Table of ContentsView AllTable of ContentsOverviewRiskComplicationsVaccine EffectsTreatmentsStaying Safe
Table of ContentsView All
View All
Table of Contents
Overview
Risk
Complications
Vaccine Effects
Treatments
Staying Safe
Early statistics suggested that people withpolycythemia verawere at a higher risk of dying from COVID-19, but more recent research suggests otherwise.
However, it’s important to remember that research on the effects of COVID-19 and how it affects people with certain conditions is ongoing.
Verywell / Michela Buttignol
What Is Polycythemia Vera?
Polycythemia vera (PV)is a rare blood disorder in which there is an increase in all blood cells, including red blood cells. Increased blood cells make the blood thicker and can cause problems with blood flow, leading to blood clots, strokes, and tissue or organ damage.
The risk factors for PV include:
Polycythemia Vera and COVID-19 Risk
There is no definitive evidence showing that people with PV are at an increased risk of getting COVID-19. However, people who are being treated for the condition at a clinic or hospital may wonder whether it’s safe for them to go to their regular phlebotomy appointments.
Experts recommend that people with PV do not skip appointments if they require phlebotomytreatmentsto control the condition.
Some people might be able to transition to telehealth appointments if they are stable and if there’s a high rate of COVID-19 infection in their community.
Research suggests that people with blood cancers may have an elevated risk of dying from COVID-19.The increased risk makes sense because those with cancer are likely to have compromisedimmune systems.
One study found COVID-19 may cause secondary polycythemia vera, which results in an increased number of red blood cells and usually develops as a response to chronic hypoxemia. The study found secondary PV occurred more often in people who were older, male, and had severe COVID-19 symptoms.
Experts do not have enough information to say for sure whether there is a link between polycythemia vera and increased COVID-19 mortality. People with PV that has progressed tomyelofibrosismay have a higher risk of COVID-19 complications.
Myelofibrosis is a rare type of bone marrow cancer in which scarring (fibrosis) in thebone marrowprevents the bone marrow from producing the right number of blood cells.
There are reports that people with COVID-19 have experiencedblood clots.People with blood disorders, like PV, are already at higher risk for blood clots. Therefore, having both conditions at the same time may further increase their risk.However, more research is needed to understand a possible link.
A person’s risk for COVID-19 complications varies depending on many other factors including their age and whether they have other health conditions.
Effects of COVID Vaccine
Studies have shown that the current COVID-19 vaccines may be less effective in people with hematologic malignancies (blood cancers), which would include PV. Data indicates there is variability in the immune response to the vaccines in this population. The study authors note larger systematic reviews of COVID-19 vaccine adverse effects and outcomes are needed.
Although rare, adverse hematologic events have been reported after COVID-19 mRNA vaccination. However, none of these adverse events have included PV.
To date there are no studies looking at how COVID-19 or the vaccine affects red blood cell count specifically in people with PV.
A study of vaccinated and unvaccinated people aged 20 and older found the vaccine was associated with higher development of:
Nutritional anemia.With this type of anemia, you do not have enough red blood cells and/or your red blood cells do not function properly.
Aplastic anemia.A rare bone marrow condition in which the bone marrow stops making enough blood cells (red blood cells, white blood cells, and platelets).
Coagulation defects.Red blood cells can become abnormally sticky and cling to the lining of blood vessels, which may cause blood clots to form.
A case study and literature review reported three cases of mRNA vaccines causing autoimmune hemolytic anemia (AIHA). In addition to needing more research, the authors noted this is a very rare complication of the vaccine, and since post-vaccination AIHA is manageable, the advantages of immunization outweigh these rare risks.
Experts recommend getting the vaccine even if you have a condition such as polycythemia vera. The Centers for Disease Control and Prevention (CDC) recommends that anyone over the age of 12 get the vaccine, including people with cancer and compromised immune systems.Immune system health can vary among people with PV, but having polycythemia vera does not mean that a person has an unhealthy immune system.However, research regarding the effects and effectiveness of COVID vaccines in people with blood disorders is ongoing.
Experts recommend getting the vaccine even if you have a condition such as polycythemia vera. The Centers for Disease Control and Prevention (CDC) recommends that anyone over the age of 12 get the vaccine, including people with cancer and compromised immune systems.
Immune system health can vary among people with PV, but having polycythemia vera does not mean that a person has an unhealthy immune system.
However, research regarding the effects and effectiveness of COVID vaccines in people with blood disorders is ongoing.
Experts say that people with PV should keep up with their treatments—even if a person tests positive for COVID-19.Abruptly stopping treatments for PV is more likely to cause adverse effects than it is to raise a person’s risk of contracting COVID-19 or experiencing complications from the virus.
COVID-19 Treatment and Drug Interactions
The only reason to stop PV treatment is if a person gets COVID-19 and needs a treatment that would cause a drug interaction. If there’s any worry of drug interaction, such as with ruxolitinib, experts recommend lowering the dose rather than stopping the treatment abruptly.
Vaccines and Treatments
Phlebotomy treatments do not need to be altered for vaccines because there is no evidence that getting a COVID-19 vaccine right after or just before phlebotomy treatment is unsafe.
Experts recommend delaying chemotherapy until at least two weeks after a person gets their second dose of the COVID vaccine to ensure that they get its full protective effects. However, this delay is not absolutely necessary.
Your healthcare provider will let you know the best way for you to fit a COVID vaccination into your treatment schedule.
How to Stay Safe
It may feel scary to continue going to treatment appointments and doctor’s visits with COVID-19 variants still circulating. However, keep in mind that many hospitals and other health institutions are taking important precautions to keep staff and patients safe.
Summary
Emerging research suggests that people with polycythemia vera are not at a higher risk for COVID-19 infection or complications. Although there are very rare blood-related complications, it’s considered safe and recommended for people with PV to get COVID vaccines.
If you have concerns about in-person appointments or questions about getting a COVID vaccine, talk to your healthcare team. They can advise you about what is best for your health.
The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit ourcoronavirus news page.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Polycythemia vera.MPN Research Foundation.What is polycythemia vera (PV)?Cancer Connect.Ask the experts about COVID-19 and myeloproliferative neoplasms (MF-PV-ET).American Society of Hematology.COVID-19 and myeloproliferative neoplasms: Frequently asked questions.Buske C, Dreyling M, Alvarez-Larrán A, et al.Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus.ESMO Open. 2022;7(2):100403. doi:10.1016/j.esmoop.2022.100403Lucijanic M, Krecak I, Soric E, et al.Secondary polycythemia associated with covid-19 is associated with higher mortality but does not seem to affect thrombotic risk. Blood. 2023;142(Supplement 1):5217-5217. doi: 10.1182/blood-2023-190447Vahdat S.A review of pathophysiological mechanism, diagnosis, and treatment of thrombosis risk associated with COVID-19 infection.Int J Cardiol Heart Vasc. 2022;41:101068. doi:10.1016/j.ijcha.2022.101068Barbui T, De Stefano V, Alvarez-Larran A, et al.Among classic myeloproliferative neoplasms, essential thrombocythemia is associated with the greatest risk of venous thromboembolism during COVID-19.Blood Cancer J. 2021;11(2):21. doi:10.1038/s41408-021-00417-3Samadizadeh S, Masoudi M, Rastegar M, Salimi V, Shahbaz MB, Tahamtan A.COVID-19: Why does disease severity vary among individuals?Respir Med. 2021;180:106356. doi:10.1016/j.rmed.2021.106356Yazdani AN, DeMarco N, Patel P, et al.Adverse Hematological Effects of COVID-19 Vaccination and Pathomechanisms of Low Acquired Immunity in Patients with Hematological Malignancies. Vaccines (Basel). 2023 Mar 15;11(3):662. doi: 10.3390/vaccines11030662Choi HS, Kim MH, Choi MG, et al.Hematologic Abnormalities after COVID-19 Vaccination: A Large Korean Population-Based Cohort Study. Infectious Diseases (except HIV/AIDS); 2023. doi: 10.1101/2023.11.15.23298565American Society of Hematology.Anemia.Litvinov RI, Weisel JW.Role of red blood cells in haemostasis and thrombosis. ISBT Sci Ser. 2017 Feb;12(1):176-183. doi: 10.1111/voxs.12331Chaudhary MH, Yennam AK, Bojanki NLSVA, et al.Autoimmune hemolytic anemia secondary to covid-19 vaccine: a case report. Cureus. Published online October 8, 2023. doi: 10.7759/cureus.46678Barbui T, Vannucchi AM, Alvarez-Larran A, et al.High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib.Leukemia. 2021;35(2):485-493. doi:10.1038/s41375-020-01107-y
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Polycythemia vera.MPN Research Foundation.What is polycythemia vera (PV)?Cancer Connect.Ask the experts about COVID-19 and myeloproliferative neoplasms (MF-PV-ET).American Society of Hematology.COVID-19 and myeloproliferative neoplasms: Frequently asked questions.Buske C, Dreyling M, Alvarez-Larrán A, et al.Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus.ESMO Open. 2022;7(2):100403. doi:10.1016/j.esmoop.2022.100403Lucijanic M, Krecak I, Soric E, et al.Secondary polycythemia associated with covid-19 is associated with higher mortality but does not seem to affect thrombotic risk. Blood. 2023;142(Supplement 1):5217-5217. doi: 10.1182/blood-2023-190447Vahdat S.A review of pathophysiological mechanism, diagnosis, and treatment of thrombosis risk associated with COVID-19 infection.Int J Cardiol Heart Vasc. 2022;41:101068. doi:10.1016/j.ijcha.2022.101068Barbui T, De Stefano V, Alvarez-Larran A, et al.Among classic myeloproliferative neoplasms, essential thrombocythemia is associated with the greatest risk of venous thromboembolism during COVID-19.Blood Cancer J. 2021;11(2):21. doi:10.1038/s41408-021-00417-3Samadizadeh S, Masoudi M, Rastegar M, Salimi V, Shahbaz MB, Tahamtan A.COVID-19: Why does disease severity vary among individuals?Respir Med. 2021;180:106356. doi:10.1016/j.rmed.2021.106356Yazdani AN, DeMarco N, Patel P, et al.Adverse Hematological Effects of COVID-19 Vaccination and Pathomechanisms of Low Acquired Immunity in Patients with Hematological Malignancies. Vaccines (Basel). 2023 Mar 15;11(3):662. doi: 10.3390/vaccines11030662Choi HS, Kim MH, Choi MG, et al.Hematologic Abnormalities after COVID-19 Vaccination: A Large Korean Population-Based Cohort Study. Infectious Diseases (except HIV/AIDS); 2023. doi: 10.1101/2023.11.15.23298565American Society of Hematology.Anemia.Litvinov RI, Weisel JW.Role of red blood cells in haemostasis and thrombosis. ISBT Sci Ser. 2017 Feb;12(1):176-183. doi: 10.1111/voxs.12331Chaudhary MH, Yennam AK, Bojanki NLSVA, et al.Autoimmune hemolytic anemia secondary to covid-19 vaccine: a case report. Cureus. Published online October 8, 2023. doi: 10.7759/cureus.46678Barbui T, Vannucchi AM, Alvarez-Larran A, et al.High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib.Leukemia. 2021;35(2):485-493. doi:10.1038/s41375-020-01107-y
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Polycythemia vera.MPN Research Foundation.What is polycythemia vera (PV)?Cancer Connect.Ask the experts about COVID-19 and myeloproliferative neoplasms (MF-PV-ET).American Society of Hematology.COVID-19 and myeloproliferative neoplasms: Frequently asked questions.Buske C, Dreyling M, Alvarez-Larrán A, et al.Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus.ESMO Open. 2022;7(2):100403. doi:10.1016/j.esmoop.2022.100403Lucijanic M, Krecak I, Soric E, et al.Secondary polycythemia associated with covid-19 is associated with higher mortality but does not seem to affect thrombotic risk. Blood. 2023;142(Supplement 1):5217-5217. doi: 10.1182/blood-2023-190447Vahdat S.A review of pathophysiological mechanism, diagnosis, and treatment of thrombosis risk associated with COVID-19 infection.Int J Cardiol Heart Vasc. 2022;41:101068. doi:10.1016/j.ijcha.2022.101068Barbui T, De Stefano V, Alvarez-Larran A, et al.Among classic myeloproliferative neoplasms, essential thrombocythemia is associated with the greatest risk of venous thromboembolism during COVID-19.Blood Cancer J. 2021;11(2):21. doi:10.1038/s41408-021-00417-3Samadizadeh S, Masoudi M, Rastegar M, Salimi V, Shahbaz MB, Tahamtan A.COVID-19: Why does disease severity vary among individuals?Respir Med. 2021;180:106356. doi:10.1016/j.rmed.2021.106356Yazdani AN, DeMarco N, Patel P, et al.Adverse Hematological Effects of COVID-19 Vaccination and Pathomechanisms of Low Acquired Immunity in Patients with Hematological Malignancies. Vaccines (Basel). 2023 Mar 15;11(3):662. doi: 10.3390/vaccines11030662Choi HS, Kim MH, Choi MG, et al.Hematologic Abnormalities after COVID-19 Vaccination: A Large Korean Population-Based Cohort Study. Infectious Diseases (except HIV/AIDS); 2023. doi: 10.1101/2023.11.15.23298565American Society of Hematology.Anemia.Litvinov RI, Weisel JW.Role of red blood cells in haemostasis and thrombosis. ISBT Sci Ser. 2017 Feb;12(1):176-183. doi: 10.1111/voxs.12331Chaudhary MH, Yennam AK, Bojanki NLSVA, et al.Autoimmune hemolytic anemia secondary to covid-19 vaccine: a case report. Cureus. Published online October 8, 2023. doi: 10.7759/cureus.46678Barbui T, Vannucchi AM, Alvarez-Larran A, et al.High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib.Leukemia. 2021;35(2):485-493. doi:10.1038/s41375-020-01107-y
Johns Hopkins Medicine.Polycythemia vera.
MPN Research Foundation.What is polycythemia vera (PV)?
Cancer Connect.Ask the experts about COVID-19 and myeloproliferative neoplasms (MF-PV-ET).
American Society of Hematology.COVID-19 and myeloproliferative neoplasms: Frequently asked questions.
Buske C, Dreyling M, Alvarez-Larrán A, et al.Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus.ESMO Open. 2022;7(2):100403. doi:10.1016/j.esmoop.2022.100403
Lucijanic M, Krecak I, Soric E, et al.Secondary polycythemia associated with covid-19 is associated with higher mortality but does not seem to affect thrombotic risk. Blood. 2023;142(Supplement 1):5217-5217. doi: 10.1182/blood-2023-190447
Vahdat S.A review of pathophysiological mechanism, diagnosis, and treatment of thrombosis risk associated with COVID-19 infection.Int J Cardiol Heart Vasc. 2022;41:101068. doi:10.1016/j.ijcha.2022.101068
Barbui T, De Stefano V, Alvarez-Larran A, et al.Among classic myeloproliferative neoplasms, essential thrombocythemia is associated with the greatest risk of venous thromboembolism during COVID-19.Blood Cancer J. 2021;11(2):21. doi:10.1038/s41408-021-00417-3
Samadizadeh S, Masoudi M, Rastegar M, Salimi V, Shahbaz MB, Tahamtan A.COVID-19: Why does disease severity vary among individuals?Respir Med. 2021;180:106356. doi:10.1016/j.rmed.2021.106356
Yazdani AN, DeMarco N, Patel P, et al.Adverse Hematological Effects of COVID-19 Vaccination and Pathomechanisms of Low Acquired Immunity in Patients with Hematological Malignancies. Vaccines (Basel). 2023 Mar 15;11(3):662. doi: 10.3390/vaccines11030662
Choi HS, Kim MH, Choi MG, et al.Hematologic Abnormalities after COVID-19 Vaccination: A Large Korean Population-Based Cohort Study. Infectious Diseases (except HIV/AIDS); 2023. doi: 10.1101/2023.11.15.23298565
American Society of Hematology.Anemia.
Litvinov RI, Weisel JW.Role of red blood cells in haemostasis and thrombosis. ISBT Sci Ser. 2017 Feb;12(1):176-183. doi: 10.1111/voxs.12331
Chaudhary MH, Yennam AK, Bojanki NLSVA, et al.Autoimmune hemolytic anemia secondary to covid-19 vaccine: a case report. Cureus. Published online October 8, 2023. doi: 10.7759/cureus.46678
Barbui T, Vannucchi AM, Alvarez-Larran A, et al.High mortality rate in COVID-19 patients with myeloproliferative neoplasms after abrupt withdrawal of ruxolitinib.Leukemia. 2021;35(2):485-493. doi:10.1038/s41375-020-01107-y
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