Thus, COVID-19 is particularly challenging for patients with critical organ involvement by amyloidosis.1,2 Vaccination against SARS-CoV-2 is the best strategy to avoid severe COVID-19, however, response to vaccines may be compromised in patients with plasma cell malignancies or other B-cell lymphoproliferative disorders.3,4 In patients with ATTR such a clone does not exist, but other factors could affect response to vaccination. The gene discussed is TTR; the disease is COVID-19.