Immune responses to COVID-19 booster vaccinations in intensively anti-CD38 antibody treated patients with ultra-high-risk multiple myeloma: results from the Myeloma UK (MUK) nine OPTIMUM trial.

Multiple myeloma (MM) and anti-MM therapy cause profound immunosuppression, leaving patients vulnerable to coronavirus disease 2019 (COVID-19) and other infections. We investigated anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies longitudinally in ultra-high-risk patients with MM receiving risk-adapted, intensive anti-CD38 combined therapy in the Myeloma UK (MUK) nine trial. Despite continuous intensive therapy, seroconversion was achieved in all patients, but required a greater number of vaccinations compared to healthy individuals, highlighting the importance of booster vaccinations in this population. Reassuringly, high antibody cross-reactivity was found with current variants of concern, prior to Omicron subvariant adapted boostering. Multiple booster vaccine doses can provide effective protection from COVID-19, even with intensive anti-CD38 therapy for high-risk MM.

The COVID-19 crisis and policy responses by continental European welfare states.

Social protection in Germany, Belgium and the Netherlands share Bismarckian roots. Over time, these welfare states were however in constant flux and incorporated to a greater or lesser extend elements of both the Anglo-Saxon and Nordic models. While the Netherlands has from the beginning deviated from the Bismarckian model, in recent years this welfare state has undergone important reforms that have made it increasingly evolve into a "Bismarck cum Beveridge" model. Germany and Belgium also witnessed a dual transformation, with retrenched earnings-related benefits for long-term unemployed and an increasing number of atypically employed people on the one hand and expanded social security to the so-called "new social risks" on the other. It is against this changing institutional background that we can understand the similarities and differences in the extent to which these three continental welfare states used traditional social insurance systems to buffer the social and economic consequences of confinement. First, all three countries strengthened to varying degrees social protection systems for the active age population. So conceived, the policy responses were a response to the dual transformation of social protection that took place in recent decades without, however, changing its course. Second, the extent to which continental welfare states made use of existing social insurance schemes seems to be related to the extent to which these welfare states have moved in the Anglo-Saxon direction.