COVID-19 vaccination immune response in patients with solid organ and haematologic malignancies: call for active monitoring.

Laudy Chehade,Jad Zeitoun,Sally Temraz,Firas Kreidieh,Ziad Salem,Nesrine Rizk,Iman Abou Dalle,Rachelle Bejjany,Mona Hassan,Maya Charafeddine,Rami Mahfouz,Arafat Tfayli,Jean El Cheikh,Hazem Assi,Deborah Mukherji,Ali Bazarbachi,Ali Taher,Ali Shamseddine,Nagi El Saghir

doi:10.3332/ecancer.2021.1284

Laudy Chehade, Jad Zeitoun + Show 17 more

Open Access

https://doi.org/10.3332/ecancer.2021.1284

Copy DOI

Abstract

Vaccines against COVID-19 have demonstrated a remarkable efficacy in decreasing hospitalisations and deaths; however, clinical trials leading to vaccine approvals did not include immunocompromised individuals such as patients receiving antineoplastic therapies. Emerging data suggest that patients on active anti-cancer therapy may have a reduced immune response to COVID-19 vaccination compared to the general population and may be at greater risk of COVID-19 infection as measures to reduce transmission in the community are relaxed. We report preliminary data from the American University of Beirut Medical Center in Lebanon demonstrating relatively low seroconversion rates. Of 36 patients on active anti-cancer therapy who had received two doses of vaccine, 17% were negative for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) anti-spike IgG. These results highlight the importance of maintaining strict precautionary measures against COVID-19 in patients on immunosuppressive treatment. There is an urgent need for active monitoring of immune response post-vaccination in prospective studies involving populations from diverse resource settings.

Highlights

Despite the lack of data on the efficacy of COVID-19 vaccination in patients on antineoplastic therapy from registration trials, vaccination in this vulnerable population is strongly recommended due to the increased risk of severe COVID-19 infection [1]
Data from case series in high-income countries suggest that the proportion of patients with cancer on active therapy who do not develop antibodies after two doses of the Pfizer BNT162b2 mRNA COVID-19 vaccine ranges from 6% to 10% [2, 3]
Following institutional review board approval of the protocol, patients diagnosed with a solid organ or haematological malignancy who were on active systemic treatment at the time of planned vaccination at the American University of Beirut Medical Center, Beirut, Lebanon, were included

Summary

Introduction

Despite the lack of data on the efficacy of COVID-19 vaccination in patients on antineoplastic therapy from registration trials, vaccination in this vulnerable population is strongly recommended due to the increased risk of severe COVID-19 infection [1]. Data from case series in high-income countries suggest that the proportion of patients with cancer on active therapy who do not develop antibodies after two doses of the Pfizer BNT162b2 mRNA COVID-19 vaccine ranges from 6% to 10% [2, 3]. We have limited data on the duration of immune response in patients on active anti-cancer therapy or the potential benefit of vaccine booster doses in patients with an insufficient or short-lived immune response.

Results

Conclusion