Colin Powell’s Passing Highlights The Need For More People To Get Vaccinated

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Colin Powell has died of Covid-19 complications according to his family, who posted the news on Facebook this morning. The ex-secretary of State was 84 and was reportedly fully vaccinated against Covid-19. Within minutes of the death, people on social media were asking questions such as: “if he was vaccinated, why did he die from Covid-19?” and the news was being used by some to erroneously suggest that Powell’s death was proof that vaccines don’t work. This is not accurate or correct.

Firstly, Powell was 84 when he passed and it is well known that older people do not produce as much of an immune response to Covid-19 vaccines as those who are younger. So, although older individuals who are vaccinated are still less likely to experience severe, or fatal outcomes from Covid-19, severe illness and deaths do still occur. Even in vaccinated younger people, severe outcomes and deaths do occur, just far more rarely than in unvaccinated people.

Secondly, as reported by NBC and others, Powell had a type of cancer called multiple myeloma, a type of blood cancer which can sometimes be controlled for several years using chemotherapy, radiotherapy and immunotherapy treatments. A wealth of new treatments for multiple myeloma have been approved recently, including innovative cellular therapies such as CAR T cells, but multiple myeloma is still largely considered an incurable, chronic cancer.

People with blood cancers are now well-known to be at a higher risk of severe outcomes should they have Covid-19 and people with multiple myeloma are no exception. A key reason for this is that multiple myeloma affects white blood cells, which build up and form tumors in bones and other places in the body where they should not be. This, unsurprisingly means that people with multiple myeloma have a reduced ability to fight off infection.

“While General Powell was fully vaccinated against Covid-19, he had undergone treatment for multiple myeloma, an incurable form of blood cancer. His disease and his age made him more vulnerable to breakthrough Covid-19 infection, complications, and death,” said Dr. Gwen Nichols, Chief Medical Officer of The Leukemia & Lymphoma Society. 

Thirdly, it has not been revealed what treatment Powell was receiving for his multiple myeloma, but several chemotherapy and immunotherapy drugs are also known to suppress the immune system to varying degrees and hence influence the ability of an individual to fight off a Covid-19 infection. For example, CAR T cells approved for multiple myeloma treatment specifically target a protein called BCMA found on white blood cells called B-cells, honing in on them and killing them. B-cells are the immune cells which produce antibodies to orchestrate the immune response, so suppressed B cells would greatly reduce the ability of a person to fight off any infection, including Covid-19.

Lastly and perhaps most importantly, people with blood cancers are known to have a reduced response to Covid-19 vaccines, both due to the cancer itself and cancer treatments they might be receiving. Powell was reportedly fully vaccinated, but depending on the specifics of his multiple myeloma and the treatments which he may have been on for his cancer, it is likely that he had a reduced response to his Covid-19 vaccines. In one study of 103 multiple myeloma patients from July this year, over half of the patients failed to mount an effective immune response to Covid-19 mRNA vaccines.

“Covid-19 vaccines are safe and provide protection to most blood cancer patients, but some will not mount a full antibody response, which is why it’s important to keep taking other precautions like wearing masks and social distancing,” said Nichols.

The CDC recommends booster shots for immunocompromised people including those with blood cancer. Early studies have shown that some immunocompromised people who don’t have much of an antibody response to initial Covid-19 vaccines do benefit from a booster shot of the vaccine.

Powell had an underlying medical condition which likely influenced his ability to fight off Covid-19, but his death should not be brushed off as less significant because of this. If anything it is more of a tragedy, as people such as Powell who have medical conditions which may inhibit their response to both Covid-19 and protective vaccines are more reliant on others to keep them safe. This can best be achieved by people getting vaccinated and by keeping community levels of Covid-19 low via sensible public health measures.

“General Powell’s death is a stark reminder of the importance of vaccination for everyone. By getting vaccinated, those with normal immunity can reduce the risk that they transmit Covid-19 to those whose immunity is impaired,” said Nichols.

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