BNT162b2 COVID-19 vaccine is significantly less effective in patients with hematologic malignancies

Katrin Herzog Tzarfati, Odit Gutwein, Arie Apel, Naomi Rahimi-Levene, Maya Sadovnik, Lotem Harel, Patricia Benveniste-Levkovitz, Adina Bar Chaim, Maya Koren-Michowitz*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


Patients with hematologic malignancies have an increased risk of severe COVID-19 infection. Vaccination against COVID-19 is especially important in these patients, but whether they develop an immune response following vaccination is unknown. We studied serologic responses to the BNT162b2 vaccine in this population. A lower proportion of patients were seropositive following vaccination (75%) than in a comparison group (99%; p < 0.001), and median (interquartile range [IQR]) antibody titers in patients were lower (90 [12.4–185.5] and 173 [133–232] AU/ml, respectively; p < 0.001). Older age, higher lactate dehydrogenase, and number of treatment lines correlated with lower seropositivity likelihood and antibody titers, while absolute lymphocyte count, globulin level, and time from last treatment to vaccination correlated with higher seropositivity likelihood and antibody titers. Chronic lymphocytic leukemia patients had the lowest seropositivity rate followed by indolent lymphoma. Patients recently treated with chemo-immunotherapy, anti-CD20 antibodies, BCL2, BTK or JAK2 inhibitors had significantly less seropositive responses and lower median (IQR) antibody titers (29%, 1.9 [1.9–12] AU/ml; 0%, 1.9 [1.9–1.9] AU/ml; 25%, 1.9 [1.9–25] AU/ml; 40%, 1.9 [1.9–92.8] AU/ml; and 42%, 10.9 [5.7–66.4] AU/ml, respectively; p < 0.001). Serological response to BNT162b2 vaccine in patients with hematologic malignancies is considerably impaired, and they could remain at risk for severe COVID-19 infection and death.

Original languageEnglish
Pages (from-to)1195-1203
Number of pages9
JournalAmerican Journal of Hematology
Issue number10
StatePublished - 1 Oct 2021


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