On August 12, 2021 the United States Food and Drug Administration (FDA) modified the Emergency Use Authorizations (EUAs) for the mRNA COVID-19 vaccines (Pfizer and Moderna) to allow for the administration of an additional dose (i.e., a third dose) after an initial two-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people.
This amendment was subsequently endorsed by the Centers for Disease Control and Prevention (CDC) on August 13, 2021.
Are these recommendations applicable to LAM patients?
These recommendations are relevant to the subset of LAM patients who take sirolimus or everolimus for treatment.
Sirolimus and everolimus belong to a class of medications called mTOR (mechanistic target of rapamycin) inhibitors. mTOR inhibitors are commonly prescribed along with other immunosuppressive medications to prevent rejection in patients with organ transplantation.
While it is clear that some patients who have had organ transplants and who are on combination immunosuppressive medications do not mount an effective response following COVID-19 vaccination, it is unclear if that is also the case for LAM patients on monotherapy with mTOR inhibitors.
Preliminary data indicates that patients with LAM who received the COVID-19 vaccination while on sirolimus are able to mount a good response following vaccination; however, this data requires further validation.