Abstract
PurposePatients with cancer have an increased risk of coronavirus disease 2019 (COVID-19) and an attenuated responses to various vaccines. This meta-analysis aims to assess the serologic response to COVID-19 vaccination in patients with cancer.MethodsElectronic databases were systematically searched on August 1, 2021 for studies that reported the serologic response to COVID-19 vaccine in cancer patients. Random effects models were used to achieve pooled serologic response rates and odds ratios (ORs).ResultsWe analyzed 16 observational studies with a total of 1453 patients with cancer. A majority of studies used mRNA vaccines (BNT162b2 or mRNA-1273). The proportion of patients achieving a serologic response after a single and two doses of COVID-19 vaccine were 54.2% (95% confidence interval [CI] 41.0–66.9) and 87.7% (95% CI 82.5–91.5), respectively. Patients with hematologic cancers had a lower response rate after the second dose of vaccine compared to those with solid organ cancers (63.7% vs. 94.9%), which was attributable to the low response rates associated with certain conditions (chronic lymphocytic leukemia, lymphoma) and therapies (anti-CD20, kinase inhibitors). A lower proportion of patients with cancer achieved a serologic response compared to control patients after one and two doses of vaccine (OR0.073 [95% CI 0.026–0.20] and 0.10 [95% CI 0.039–0.26], respectively).ConclusionsPatients with cancer, especially those with hematologic B-cell malignancies, have a lower serologic response to COVID-19 vaccines. The results suggest that cancer patients should continue to follow safety measures including mask-wearing after vaccination and suggest the need for additional strategies for prophylaxis.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persists and the world is seeing another year of a global health emergency [1]
The three studies that included both types of cancers reported seroconversion rates separately among the types of cancers, so we reported them separately
We demonstrated that only 54% of patients with cancer achieved a serologic response to a single dose of COVID-19 vaccine, which improved to 88% after two doses
Summary
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persists and the world is seeing another year of a global health emergency [1]. Extensive research over the past year has demonstrated that elderly patients as well as those with pre-existing conditions such as obesity, diabetes, and cancer are more susceptible to getting infected with SARS-CoV-2 and developing life threatening pneumonia [2,3,4]. 9.5% of the adult population in the USA have or have had a diagnosis of cancer of any type and 1 in 3 adults will be diagnosed with cancer at some point during their lifetimes [5, 6]. Protecting the health and safety of patients with cancer is vital and considered a major priority during the COVID19 pandemic [7].
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