By Peter A. McCullough, MD, MPH
My very frail patients with hematologic malignancies such as chronic myeloid and lymphocytic leukemias have asked me if there are safer alternatives than COVID-19 vaccination. This study by Salvini and colleagues demonstrated that fortunately later in the pandemic with the milder Omicron strains despite being highly prevalent, rarely resulted serious COVID-19 illness. The study group was 100% vaccinated with one of the failed vaccine products, however the time from the last injection was not reported and the authors failed to disclose prior infection as a proxy for natural immunity. The investigators must have lost faith in the vaccines and hence the decision to give the long-acting tixagevimab-cilgavimab monoclonal antibody combination.
“At data cutoff (March 1, 2023), the rate of breakthrough infections was 28 of 130 (21%) among patients exposed to tixagevimab-cilgavimab vs 28 of 74 (38%) in the control group (P = .01). The incidence of COVID-19 was 13.8 per 10000 person-days in the tixagevimab-cilgavimab group vs 28.0 in the control arm (hazard ratio [HR], 0.47; 95%CI, 0.27-0.81; P = .01). Administration of tixagevimab-cilgavimab was associated with a significant reduction in the incidence of severe or critical COVID-19 (1.4 vs 4.0 per 10 000 person days; HR, 0.18; 95% CI, 0.03-0.99; P = .0495). Need for hospitalization was also significantly lower in patients receiving prophylactic tixagevimab-cilgavimab (1.3 vs 4.0 per 10 000 person-days; HR, 0.19; 95% CI, 0.04-0.91; P = .04) (Table).”
