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Leo I. Gordon, MD, FACP


Risk of COVID-19 Breakthrough Infections in Vaccinated Patients With Hematologic Cancer

By: Kayci Reyer
Posted: Friday, May 27, 2022

Among patients with cancer who have been vaccinated against COVID-19, breakthrough infections and severe outcomes are more likely for those with hematologic cancer versus solid tumors, according to research presented in the Journal of Clinical Oncology, although vaccination lowered the overall risk of COVID-19. Jing Su, PhD, of the Indiana University School of Medicine, and colleagues also observed a strong association between risk for breakthrough infection and immunosuppressive therapies and/or bone marrow transplantation.

“The COVID pandemic provides a unique opportunity for us to screen the immune competence among all cancer patients at a national level,” noted Dr. Su in a university press release. “We could use this to imitate the differential immune capacities among cancer patients. This could guide us to better understand whether cancer patients will have good responses to cancer vaccines and if they are at a higher risk of infection of other viruses, such as the flu.”

The study identified 6,860 breakthrough cases of COVID-19 that occurred between December 2020, and May 2021, among fully or partially vaccinated individuals within the National COVID Cohort Collaborative population. Of those cases, 1,460 (21.3%) were patients with cancer, a group that had a substantially higher risk for breakthrough infection and severe outcomes compared with patients without cancer. Patients with hematologic cancers were at a particularly increased risk for breakthrough infections versus those with solid tumors. However, the overall risk of breakthrough infection was reduced for patients with cancer following receipt of the second dose of the vaccine. Notably, patients who received the Moderna mRNA-1273 vaccine versus the Pfizer BNT162b2 vaccine experienced a lower breakthrough risk. This effect was heightened for patients with multiple myeloma.

Disclosure: For full disclosures of the study authors, visit

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