LAUSR

The COVID-19 pandemic has led to heroic achievements in vaccine development targeting the spike protein of SARS-CoV-2. Importantly, the vaccine produces neutralizing antibodies (Abs) and induces a T-cell response against the spike protein; however, there are no approved tests to assess the T-cell-mediated immune and protective response against COVID-19 and there is no correlation between the antibody level and protection against the virus. During the early COVID-19 vaccine trials, patients with cancer were generally excluded from the studied populations [1]. Nonetheless, given the increased mortality rate of up to 13% of patients with cancer and COVID19 infection and the worrisome complications including delays in cancer treatment, the National Comprehensive Cancer Network and other oncologic societies, such as the American Society of Clinical Oncology and European Society for Medical Oncology, have recommended the COVID-19 vaccine to patients with active cancer regardless of therapy [2–4]. Multiple cohorts have now been examined, and a recent study evaluating the efficiency of the mRNA COVID-19 vaccine in patients with hematological malignancies found that patients who were actively receiving BTKIs, ruxolitinib, venetoclax or anti-CD20 antibody therapies mounted a blunt vaccine-immune response, were unprotected from the SARS-CoV-2 infection and could still develop severe and critical disease [5]. Similar studies show the reduced mRNA vaccine immunogenicity in patients receiving immunosuppressive medications, such as rituximab or mycophenolate, and in patients with liquid tumors [6].