Table 2.

Implications of findings for COVID-19 vaccination guidelines

Condition	Advice
Myeloid malignancies	Do not postpone vaccination during chemotherapy or therapy with TKI
	Antibody responses are less during hypomethylating or ruxolitinib therapy
Lymphoid malignancies	Do not postpone vaccination during active treatment of multiple myeloma
	Effective B-cell–depleting therapy precludes generation of antibody responses, although B-cell numbers do not need to be normalized to generate sufficient antibody concentrations
	Do not interrupt B-cell–depleting therapy for vaccination as B-cell reconstitution to levels sufficient for the generation of antibody responses takes at least 8 mo
	Ibrutinib and venetoclax hamper potent antibody responses
Autologous HCT	Multiple myeloma: vaccination is immunogenic immediately after autologous HCT
	B-NHL: sufficient antibody responses cannot be generated<8 mo after autologous HCT
Allogeneic HCT	Vaccination can be immunogenic as early as 4 mo after allogeneic HCT
	Vaccination is immunogenic in most patients with cGVHD
CAR T-cell therapy	Effective B-cell–depleting therapy precludes generation of antibody responses
Sickle cell disease	Vaccination is immunogenic despite functional asplenia and the use of hydroxyurea
Determinants of response	IgG4 concentration, B- and NK-cell numbers, number of immunosuppressants used

Conclusions are based on S1 IgG concentrations obtained 4 wk after the standard 2-dose mRNA-1273 vaccination schedule given 28 d apart. Other markers of immunogenicity, such as antigen-specific T-cell responses, are not taken into consideration here.