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Prashant Kapoor, MD, FACP


Are Fully Vaccinated Patients With Myeloma Likely to Experience Breakthrough COVID-19 Infections?

By: Kayci Reyer
Posted: Monday, February 14, 2022

According to a research letter presented in JAMA Network Open, patients with multiple myeloma fully vaccinated against SARS–CoV-2 (COVID-19) are at an increased risk for breakthrough infection. Rong Xu, PhD, FACMI, of Case Western Reserve University in Cleveland, and colleagues found that breakthrough infections in this population were associated with an increased risk for hospitalization. Nathan A. Berger, MD, also of Case Western Reserve University, is co-corresponding author of this study.

The study included data from 507,288 patients who had been fully vaccinated against COVID-19 between December 1, 2020, and October 8, 2021; had not previously been infected with the virus; and had received medical care more recently than December 1, 2020. Of the 1,182 patients with multiple myeloma, 88.7% had never achieved remission and 11.7% were in relapse. Treatment types experienced by this population included chemotherapy (60.0%), targeted therapy (50.3%), stem cell transplantation (26.5%), and radiation therapy (12.1%).

The risk of breakthrough infection was 15.4% for patients with multiple myeloma versus 3.9% for patients without the disease. Overall, breakthrough infections occurred in 187 patients with multiple myeloma. At the time of data cutoff, the estimated probability for hospitalization was significantly higher for patients with multiple myeloma (34.4% vs. 4.5%). After the investigators adjusted propensity scores for factors such as demographics, comorbidities, and vaccine types, they found that patients with multiple myeloma remained substantially more likely to experience breakthrough infections versus matched participants without multiple myeloma (hazard ratio [HR] = 1.34; 95% confidence interval [CI] = 1.06–1.69).

“These findings raise consideration for the development and implementation of enhanced mitigation strategies and the need for studies to evaluate the timing and impact of vaccine boosters in this unique, immunosuppressed population,” concluded the study authors.

Disclosure: For full disclosures of the study authors, visit

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