Cancer patient seeks vaccine certainty
When Trevor Gately gets his second Covid19 vaccine later this month, he would like to travel and visit family overseas.
But while for most the vaccine offers a renewed ticket to the world, the 74-year-old Richmond man won’t have the same surety.
Gately lives with myeloma, a form of blood cancer that impacts immunity.
Because of this, there is a greater likelihood he won’t develop antibodies to Covid-19 after getting the vaccination – but he has been told a blood test to let him know if it has worked is not recommended.
More than nine out of 10 people produce antibodies to Covid-19 after the first dose of the Pfizer and AstraZeneca vaccines, BMJ (British Medical Journal) reported in May.
But an article from The Lancet Haemotology in June reported 30 per cent of myeloma patients had not had a positive antibody response to the same vaccines after the first dose. The result was ‘‘concerning’’, the study found.
‘‘It will be important to track this group closely, as non-responders could be left vulnerable to severe Covid-19 infection.
‘‘These patients might need to take extra precautions to reduce infection risk, although they might have some degree of protection through other immune mechanisms or after their second vaccination.’’
For Gately, who was first diagnosed with myeloma five years ago, the answer was
simple – get a blood test after the vaccination so you can know if you have developed antibodies or not. But when he asked he was not told this was not recommended and if he wanted it done he would have to pay for it.
Myeloma was a ‘‘treatable cancer, not a curable cancer’’, so he was used to having it impact his life – including paying for medication not funded by Pharmac. ‘‘To now find that I will have to pay for my own blood test, for peace of mind, and to know how best to look after myself in the future, is disappointing.’’ It was reasonable not to have every person tested to see if the vaccine was effective but there should be a case for it when circumstances indicated it was necessary, he said.
A blood test would offer peace of mind, particularly as he hoped to travel to visit family when things were more settled globally but would not know if he was protected.
He had seen people posting similar concerns in myeloma support groups.
Professor Diana Sarfati, chief executive of Te Aho o Te Kahu, the Cancer Control Agency, said it was possible for immunocompromised people to have a lesser response to vaccination.
‘‘We know from international evidence that the immune response after one dose of vaccine is lower for cancer patients than those without cancer, with immune response increasing significantly following the second dose.
‘‘For this reason it is critical to receive the second dose of the vaccine.’’
There was no policy around making blood tests available to determine the effectiveness of the vaccine, and Te Aho o Te Kahu and the Ministry of Health did not plan to develop a policy, she said. ‘‘The routine testing of immune response is not currently recommended ... Patients who are immunosuppressed are encouraged to take precautions to safeguard their health whether they are vaccinated or not.’’
Myeloma New Zealand chief executive Dr Ken Romeril said there was not enough information available yet to suggest a blood test would be useful.