A Vaccine Booster (GEO-CM04S1) for the Prevention of COVID-19 in Patients With Chronic Lymphocytic Leukemia

This phase II trial compares the effect of the GEO-CM04S1 vaccine with the current standard of care vaccine in preventing COVID-19 infections in patients with chronic lymphocytic leukemia (CLL). The GEO-CM04S1 vaccine uses a modified vaccinia virus (MVA) backbone that may be more effective at boosting COVID-19 immunity in patients with poor immune responses. MVA strongly induces T cell expansion (infection fighting blood cells) even in the background of a suppressed immune system, which is the case in the targeted CLL patient population. Using the GEO-CM04S1 vaccine may be more effective at preventing COVID-19 infection in patients diagnosed with CLL.

Inclusion Criteria:Documented informed consent of the participant and/or legally authorized representativeAge: >= 18 yearsEastern Cooperative Oncology Group (ECOG) =< 1Histologically confirmed diagnosis of CLL according to World Health Organization (WHO) classificationPrior COVID-19 Vaccination (2 or more Pfizer or Moderna) with last injection >= 3 months priorFully recovered from the acute toxic effects (except alopecia) to =< Grade 1 to prior anti-cancer therapyWhite Blood Cells (WBC) >= 1,000/mm^3 (To be performed within 14 days prior to Day 1 of protocol therapy)Platelets >= 50,000/mm^3 (To be performed within 14 days prior to Day 1 of protocol therapy)Total bilirubin =< 1.5 X upper limit of normal (ULN) (unless has Gilbert's disease) (To be performed within 14 days prior to Day 1 of protocol therapy)Aspartate aminotransferase (AST) =< 2.5 x ULN (To be performed within 14 days prior to Day 1 of protocol therapy)Alanine transaminase (ALT) =< 2.5 x ULN (To be performed within 14 days prior to Day 1 of protocol therapy)Creatinine clearance <1.5 ULN (To be performed within 14 days prior to Day 1 of protocol therapy)Women of childbearing potential (WOCBP): negative urine or serum pregnancy test (To be performed within 14 days prior to Day 1 of protocol therapy)If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be requiredAgreement by females and males of childbearing potential to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 6 weeks after the last vaccine injectionChildbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for > 1 year (women only)Exclusion Criteria:Known current SARS CoV-2 infectionPrior Evusheld or other anti-SARS CoV-2 prophylaxis < 2 weeks priorPrior hematopoietic cell transplantation (HCT) or chimeric antigen receptor (CAR) T cell therapy within the previous yearSystemic corticosteroids required for chronic conditions at doses > 0.5mg/kg/day prednisone equivalent within 7 days of enrollmentIntensive cytotoxic therapies, T-cell depleting therapies, within 30 days of enrollment; however, patients with stable disease on maintenance therapies are allowed (See ConMeds for lists of acceptable and contraindicated therapies)Participants who have had a live vaccine =< 30 days prior to administration of any dose of study vaccine or subjects who are =< 2 weeks within administration of inactivated vaccines (e.g., influenza vaccine). Flu shots are allowed > 2 weeks before a study vaccine injection and > 2 weeks post study vaccine injectionHistory of allergic reactions attributed to compounds of similar chemical or biologic composition to study agent (e.g., egg allergies)Active infection not controlled on appropriate therapyHistory of adverse event with a prior smallpox vaccinationHistory of pericarditis or myocarditisAny MVA vaccine or poxvirus vaccine in the last 12 monthsFemales only: Pregnant or breastfeedingAny other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study proceduresProspective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)