Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec:159:259-274.
doi: 10.1016/j.ejca.2021.10.013. Epub 2021 Oct 25.

Evaluation of COVID-19 vaccine response in patients with cancer: An interim analysis

Affiliations
Review

Evaluation of COVID-19 vaccine response in patients with cancer: An interim analysis

Son Tran et al. Eur J Cancer. 2021 Dec.

Abstract

Background: Efficacy and safety data of COVID-19 vaccines among cancer populations have been limited; however, preliminary data from recent studies have emerged regarding their immunogenicity and safety in this population. In this review, we examined current peer-reviewed publications containing serological and safety data after COVID-19 vaccination of patients with cancer.

Methods: This analysis examined 21 studies with a total of 5012 patients with cancer, of which 2676 (53%) had haematological malignancies, 2309 (46%) had solid cancers and 739 were healthy controls. Serological responses by anti-SARS-CoV-2 spike protein S1/S2 immunoglobulin G antibody levels and post-vaccination patient questionnaires regarding vaccine-related side-effects after the first and second dose were collected and analysed.

Results: In general, a single dose of the COVID-19 vaccine yields weaker and heterogeneous serological responses in both patients with haematological and solid malignancies. On receiving a second dose, serological response rates indicate a substantial increase in seropositivity to the SARS-CoV-2 spike protein in all cancer cohorts, but antibody titres remain reduced in comparison with healthy controls. Furthermore, seroconversion in patients with haematological malignancies was significantly lower than that in patients with solid tumours. COVID-19 vaccines are safe and well-tolerated in patients with cancer based on current data of local and systemic effects.

Conclusion: Together, these data support the prioritisation of patients with cancer to receive their first and second doses to minimise the risk of COVID-19 infection and severe complications in this vulnerable population. Additional prophylactic measures must be considered for high-risk patients where current vaccination programs may not mount sufficient protection against SARS-CoV-2 infection.

Keywords: COVID-19; COVID-19 vaccines; Immunity; Neoplasms; SARS-CoV-2; Seroconversion.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

Figures

Fig. 1
Fig. 1
Boxplots of positive serological response rates (%) by disease group (A) after partial COVID-19 vaccination (first dose) or (B) after complete COVID-19 vaccination (second dose). The detection thresholds for positive anti-S IgG antibodies are dependent on the biochemical assay used in each study, which are indicated in Table 2, Table 3. Each point indicates a study cohort where data were available. Pairwise comparisons are based on the non-parametric Mann-Whitney U independent-samples test. anti-S IgG, anti–SARS-CoV-2 spike protein S1/S2 immunoglobulin G.
Fig. 2
Fig. 2
Local and systemic toxicities reported after injection of COVID-19 vaccines in patients with cancer. (A) Breakdown of specific local and systemic effects after partial (first dose) and complete (second dose) vaccination. (B) Breakdown of severity of side-effects exhibited after vaccination. Symptoms were assessed as per the following scale: mild (does not interfere with activity), moderate (interferes with activity) and severe (prevents daily activity). Each point indicates a study cohort where data were available; the error bars represent the SD of the mean for each category. SD, standard deviation.

References

    1. WHO Coronavirus Disease (COVID-19) Dashboard 2021. https://covid19.who.int/
    1. Scarfò L., Chatzikonstantinou T., Rigolin G.M., Quaresmini G., Motta M., Vitale C., et al. COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus. Leukemia. 2020;34:2354–2363. doi: 10.1038/s41375-020-0959-x. - DOI - PMC - PubMed
    1. Cook G., John Ashcroft A., Pratt G., Popat R., Ramasamy K., Kaiser M., et al. Real-world assessment of the clinical impact of symptomatic infection with severe acute respiratory syndrome coronavirus (COVID-19 disease) in patients with multiple myeloma receiving systemic anti-cancer therapy. Br J Haematol. 2020;190:e83–e86. doi: 10.1111/bjh.16874. - DOI - PMC - PubMed
    1. Kuderer N.M., Choueiri T.K., Shah D.P., Shyr Y., Rubinstein S.M., Rivera D.R., et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395:1907–1918. doi: 10.1016/S0140-6736(20)31187-9. - DOI - PMC - PubMed
    1. Hultcrantz M., Richter J., Rosenbaum C.A., Patel D., Smith E.L., Korde N., et al. COVID-19 infections and clinical outcomes in patients with multiple myeloma in New York city: a cohort study from five academic centers. Blood Cancer Discov. 2020;1:234–243. doi: 10.1158/2643-3230.bcd-20-0102. - DOI - PMC - PubMed

MeSH terms