Third primary SARS-CoV-2 mRNA vaccines enhance antibody responses in most patients with haematological malignancies

• DOI: 10.1038/s41467-022-34657-z
• Publication Date: 2022-11-14T17:03:23Z
• Authors: Lucy B. Cook; Gillian O’Dell; Eleni Vourvou; Renuka Palanicawa...; Sasha Marks; Dragana Milojkovic; Jane F. Apperley; Sandra Loaiza; Simone Claudiani; Marco Bua; Catherine Hockings; Donald Macdonald; Aris Chaidos; Jiri Pavlu; Nichola Cooper; Sarah Fidler; Paul Randell; Andrew J. Innes
• Keywords: 0301 basic medicine; Science & Technology; COVID-19 Vaccines; SARS-CoV-2; Science; Q; 610; COVID-19; Viral Vaccines; Antibodies, Viral; CANCER; Antibodies; Article; 3. Good health; Multidisciplinary Sciences; 03 medical and health sciences; Hematologic Neoplasms; Antibody Formation; Science & Technology - Other Topics; Humans; Viral; mRNA Vaccines

AbstractSARS-CoV-2 infection, and resulting disease, COVID-19, has a high mortality amongst patients with haematological malignancies. Global vaccine rollouts have reduced hospitalisations and deaths, but vaccine efficacy in patients with haematological malignancies is known to be reduced. The UK-strategy offered a third, mRNA-based, vaccine as an extension to the primary course in these patients. The MARCH database is a retrospective observational study of serological responses in patients with blood disorders. Here we present data on 381 patients with haematological malignancies. By comparison with healthy controls, we report suboptimal responses following two primary vaccines, with significantly enhanced responses following the third primary dose. These responses however are heterogeneous and determined by haematological malignancy sub-type and therapy. We identify a group of patients with continued suboptimal vaccine responses who may benefit from additional doses, prophylactic extended half-life neutralising monoclonal therapies (nMAB) or prompt nMAB treatment in the event of SARS-CoV-2 infection.