Researchers found in a study called the “Shivering 2 Trial” during last year’s flu season, that persons with plasma cell disorders, i.e.multiple myeloma, do not get much protection from the flu even after getting the high dose shot. When we have compromised immunity to start with and are often older, or have other health challenges, our bodies are set up for a weaker, shorter-term responses to the vaccine. Though we need six months of full immunity to be protected through a normal flu season, myeloma patients start losing their seroprotection early, some after just one month.
The study was described at an ASH presentation by Dr. Andrew Branagan as follows:
Forty-eight patients received a single standard of care influenza vaccination and 74 patients received two doses of Fluzone High-Dose vaccine. Median age was 67 years (range 42-90). Following the second vaccine, rates of total seroprotection (against all 3 influenza vaccine strains) were 86.3% for patients who received two high dose vaccines and 63.9% for standard vaccination patients. At the end of the flu season, rates of total seroprotection were 58.5% for patients who received two high dose vaccines and 33.3% for standard vaccination patients.
Those patients who had a lower likelihood of serologic response to the flu vaccine were those who were older, male, had a remission status less than partial response and/or were receiving alkylating agent chemotherapy.
The second vaccination was given at 30 days after the first and was well-tolerated.
All of which begs the question, what might this mean for all the other immunizations MM patients get—particularly after ASCT?
Dr. Branagan urged more study for dosing and timing of flu vaccinations with the thought that it may result in practice-changing implications for other vaccines and therapies going forward.