Loss of Anti-Spike Antibodies Following mRNA Vaccination for COVID-19
Among Patients with Multiple Myeloma
Abstract
Background Multiple myeloma (MM) patients have variable
responses to mRNA vaccination to COVID-19. Little is known regarding
their vaccine-induced antibody levels over time. Methods We
monitored spike IgG antibody levels over 24 weeks among a subset of 18
MM patients who showed a full response after two mRNA vaccinations. MM
patients had a more rapid decline in antibody levels as compared to 8
healthy controls, with power law half-lives of 72 days (versus 107 days)
and exponential half-lives of 37 days (versus 51 days). Results
The patients with longer SARS-CoV-2 antibody half-lives were more likely
to have undetectable monoclonal protein than those with shorter
half-lives, suggesting better disease control may correlate with longer
duration of vaccine-induced antibodies. Regardless, by 16 weeks
post-second dose of mRNA vaccination, the majority of patients had
antibody levels below 250 binding arbitrary units per milliliter, which
would be unlikely to contribute significantly to preventing COVID-19.
Conclusions Thus, even MM patients who respond adequately to
vaccination are likely to require more frequent booster doses than the
general population.