Early COVID-19 booster is beneficial in cancer patients

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its corresponding coronavirus disease was first reported as a cluster of pneumonia cases in Wuhan, China, on 31 December 2019 1 and led to an unprecedented pandemic in modern times. It quickly overwhelmed healthcare s y s t e m s a r o u n d t h e w o r l d , a n d r e n d e r e d immunocompromised patients, such as those with cancer, particularly vulnerable to severe infections.Also unprecedented was the rapid development of several highly effective vaccines, thanks to concerted global efforts. Once COVID-19 vaccinations were available, the Ministry of Health (MOH) in Singapore implemented a nationwide SARS-CoV-2 vaccination programme for healthcare staff in early January 2021, started a pilot for vaccinations for senior citizens in late January 2021, and progressively made the COVID-19 vaccine freely available for all Singaporeans and permanent residents. In line with emerging data thereafter, MOH offered a booster to immunocompromised patients as early as 2 months after the second dose. Currently, as of 7 November 2022, MOH encourages all eligible residents aged 18 years and above 2 to undergo a second COVID-19 booster or a fourth vaccination dose.Other regulatory healthcare institutions recommended administering a COVID-19 booster within 3-6 months of the completion of the initial mRNA vaccination course and the Committee for Medicinal Products for Human Use approved an extra dose of the COVID-19 mRNA vaccines at least 28 days after the second dose. 3 Against this background, the study by Lee et al. is timely. In their large, prospective observational study, the authors 4 presented real-world efficacy data in haematological (40/273) and solid cancer (233/273) patients in Singapore who received 2 doses of an mRNA vaccine, either BNT162b2 or mRNA1273, followed by a 3rd dose of BNT162b2 against SARS-CoV-2 during the COVID-19 pandemic. In total, 273 patients were recruited between July 2021 and March

Humoral Response and Safety after a Fourth Dose of the SARS-CoV-2 BNT162b2 Vaccine in Cancer Patients Undergoing Active Treatment—Results of a Prospective Observational Study

“…A systemic review has demonstrated that booster doses of COVID-19 vaccines are effective in improving seroconversion and antibody levels; however, patients with haematological cancer consistently demonstrated a poorer response to booster vaccines than patients with solid cancers [ 9 ]. Similar results after an early COVID-19 booster dose were reported by Samol J. et al [ 10 ]. However, there is a paucity of data on the serological response to and safety of a fourth dose of an mRNA COVID-19 vaccine in patients with cancer in active treatment [ 11 , 12 ].…”

“…It is well known that the prevention of the higher risk of severe COVID-19 and poor outcomes is crucial for patients with cancer, with vaccination being the most effective method for achieving this goal [ 9 , 11 ]. The clinical efficacy of COVID-19 vaccination in reducing the rates of symptomatic infections and severe outcomes has been described [ 9 , 10 , 11 , 12 ] and the results of third and fourth boosters have been reported to enhance protection in almost all immunocompromised patients [ 9 ]. However, there is a paucity of evidence that a fourth booster dose of COVID-19 vaccines is effective in improving antibody levels and is safe in patients with solid tumors and in active treatment.…”

“…The COVID-19 BNT162b2 and mRNA-1273 vaccines have been found to be safe and effective in patients with cancer aged >70 years and undergoing active anticancer treatment [ 8 ]. Other studies have shown that a third dose of COVID-19 vaccines strongly boosts the waning immune system in cancer patients [ 9 , 10 ]. A systemic review has demonstrated that booster doses of COVID-19 vaccines are effective in improving seroconversion and antibody levels; however, patients with haematological cancer consistently demonstrated a poorer response to booster vaccines than patients with solid cancers [ 9 ].…”