Rebecca Rooks

Pronouns

She/Her/Hers

Job Title

Research Assistant II

Academic Rank

Department

Medicine

Authors

Rebecca Rooks, Natalie Izaguirre, Urwah Kanwal, Omolola Ometoruwa, Xiaofang Li, Kimberly Dufresne, Lindsey Baden, M.D., Nicolas Issa, M.D., and Amy Sherman, M.D.

Principal Investigator

Nicolas Issa

Research Category: COVID-19

Temporal relationships between COVID-19 vaccinations and SARS-CoV-2 infections in patients with lymphoid malignancies

Scientific Abstract

Background: Immunocompromised individuals, such as those diagnosed with hematologic malignancies, show reduced immune responses to COVID-19 vaccination and higher rates of poor outcomes from COVID-19 infection.

Methods: 75 patients with hematologic malignancies at Dana-Farber Cancer Institute were consented from January 4th, 2021 to August 25th, 2022. Blood samples were drawn every 2 months for each patient, and demographic information, COVID-19 vaccine histories, and SARS-CoV-2 infections were collected from the electronic medical record to assess temporal relationships between vaccinations and subsequent infections. SARS-CoV-2 infection was assessed by either a positive PCR or reported history.

Results: 16/75 (21.3%) patients reported SARS-CoV-2 infections between their first COVID-19 vaccination and August 25th, 2022. 14/16 (87.5%) became infected once, 1/16 twice, and 1/16 three times. The median time from receipt of first vaccination to first COVID-19 infection was 458.0 days (IQR 343.50-516.00) and from receipt of last vaccination to first COVID-19 infection was 160.5 days (IQR 62.50-275.75).

Conclusions: In this cohort, SARS-CoV-2 infections generally occurred about five months after last vaccination, suggesting waning of vaccine-induced immunity over time and/or reduced protection against later variants of concern. Future work will evaluate host characteristics that may increase risk of infection in this vulnerable population.

Lay Abstract

Background: Individuals with compromised immune systems, such as those diagnosed with hematologic malignancies like lymphoma, show less of an immune response to COVID-19 vaccinations and poorer outcomes from COVID-19 infection than healthy individuals.

Methods: 75 patients with hematologic malignancies at Dana-Farber Cancer Institute were consented from January 4th, 2021 to August 25th, 2022. Blood samples were drawn every 2 months for each patient, and demographic information, COVID-19 vaccine histories, and SARS-CoV-2 infection data were collected to assess relationships between vaccinations and subsequent infections. SARS-CoV-2 infection was assessed by either a positive PCR or reported history.

Results: 16 of the 75 patients in the cohort (21.3%) reported SARS-CoV-2 infections between their first COVID-19 vaccination and August 25th, 2022. The median time from receipt of first vaccination to first COVID-19 infection was 458.0 days (1 year and 3 months) and from receipt of last vaccination to first COVID-19 infection was 160.5 days (5 months and 1 week).

Conclusions: In this cohort, SARS-CoV-2 infections generally occurred about five months after last vaccination, suggesting waning of vaccine-induced immunity over time and/or reduced protection against later SARS-CoV-2 variant strains. Future work will evaluate other factors that may increase risk of infection in this vulnerable population.

Clinical Implications

This research will help inform COVID-19 vaccination policy and decision making for those with hematologic malignancies by outlining the waning of immunity as seen from the average time between most recent vaccination and first infection of patients in our cohort.

Temporal relationships between COVID-19 vaccinations and SARS-CoV-2 infections in patients with lymphoid malignancies

Scientific Abstract

Lay Abstract

Clinical Implications

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