Emerging issues related to COVID-19 vaccination in patients with cancer

Abstract

Coronavirus disease 2019 (COVID-19) has resulted in millions of deaths globally. The pandemic has had a severe impact on oncology care and research. Patients with underlying cancer are more vulnerable to contracting COVID-19, and also have a more severe clinical course following the infection. The rollout of COVID-19 vaccines in many parts of the world has raised hopes of controlling the pandemic. In this editorial, the authors outline key characteristics of the currently approved COVID-19 vaccines, provide a brief overview of key emerging issues such as vaccine-induced immune thrombotic thrombocytopenia and SARS-CoV-2 variants of concern, and review the available data related to the efficacy and side effects of vaccinating patients with cancer.

Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

“…The low humoral immune response mounted by oncological patients after being vaccinated against SARS-CoV-2 is of utmost importance due to their higher risk of developing severe disease with consequent poor prognosis if infected. [ 4 , 11 , 55 , 56 ] Immunization against COVID-19 has been widely recommended among cancer patients, regardless of site of disease, setting, and type of treatment, as its benefits outweigh the potential risks. [ 55 , 57 ] Oncological patients should be encouraged to adhere to COVID-19 prevention guidelines and complete their vaccination schemes following the recommended intervals between doses (i.e., 3- or 4-weeks for mRNA vaccines).…”

“…[ 4 , 11 , 55 , 56 ] Immunization against COVID-19 has been widely recommended among cancer patients, regardless of site of disease, setting, and type of treatment, as its benefits outweigh the potential risks. [ 55 , 57 ] Oncological patients should be encouraged to adhere to COVID-19 prevention guidelines and complete their vaccination schemes following the recommended intervals between doses (i.e., 3- or 4-weeks for mRNA vaccines). As shown by this meta-analysis, a substantial proportion of patients with cancer do not mount an appropriate immunological response after partial vaccination and could be at a relatively high risk of infection and severe COVID-19 when delaying the second dose.…”

Impact of the COVID-19 Pandemic on Breast Cancer Management in Portugal: A Cross-Sectional Survey-Based Study of Medical Oncologists

“…A follow-up survey would be useful to evaluate further changes to clinical oncology practices over time as our healthcare system adapts to a new era in which evolving COVID-19 variants will emerge. Within this context, it would be useful to understand variations between countries with respect to COVID-19 vaccination practices, including the potential role of booster doses and seasonal vaccination in high-risk patients, such as those with active cancer [ 39 ]. Of note, COVID-19 vaccination was only available for priority high-risk patient groups at the time of this survey, including frontline healthcare professionals, armed forces, and patients aged ≥ 65 years, which excluded most patients with breast cancer.…”

Differences in the Impact of COVID-19 on Pathology Laboratories and Cancer Diagnosis in Girona

“…Although this could be due to changes in the prioritization protocols used by different care services and recommendations by scientific societies and expert groups to minimize the risks [ 20 , 21 , 22 ], in certain types of cancer, it could also be due to the increase in the number of scans due to COVID-19 in patients with undiagnosed cancers. In fact, patients with underlying cancers are probably more vulnerable to SARS-CoV-2 infection and display a worse progression of the disease [ 23 , 24 , 25 ]. Therefore, it is plausible that people with cancer have a higher probability of having required hospitalization during the COVID-19 pandemic than others.…”