COVID-19 vaccination in patients with cancer
By Kathy Cooke. 13th January 2022
Most cancer patients with COVID-19 will experience severe outcomes whether they have been vaccinated or not.
The oncology community around the world has responded the effects COVID has had on cancer diagnosis and treatment.
Various registries have been set up recently to investigate risk factors and outcomes of patients with cancer who are diagnosed with COVID-19.
Cancer patients remain vulnerable to COVID-19 infection even after vaccination according to a review of patient data from the international COVID-19 and Cancer Consortium (CCC19) registry.
COVID-19 and Cancer Consortium (CCC19)
In the trial, which appeared online in Annals of Oncology December 24 2021, there were 1787 cancer patients with COVID-19, 1656 (97%) were unvaccinated, 77 (4%) partially vaccinated, and 54 (3%) fully vaccinated.
Of the 54 fully vaccinated cancer patients with COVID-19:
- 35 (65%) were hospitalised
- 10 (19%) were admitted to the intensive care unit or required mechanical ventilation
- 7 (13%) died within 30 days
Comparable rates were observed in the unvaccinated group, with no statistical difference in 30-day mortality between the fully vaccinated patients compared with the unvaccinated. There was also no significant difference in rates of hospitalisation.
The efficacy of coronavirus vaccinations may be reduced by immunosuppression and recent systemic therapy for cancers.
Lower seroconversion rates (the transition from the point of COVID-19 infection to when antibodies of the virus become present in the blood) following the receipt of COVID-19 vaccines have been observed in patients with cancer. The authors of the trial noted that:
" consistent with evidence that these patients may have a blunted serologic response to vaccination secondary to disease or therapy ”
More recent research has indicated that receiving a COVID-19 booster jab increases antibody levels among cancer patients under active treatment, so may provide additional protection against the virus.
The CCC19 is currently conducting additional studies that focus on older patients with cancer, minority, racial and ethnic groups with cancer, patients with prostate cancer, patients with co-occurring infections, sarcoma and bleeding complications.
OnCovid (sponsored by Imperial College London)
This was started March 2020 with the aim of documenting characteristics and outcomes of COVID-19 infection among cancer patients across Europe. The study of 900 patients with cancer who had been diagnosed with COVID-19 was across in The UK, Germany Spain and Italy. It was found that:
- The average mortality rate among patients with cancer infected with COVID-19 was 33.6%
- Older male patients with pre-existing conditions were more likely to have worse outcomes from COVID-19
- Cancer treatment with chemotherapy or immunotherapy made little difference on COVID-19 severity or survival rates
- There was beneficial effect in cancer patients from the use of the antimalarial drug hydroxychloroquine
- The UK had the highest incidence of hospital-based transmission and highest mortality rates for cancer patients with COVID-19
TERAVOLT - Thoracic Cancers International COVID-19 Collaboration
The primary focus of TERAVOLT is to understand the affects of COVID-19 among patients with thoracic cancers, including small cell lung cancer, asbestos lung cancer and mesothelioma.
In 2020, data was collected from 200 cancer patients. Of these:
- 151 patients (76%) had non–small cell lung cancer
- 148 patients (74%) were receiving active treatment for cancer
- 152 patients (76%) required hospitalisation
- 66 patients (33%) with thoracic cancer died
Factors associated with an increased risk of death included smoking, old age, treatment with chemotherapy and the presence of comorbidities. Updated data from 400 patients revealed a 35.5% mortality rate. Other factors that were associated with worse outcomes included a later stage (IV) OF cancer and no treatment of the cancer.
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Sources:
COVID-19 vaccination and breakthrough infections in patients with cancer
https://www.annalsofoncology.org/article/S0923-7534(21)04880-8/fulltext
OnCovid: History and outcomes of cancer patients during the COVID-19 pandemic
https://imperialbrc.nihr.ac.uk/research/covid-19/covid-19-ongoing-studies/oncovid/
Author
Kathy Cooke MA. BSc
Cancer consultant and advisor
Kathy has worked in the cancer field for over 30 years. She was course leader for the MSc in Radiotherapy and Oncology at University of Hertfordshire. Then pre-treatment radiotherapy manager at the Cromwell Hospital in London and Partnership Quality Lead for Macmillan Cancer Support.. Read more >
