key: cord-0932613-s62iimww
authors: Booth, Garrett S.; Savani, Bipin N.
title: The Intersection of Photopheresis and COVID-19 Vaccination
date: 2021-01-14
journal: Transplant Cell Ther
DOI: 10.1016/j.jtct.2021.01.008
sha: 63aefb6f4c3ba908c0cd5d21ad454293423ebf77
doc_id: 932613
cord_uid: s62iimww

nan

The ongoing global pandemic caused by the novel coronavirus SARs-CoV2 has upended and altered innumerable facets of oncologic and hematopoietic stem cell transplantation utilization and delivery 1,2 , including delays in cancer diagnosis and treatment. 3 Yet, there is reason for hope with newly approved emergency use authorization vaccines for the prevention of severe COVID19 ,4,5 , but outstanding questions remain related to the appropriateness, timing, and efficacy of such vaccines in cancer patients. 6 To date, no universal deferral time period has been accepted between vaccination and initiation or continuation of immunosuppressive therapy, including for patients that are undergoing extracorporeal photopheresis (ECP) immunomodulatory therapy. In North America, the two most commonly used medical devices used for ECP are the UVAR-XTS device (Therakos Inc) and the CELLEX (Therakos Inc) and at present there are no recommendations related ECP treatment and timing of COVID-19 vaccination from the device manufacturer (Laurence Covassin, PhD, email and phone conversation, January 4-5, 2021). Alas, despite the paucity of safety and efficacy related vaccine data in ECP patients, we propose a minimum 14 day deferral time period between vaccination and ECP treatment. This two week deferral period is consistent with effectiveness recommendations for inactivated influenza vaccine vaccination in immunocompromised patient. 7 There exists limited published data on the impact of ECP on T-and B-cell suppression 8 , yet out of an abundance of precaution, ECP providers should remain vigilant regarding care of oncologic patients given the increased risk of morbidity and mortality in patients with ongoing cancer treatment or a known history of cancer. 9,10 It is essential that ECP and vaccine deferral recommendations become part of the evolving discussion for stem cell transplant survivors. 1 

Changes in Hematopoietic Cell Transplantation Practices in Response to COVID-19: A Survey from the Worldwide Network for Blood & Marrow Transplantation

How to optimize cancer therapy when coronavirus hits the fan

Impact of COVID-19 on Cancer Care: How the Pandemic is Delaying Cancer Diagnosis and Treatment for American Seniors

Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

What can we expect from first-generation COVID-19 Vaccines?

The COVID-19 Vaccine & Patients with Cancer

General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP): Altered Immunocompetence

Extracorporeal photochemotherapy does not suppress T-or B-cell responses to novel or recall antigens

Prognostic factors for severity and mortality in patients infected with COVID-19: A systematic review

Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis