What to Know About the COVID Vaccine When You Have Multiple Myeloma

People with cancer are at a higher risk of serious COVID-19 illness, according to the Centers for Disease Control and Prevention (CDC). As such, it’s important for people with multiple myeloma to receive the COVID-19 vaccine.

Multiple myeloma weakens the immune system, increasing your risk of getting infections. Some research has found that, compared with healthy individuals, those with multiple myeloma are at a 10-fold higher risk of contracting viral infections.

The effects of some multiple myeloma treatments can also weaken your immune system. Some examples include stem cell transplants, CAR T-cell therapy, and chemotherapy.

The National Comprehensive Cancer Network (NCCN) recommends that all people with cancer get vaccinated for COVID-19 as soon as they can. This includes a primary vaccine series as well as boosters.

The American Cancer Society supports the NCCN’s recommendation. The American Society of Hematology also recommends COVID-19 vaccination for people with multiple myeloma after consideration of individual and treatment-related factors.

The CDC has a separate vaccination schedule for those with a weakened immune system, such as individuals with multiple myeloma. The table below shows the current vaccine recommendations for immunocompromised adults.

Check with your doctor before getting vaccinated

Some people with multiple myeloma may need to delay vaccination. According to the NCCN recommendations, those receiving a stem cell transplant or CAR T-cell therapy should wait at least 3 months after their treatment to get vaccinated.

Overall, research has found that the reported side effects of the COVID-19 vaccine are similar between the general public and people with cancer. According to the CDC, these can include things such as:

• pain, swelling, or redness at the injection site
• fatigue
• fever
• chills
• muscles aches and pains
• headache
• nausea

If you have concerns about the risks associated with getting the COVID-19 vaccine with multiple myeloma, discuss them with a doctor.

Because people with multiple myeloma already have a weakened immune system, their response to the COVID-19 vaccine isn’t usually as strong. This means that if you have multiple myeloma, the COVID-19 vaccine may be less effective for you.

One 2022 study of 238 people with multiple myeloma found that only 54% of vaccinated people made neutralizing antibodies. These are antibodies that prevent the virus that causes COVID-19 from binding to a host cell.

Additionally, a 2021 study found that, compared with people without cancer, those with multiple myeloma are at an increased risk of breakthrough infections and hospitalization after COVID-19 vaccination.

However, it’s important to remember that having some protection is always better than having no protection.

You can choose which vaccine you get, but the CDC recommends mRNA vaccines over the Johnson & Johnson adenoviral vector vaccine. Pfizer-BioNTech and Moderna produce the two mRNA vaccines.

The recommendation comes after a review of data on the safety and effectiveness of the Johnson & Johnson vaccine. Overall, mRNA vaccines were more effective and had a lower risk of serious side effects.

According to the National Cancer Institute, there’s no evidence that the COVID-19 vaccine lowers the effectiveness of your cancer treatment. However, some multiple myeloma treatments may lower the effectiveness of the COVID-19 vaccine.

A 2021 study found that people receiving certain types of targeted therapy or CAR T-cell therapy had a lower antibody response to two doses of an mRNA vaccine.

However, a 2022 study showed that receiving a third vaccine dose raised antibody levels in individuals with multiple myeloma. This also included those receiving treatments associated with a lower antibody response to two vaccine doses.

Yes, it’s important to get the COVID-19 vaccine even if you’ve already had COVID-19. Some research has found that those who don’t get vaccinated after having COVID-19 are at an increased risk of contracting the infection again.

Additionally, other research has found that getting your COVID-19 vaccine either before or after contracting COVID-19 is associated with enhanced immunity. You may see this referred to as hybrid immunity or super immunity.

If you have multiple myeloma, it’s important to continue to take steps to minimize your risk of COVID-19, even if you’ve been vaccinated. To do this:

• Request that your family, friends, and caregivers also get the COVID-19 vaccine.
• Wash your hands frequently.
• Wear a well-fitting mask and maintain physical distancing when you’re out in public.
• Avoid spaces that are very crowded or poorly ventilated.
• Regularly disinfect high-touch surfaces in your home, such as light switches and doorknobs.

It’s also vital that you monitor your health and contact your doctor promptly if you think that you have COVID-19. Antiviral medications such as Paxlovid are now available to help lower the risk of serious illness due to COVID-19.

People with multiple myeloma are at an increased risk of serious illness due to COVID-19. Because of this, it’s important for them to receive their primary vaccine series and boosters.

While COVID-19 vaccines may be less effective in people with multiple myeloma, some protection from COVID-19 is better than none at all. The side effects of vaccination are also similar to those of the general population.

If you have multiple myeloma, talk with a doctor about getting vaccinated for COVID-19. They can evaluate your situation and current treatment plan to determine an optimal timeline for you to get your vaccine.