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Review
. 2022 Nov 16;14(22):5630.
doi: 10.3390/cancers14225630.

Cancer Patients and the COVID-19 Vaccines: Considerations and Challenges

Muna Almasri  1 , Khalifa Bshesh  1 , Wafa Khan  1 , Malik Mushannen  1 , Mohammad A Salameh  1   2 , Ameena Shafiq  1   3 , Ahamed Lazim Vattoth  1 , Nadine Elkassas  4 , Dalia Zakaria  5
Affiliations
Review

Cancer Patients and the COVID-19 Vaccines: Considerations and Challenges

Muna Almasri et al. Cancers (Basel). .

Abstract

Few guidelines exist for COVID-19 vaccination amongst cancer patients, fostering uncertainty regarding the immunogenicity, safety, and effects of cancer therapies on vaccination, which this review aims to address. A literature review was conducted to include the latest articles covering the immunogenicity and safety of COVID-19 vaccination in patients with solid and hematologic cancers receiving various treatments. Lower seropositivity following vaccination was associated with malignancy (compared to the general population), and hematologic malignancy (compared to solid cancers). Patients receiving active cancer therapy (unspecified), chemotherapy, radiotherapy, and immunosuppressants generally demonstrated lower seropositivity compared to healthy controls; though checkpoint inhibition, endocrine therapy, and cyclin dependent kinase inhibition did not appear to affect seropositivity. Vaccination appeared safe and well-tolerated in patients with current or past cancer and those undergoing treatment. Adverse events were comparable to the general population, but inflammatory lymphadenopathy following vaccination was commonly reported and may be mistaken for malignant etiology. Additionally, radiation recall phenomenon was sporadically reported in patients who had received radiotherapy. Overall, while seropositivity rates were decreased, cancer patients showed capacity to generate safe and effective immune responses to COVID-19 vaccination, thus vaccination should be encouraged and hesitancy should be addressed in this population.

Keywords: COVID-19; cancer; cancer therapies; immunogenicity; safety; vaccination; vaccine hesitancy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Reasons supporting the importance of COVID-19 vaccination in cancer patients, and mechanisms attributed to cancer patients’ increased susceptibility, severity, and morbidity from COVID-19 disease.
Figure 2
Figure 2
Reasons for and factors associated with vaccination hesitancy or acceptance among cancer patients compiled from studies which conducted surveys in different countries and the suggested ways to combat such hesitancy.
Figure 3
Figure 3
Immunogenicity of COVID-19 vaccines in cancer patients with hematologic or solid cancers and the effect of different types of anti-cancer therapy on the immunogenicity. Immunogenicity was measured in most of the studies by rates of seropositivity and/or antibody titers. * Only chemotherapy was reported to reduce both rates of seropositivity and antibody titers.
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