 <——— whyyyy? (will retest in a few weeks)
CT NED 12/1/20 CEA: 3.5 (happy to see a lower number)
CEA 5/17/21 4.2
CEA 10/18/21 3.4
colonoscopy 10/2021 10mm polyp

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: 3rd covid vaccine

Postby roadrunner » Fri Aug 13, 2021 12:43 pm

I don’t believe it would be appropriate or practical to apply a bright line to this. “Immunocompromised” is a fine line and a moving target. Most solid tumor patients respond better than many solid transplant patients. However, solid tumor patients respond poorly to one shot (far below healthy controls) but better to a second shot. That said, even then their numbers are often lower than those of controls—especially but not exclusively if on active therapy—and with time from previous immunization (immunity wanes) and new variant vaccine escape as relatively ill-defined variables, it’s really individual, and really hard to know in an individual case. For example, pelvic radiation treatment (usually for RC) can have long-term (years of) immunosuppressive effects (and even then the type and amount of radiation matters). Blood counts may give you an idea of where you stand in general, but aren’t dispositive. Even antibody titer doesn’t decide the issue, because T-cell response is also crucial. Thus, this should—and I believe ultimately will—be a personal evaluation by patients and their doctors. Plus, can CVS and Walgreen’s really make these calls?
Last edited by roadrunner on Fri Aug 13, 2021 1:45 pm, edited 1 time in total.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

JMRWife
Posts: 96
Joined: Mon Oct 05, 2015 9:41 pm

Re: 3rd covid vaccine

Postby JMRWife » Fri Aug 13, 2021 12:57 pm

I was offered one through work. My oncologist said get it.
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Neoadjuvant Folfox 5/18; CEA 107.
9/8: 9 rounds Folfox completed. CEA 2.1.
Pathology: COLON, SIGMOID: -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED Clinical stage IIA.

9/28/21 CAT scan: Tumor was 6.4 x 3.8 cm, now 2.6 x 4.5 cm.

10/4/21: Sigmoid colectomy. 36 lymph nodes removed, 0 cancerous. Stage T2N0M0.

Koreysue
Posts: 229
Joined: Mon Apr 30, 2018 2:36 pm

Re: 3rd covid vaccine

Postby Koreysue » Fri Aug 13, 2021 1:05 pm

All good points. It most certainly should be decided by discussing with your doctor. I was just curious if anyone on here has had that convo with their doctor, as I wait to hear from mine. There are so many variables.
Ksue
Dx: 6/2017 stage 3 colon cancer
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/2018 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/2019 / CEA : 3.4
CEA 10/21/19: 3.2
CEA 3/9/20: 3.8
CT NED /CEA 6/17/20: 3.8
CEA 11/4/20 4.6 <——— whyyyy? (will retest in a few weeks)
CT NED 12/1/20 CEA: 3.5 (happy to see a lower number)
CEA 5/17/21 4.2
CEA 10/18/21 3.4
colonoscopy 10/2021 10mm polyp

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: 3rd covid vaccine

Postby roadrunner » Fri Aug 13, 2021 1:48 pm

Not that I’m against consulting doctors, but how does an oncologist (or a GP) really make a reliable call about immune response in a fluid, uncertain, hyper-individualized situation like this? Maybe an immunologist who studies cancer patients for a living has the background to do it, but everybody else is just reading the preprint studies.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: 3rd covid vaccine

Postby roadrunner » Fri Aug 13, 2021 2:01 pm

Btw, just read reports on the guidance and it is consistent with my comments above. Seems to be up to patients and their doctors.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

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horizon
Posts: 1642
Joined: Tue Apr 12, 2011 10:10 pm

Re: 3rd covid vaccine

Postby horizon » Sun Aug 15, 2021 4:20 pm

I was wondering this myself. I got my vaccine a little earlier where I was treated, but it's been ten years since I had cancer.
I'm just a dude who still can't believe he had a resection and went through chemo (currently 10 years NED). Is this real life?

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O Stoma Mia
Posts: 1691
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: 3rd covid vaccine

Postby O Stoma Mia » Tue Aug 17, 2021 8:44 am

Last edited by O Stoma Mia on Wed Aug 18, 2021 2:23 am, edited 1 time in total.

roadrunner
Posts: 179
Joined: Sun Jan 12, 2020 8:46 pm

Re: 3rd covid vaccine

Postby roadrunner » Tue Aug 17, 2021 4:18 pm

I would stress that is is MSK’s interpretation of the CDC guidance only. So it’s guidance on guidance. It is very carefully written so as not to be exclusive (“Those cancer patients who are considered considered immunocompromised include . . ..”). “[I]nclude,” not “are.”)

This is a very uncertain and fluid area. While there is some data to suggest that solid tumor patients usually do alright after the second shot, everyone is different, and much of the old data may be irrelevant in the age of the Delta variant and recent evidence of waning immunity. Israel and Pfizer agree that waning immunity very significantly affects efficacy in *healthy people*. Cancer patients, in particular those who’ve received pelvic radiation or chemotherapy, recover at different rates immunologically. Many of us also got the vaccine early, months ago. Also, the US just followed Israel’s and Europe’s lead in authorizing boosters for *everyone* at 8 months (Israel I believe is at 6). There is no vaccine shortage at present. So I would read this not as gospel or as restrictive but as just one opinion. I would urge everyone to carefully consider their own risk tolerance and do their own relevant research.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

zephyr
Posts: 323
Joined: Thu Aug 18, 2016 7:31 am

Re: 3rd covid vaccine

Postby zephyr » Tue Aug 17, 2021 4:33 pm

I just had my booster at Walgreens because my oncologist felt strongly enough about me getting it that he suggested I postpone my chemo this week so that I could get the shot instead. I'm sure a lot went into his decision: my blood counts, my current response to chemo, etc. I'm more afraid of COVID, which I think might kill me quickly & now, than cancer which will likely kill me slowly & later ... so I was "on it" the minute I learned the booster had been approved. But that's just me. As to how Walgreens (and I assume CVS) makes the determination that you need it, they don't. They have you sign a piece of paper confirming that you are in one of the eligible groups.
Nov-2009 Early stage CRC found during routine colonoscopy
2010, 2011, 2014 F/U colonoscopies, all clear
Jun-2016 CRC during followup colonoscopy, surgery, Stage 4, KRAS, MSS, inoperable lung mets
Aug-2016-May-2018 Folfox, 5FU & Avastin, 5FU, Folfiri & Cyramza
Aug/Sep-2018 YAG laser surgeries (Germany), 11 nodules removed
Nov-2018 clean CT scan
Mar-2019 New lung nodules
Apr-2019 Dec-2020 Xeloda/Avastin, SBRT, cont. Xeloda/Avastin
Dec-2020 Progression, considering all options
Mar-2021 Forfiri/Avastin

SigmoidFreud
Posts: 2
Joined: Thu Oct 28, 2021 11:06 pm
Location: Boston

Re: 3rd covid vaccine

Postby SigmoidFreud » Fri Oct 29, 2021 12:41 am

I decided to get the 3rd (booster) Moderna shot at CVS. Main reason was I was having a resection surgery within the week at a hospital where 10% of the staff was unvaccinated.
10/08/21 Diagnosed 5 cm tumor in Sigmoid, age 52, female
10/18/21 CT of C/A/P all clear
11/01/21 Laparoscopic resection

Dennyp
Posts: 23
Joined: Thu Oct 29, 2020 9:28 pm

Re: 3rd covid vaccine

Postby Dennyp » Fri Oct 29, 2021 2:10 pm

Koreysue wrote:Does anyone know if cancer survivors in general qualify for the 3rd shot, or is it only for those currently in treatment? I sent a message to my doctor, but am curious what ya’ll have heard.
Ksue


I don’t think it really matters, it is unlikely any pharmacy would ask if you qualify.
5/19 IIIC sigmoid cancer 2/25 lymph nodes positive
5/19 surgery
7/19 FOLFOX 6 months
9/20 recurrence to single lymph node
10/20 FOLFIRI 5 rounds
1/21 surgery to remove lymph node
4/21 CT NED
8/21 CT NED
11/2 CT NED

User avatar
CRguy
Posts: 10346
Joined: Sun Feb 10, 2008 6:00 pm

Re: 3rd covid vaccine

Postby CRguy » Fri Oct 29, 2021 8:01 pm

Third dose implementation will be variable as our knowledge develops WRT waning immunity,
variant responses and public health policy.

Unless we have actual protective titer evaluations and real life in vivo experiences to draw conclusions from ....... ????? WTF

A recent news release locally gives me enhanced respect for my own loco-regional health leaders !!!!!
https://vancouversun.com/news/local-new ... columbians

I believe this is a pro-active and forward thinking move, to NOT restrict third dose boostering during a global pandemic.

We booster EVERY YEAR for influenza and have a long epidemiological record / history to draw from.
Influenza is Protean and mutates regularly.
Covid has already shown THAT attribute ... AND ...
Covid is NEW so ... BETTER SAFE THAN SORRY !

This is JMO

Stay safe
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
14 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

Rock_Robster
Posts: 608
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: 3rd covid vaccine

Postby Rock_Robster » Fri Oct 29, 2021 9:53 pm

Just a data point - I’m in Australia and it looks almost certain they’ll be starting 6 monthly boosters using the same prioritisation criteria as the initial rollout, which meant people with an “underlying medical condition” are prioritised in the 2nd priority category (this includes a cancer diagnosis in the last 5 years); while 1st priority is frontline health/quarantine / aged care workers. One interesting part is they are strongly recommending an mRNA for boosters, while quite a lot of Australians received AstraZeneca for their first dose, meaning there will be a lot of mixing of vaccines and boosters going on (which I understand to not be as widely studied).

Rob
Last edited by Rock_Robster on Sat Oct 30, 2021 3:03 am, edited 1 time in total.
39M Australia
2018 Dx RC, 12cm high
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a Stage IVa. MSS NRAS G13R
CEA: Nov-18= 14; then 2.0 - 3.1. Nov-21: 5.4
11/18 FOLFOX x6
3/19 Liver resection
5/19 25x pelvic radiation
07/19 ULAR w ileo, 1/27 LN+
08/19 Liver spot
08/19 FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19 Liver resection
02/20 Ileo reversed
03/20 NED (since Dec-19)
11/21 New liver lesion (2 lymph nodes?), maybe 4 very small (<2mm) lung things

User avatar
CRguy
Posts: 10346
Joined: Sun Feb 10, 2008 6:00 pm

Re: 3rd covid vaccine

Postby CRguy » Fri Oct 29, 2021 11:50 pm

Good post Rob
I had two Pfizer ( mRNA ) and would be looking to get any boosters with mRNA again
... BUTT ... the mix and match scenarios do need to be fully followed up on.

Current info that I have heard is that Pfizer / Moderna / AstraZeneca are all in play for effective
mix and match.

A work in progress

Stay safe
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
14 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far


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