People with cancer are more likely to get a severe illness. Multiple myeloma is a type of blood cancer.

“Getting a COVID-19 vaccine may seem intimidating if you have multiple myeloma. You may be unsure about how effective the vaccine will be if you are undergoing certain types of treatments. Experts recommend that you get a full dose of the vaccine as soon as possible, even though multiple myeloma can affect the vaccine’s efficacy.”

We will look at multiple myeloma, the COVID-19 vaccine, and how it works with treatment. Continue reading to learn more.

Multiple myeloma (MM) is a blood cancer that affects plasma cells in the bone marrow. It’s rarer than other types of cancer and is estimated to make up only 1.8 percent of all new cancer diagnoses in the United States in 2022.

According to the Centers for Disease Control and Prevention (CDC), people with cancer are at an increased risk of severe illness due to COVID-19. This may also include people with a history of cancer.

A 2021 study comparing people with and without a history of cancer found that having received a cancer diagnosis was associated with poorer COVID-19 outcomes. This effect was strongest in people whose cancer was active.

Another 2021 study saw that compared to people without MM, those with MM were at a higher risk of developing COVID-19. The study also found that excess deaths in 2020, the year the pandemic began, were higher for people with MM.

Are people with multiple myeloma immunocompromised?

MM affects the cells that are called B cells. MM cells become cancer and start to grow and divide.

When this happens, healthy blood cells in the bone marrow, including other immune cells, are crowded out. As such, one of the effects of MM is a weakened immune system.

This means that if you have MM, you’re more vulnerable to infections. A 2015 study found that, compared to healthy people, individuals with MM had a 10-fold higher risk of contracting viral infections.

The side effects of some cancer treatments can also weaken the immune system. According to the American Cancer Society (ACS), The treatment is called Chemo. (chemo) is the treatment that most often causes a weakened immune system.

How does multiple myeloma affect the COVID-19 vaccine?

Based on the above findings, it’s easy to see why people with MM might have a poorer response to vaccines, including the COVID-19 vaccine.

A 2022 study looked at neutralizing antibodies people with MM made after getting the COVID-19 vaccine. Though your body makes many types of antibodies after vaccination, the COVID-19 vaccine can actually block the virus from binding to a cell.

After analyzing samples from 238 people with MM, neutralizing antibodies were detected only in 54 percent of the samples. Those who received the Moderna vaccine had significantly higher levels than people who got the Pfizer-BioNTech vaccine.

The research shows that people with MM have a response to the vaccine, but it decreases over time. The effects are more pronounced in those with MM, and this is true of everyone.

“The researchers reported that treatment-related factors played a role in the level of neutralizing antibodies. Let’s look at this a little more now.”

Because chemo weakens the immune system, the immune system may not respond as strongly to a vaccine. This means that the vaccine may be less effective at protecting you from an infectious disease.

You may also have heard that people receiving chemo shouldn’t receive some types of vaccines in the first place. Though this is true, it doesn’t apply to the COVID-19 vaccine.

Some older vaccines, such as the MMR and chickenpox vaccines, contain a weak form of a virus. Because the virus can still replicate in the body, this can cause potentially problems for someone with a weakened immune system.

The COVID-19 vaccines aren’t live vaccines. Because of this, they can safely be given to people with cancer who are getting immunosuppressive treatments like chemo and others.

There’s another important point to make on MM and chemo, though. According to the ACS, chemo is now a less important part of MM treatment because of newer, more effective treatments. But these newer treatments can also impact vaccine effectiveness as well.

Many of the treatment options for MM have side effects that affect how well the immune system works. But some may have a greater effect on COVID-19 vaccines. These treatments can include:

A 2021 study looked into the effectiveness of two doses of mRNA vaccines in people with MM. People actively receiving treatment for MM made lower levels of antibodies in response to two vaccine doses.

Researchers then broke down the results by treatment type. Some treatments were associated with lower responses to the immune system. These include:

  • Therapy drugs were targeted. that target a protein called CD38, including:
    • The two drugs are darzalex and hyaluronidase.
    • Isatuximab is a drug.
  • treatments that target a protein called BCMA, such as:
    • belantamab mafodotin-blmf (Blenrep)
    • the CAR T-cell therapies ciltacabtagene autoleucel (Carvykti) and idecabtagene vicleucel (Abecma)

But a 2022 study found that getting a third dose of an mRNA vaccine increased antibody levels in people with MM, including in those receiving the treatments above.

COVID-19 vaccine side effects for those with cancer

Research has found that COVID-19 vaccine side effects in people with cancer are similar to those seen in the general population. These can include:

The side effects should go away in a few days. If they last longer or get worse, you should contact a doctor.

The COVID-19 vaccine is effective in people without MM, but it is not as effective in people with MM.

The National Comprehensive Cancer Network recommends that all people with cancer get vaccinated for COVID-19 as soon as they can. But people receiving a Stem cell transplant. or CAR T-cell therapy is a therapy. should wait at least 3 months after treatment before getting vaccinated for the best effect.

The ACS supports this recommendation. The American Society of Hematology also recommends that people with MM get the COVID-19 vaccine, although the society notes that timing may depend on your overall health and treatment.

The CDC has a different recommended vaccine schedule for people with a weakened immune system, including those with MM. The table shows the vaccine schedule for immunocompromised adults at the time of publication.

Vaccine Primary series 1st booster 2nd booster
Pfizer-BioNTech (mRNA) Three doses. 2nd dose given 3 weeks after the first dose. 3rd dose given at least 4 weeks after the second dose. Given at least 3 months after the primary series. Must be mRNA, given at least 4 months after the 1st booster.
Moderna (mRNA) Three doses. 2nd dose given 4 weeks after the first dose. 3rd dose given at least 4 weeks after the second dose. Given at least 3 months after the primary series. Must be mRNA, given at least 4 months after the 1st booster.
Johnson & Johnson (adenoviral vector) Two doses. 2nd dose must be mRNA and is given at least 4 weeks after the first dose. Given at least 2 months after the primary series. Must be mRNA, given at least 4 months after the 1st booster.

The mRNA vaccines are preferred over the Johnson & Johnson (J&J) vaccine for the primary series and the boosters because mRNA vaccines are more effective and have a better safety profile than the J&J.

After your COVID-19 vaccination

People with MM are still at a high risk of COVID-19 even after being fully vaccinated. A 2021 study found that the risk of a breakthrough infection was 15.4 percent in people with MM, compared to 3.9 percent in those without cancer.

People with MM were more likely to be hospitalized. People with MM need to take other preventive measures.

  • Encouraging people to get vaccinations.
  • washing your hands frequently
  • wearing a well-fitting mask when you’re out in public
  • avoiding crowded areas
  • Staying at least 6 feet apart from others.
  • regularly disinfecting high-touch surfaces in your home, such as doorknobs and light switches

How to get vaccinated against COVID-19?

If you want to get the COVID-19 vaccine, you should ask your doctor or pharmacy if they are providing it.

If not, you can also find a vaccination site close to you using the search tool or contacting your state or local health department.

COVID-19 vaccines are free to all people in the United States. Vaccine providers will not ask you to pay any costs or fees when you get your vaccine.

People with MM are at an increased risk of developing a more severe illness. People with MM should get the vaccine.

The vaccine is less effective in people with MM due to the effects of cancer. Some protection from the vaccine is better than none.

If you have MM, you should talk to your doctor about getting the vaccine. The exact timing of the vaccine may be dependent on your health and MM treatment plan.