39-year-old mom with cancer asks for second shot soon
A 39-year-old mother undergoing chemotherapy for late-stage breast cancer is asking the province to give her a second COVID shot within three weeks — protection Ontario gives its clinically extremely immunecompromised residents.
Lise Berube, who ran a marathon for charity last year after learning her breast cancer had metasticized to her lungs and brain, is in active chemotherapy and receives an immunotherapy drug that has helped keep her cancer stable, but she is vulnerable to infections and viruses.
Berube and her husband both work at home, and they have two young children, ages seven and five, in school.
Last week, she chose to pull them from school after a COVID exposure warning within their learning cohort.
On April 15, Berube received her first dose of Pfizer-BioNTech vaccine as a clinically extremely vulnerable person. But instead of feeling the jubilation others feel — knowing their immunity will likely increase over the four months until their second dose — Berube worries her immunity will only wane.
The Canadian Association of Pharmacy in Oncology said weeks ago that cancer patients are significantly less protected by a single dose of the PfizerBioNTech vaccine than the general population.
Preliminary research from the U.K. indicates protection rates of 39 per cent after a single dose of the Pfizer-BioNTech vaccine in people with solid cancers and 13 per cent in people with blood cancers, versus 97 per cent in those with no cancer.
The study also showed, however, that cancer patients who received a second dose three weeks after the first had a sharp rise in their antibody response against COVID-19, with up to 95 per cent protection against the virus.
Berube presented those arguments to Health Minister Adrian Dix and provincial health officer Dr. Bonnie Henry in a letter on April 16. She noted that people who qualified for vaccination as clinically extremely vulnerable on March 29 were due for a second shot at three weeks, on Monday. She did not hear back and so, desperate for action, she spoke to the Times Colonist.
On Monday Henry said the clinically extremely vulnerable vaccination program is well underway, with about 210,000 letters sent and 60 per cent of those receiving letters booked or immunized.
With ICU admissions in B.C. at record highs, Berube said she’s scared of what could happen if she doesn’t get the second dose soon.
The young mother watches televised conversations between ICU doctors in Ontario who have to decide which patients get intervention, and while she recognizes B.C. is in a far better situation than Ontario, it’s nonetheless “terrifying.”
“Knowing that I’m at higher risk of getting sick, and I’m at higher risk of having complications and needing to be in the ICU, and knowing that as cases continue to mount if I were to be put in ICU and we were in that position — that we have to be triaged — that I might be one of the ones who don’t get an ICU bed, you know, that’s obviously a worst-case scenario but it’s scary because we’re kind of getting to that point, in some parts of the country, anyways.”
Berube noted that while the research has not yet been peerreviewed, a leading cancer centre in Canada and the world — the Princess Margaret Cancer Centre in Toronto — has been giving active chemo patients their second dose of COVID vaccine within the manufacturer-recommended three-week interval since March.
Severely immuno-compromised patients in Ontario have also started receiving second doses within three weeks.
Dr. Isaac Bogoch, an infectious disease specialist and scientist in Toronto, said in an interview Wednesday the “first-dose-fast” approach that stretches out the second dose to three or four months to get more people vaccinated faster “is the smart approach,” but added that there are always exceptions to the rule.
“In Ontario, we determined that there are some individuals who are at greater risk of having a poor immunologic response to a single dose where we should shorten the duration [for the second dose],” said Bogoch.
In Ontario, that includes people with various types of cancer, those undergoing chemotherapy and organ transplant recipients.
“Some argue we should have gone further and made an age cutoff as well,” said Bogoch, adding some individuals just don’t mount the same degree of immune response and remain vulnerable after one dose.
“I think, in the absence of firm national guidelines, we’re going to see provinces decide what they feel is appropriate for themselves.”
The province reported 862 new COVID-19 cases Wednesday, bringing active cases to 8,906, of which 483 are in hospital, including 164 in intensive care units, another daily record high. There have been seven new deaths. In the last week there’s been a report of a 20-year-old and a toddler under two years old dying from COVID-19.