12th July 2021 // Caroline Donoghue
Last week results from a study measuring the effectiveness of COVID-19 vaccines in people with a high risk of severe COVID-19 infection were published by Public Health England (PHE).
This study was a large nationwide study that used electronic patient data from over 1 million people to understand more about vaccine effectiveness.
It provides the first data about the level of protection COVID-19 vaccines give clinically high-risk patients. It gives us more information about how well the vaccines have worked for people with diabetes, severe asthma, chronic heart disease, chronic kidney disease, chronic liver disease, neurological disease and immunosuppression (weakened immune systems).
The results indicate that vaccines were effective for most clinically high-risk patients. The Pfizer-BioNTech vaccine was 89% effective and the Oxford-AstraZeneca vaccine 80% effective for those aged 65 and over.
It also indicates that vaccine effectiveness in immunosuppressed patients was much higher after the second dose. The results reported that the vaccines were 74% effective after the second dose compared to 4% after the first dose.
This study gives us a general idea about how vaccines work in a wide range of clinically high-risk patients.
It tells us that two doses of the vaccine provide better protection than one and that the second dose is particularly important for people with immunosuppression.
However, it also tells us the vaccine is not 100% effective and that some patients in the clinically high-risk groups still get COVID-19 after receiving both doses of a COVID-19 vaccine.
The study doesn’t tell us how effective the vaccines are for myeloma patients.
When the researchers refer to immunosuppressed people, they are not talking exclusively about myeloma patients or even blood cancer patients: they are referring to any person defined as immunosuppressed on their electronic patient record. Therefore, the group of patients in the immunosuppressed group could include cancer patients on treatment, people with HIV or people with autoimmune diseases, and might not include any myeloma patients.
It also doesn’t tell us anything about the patients for whom the vaccines were less effective: The people who got COVID-19 following vaccination. So, it can’t tell is who is more or less likely to respond to COVID-19 vaccines and why.
Whilst it is encouraging to see data about the protection vaccines give clinically high-risk groups, it doesn’t really change anything for the myeloma community. It simply doesn’t answer the questions most important to myeloma patients.
Vaccine efficacy in myeloma is nuanced and to truly understand how well the COVID-19 vaccines work in myeloma patients we need more myeloma specific research.