COVID-19 Vaccine Effectiveness in Patients With Hematologic Malignancies: A Nationwide Cohort Study
Hofsink, Quincy Lissenberg-Witte, Birgit I Haggenburg, Sabine Goorhuis, Abraham Hazenberg, Mette D Rutten, Caroline E den Tex, Paul de Vries, Elisabeth GE van der Veldt, Astrid AM Kemmeren, Jeanet M
Hofsink, Quincy
Lissenberg-Witte, Birgit I
Haggenburg, Sabine
Goorhuis, Abraham
Hazenberg, Mette D
Rutten, Caroline E
den Tex, Paul
de Vries, Elisabeth GE
van der Veldt, Astrid AM
Kemmeren, Jeanet M
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2026-02-18
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
COVID-19 Vaccine Effectiveness in Patients With Hematologic Malignancies: A Nationwide Cohort Study
Translated Title
Published in
J Infect Dis 2026; 233(2):e363-e372
Abstract
BACKGROUND: In patients with hematologic malignancies, COVID-19 vaccine effectiveness is unknown and determinants of severe COVID-19 lack granularity.
METHODS: To identify determinants of SARS-CoV-2 infection outcome we conducted a population-based, nationwide cohort study, including all adult Dutch residents who tested positive for SARS-CoV-2 between 1 June 2020, and 31 March 2022. Individuals were classified as having a (history of) hematologic malignancy, solid malignancy, or no malignancies. Primary outcome was severe COVID-19, defined as COVID-19-related hospitalization or death following first SARS-CoV-2 infection.
RESULTS: Among 4 649 341 included individuals, those with hematologic malignancies were at highest risk of severe COVID-19. Vaccine effectiveness against severe COVID-19 in patients with hematologic malignancies was up to 74% (95% CI, 60% to 83%), depending on the SARS-CoV-2 variant period, the number of received vaccinations, and the time interval since vaccination. Risk of severe COVID-19 was highest for patients with recently diagnosed hematologic malignancies and declined over time, except for patients with chronic hematologic malignancies. Risk of severe COVID-19 tended to be higher in patients on tumor-specific treatment such as CD38 and CD20 antibodies, proteasome inhibitors, and protein kinase inhibitors.
CONCLUSIONS: COVID-19 vaccination lowered the risk of severe COVID-19 in SARS-CoV-2-infected patients with hematologic malignancies, although these patients remained at elevated risk compared with others. Determinants of severe COVID-19 included type of malignancy, time interval between malignancy diagnosis and SARS-CoV-2 infection, and treatment. These data can guide healthcare professionals in designing additional prevention and therapeutic strategies against respiratory virus infections for patients with hematologic malignancies.