Vaccination against SARS-CoV-2 protects from morbidity, mortality and sequelae from COVID19 in patients with cancer

• Published in: European journal of cancer (1990) Vol. 171; pp. 64 - 74
• Main Authors: Pinato, David J., Ferrante, Daniela, Aguilar-Company, Juan, Bower, Mark, Sureda, Anna, Bertuzzi, Alexia, Brunet, Joan, Pedrazzoli, Paolo, Biello, Federica, Lee, Alvin J.X., Sng, Christopher C.T., Liñan, Raquel, Carmona-García, M.Carmen, Sharkey, Rachel, Eremiev, Simeon, Rizzo, Gianpiero, Bain, Hamish DC, Yu, Tamara, Cruz, Claudia A., Saoudi-Gonzalez, Nadia, Roldán, Elisa, Zoratto, Federica, Bruna, Riccardo, Patriarca, Andrea, Martinez-Vila, Clara, Berardi, Rossana, Mazzoni, Francesca, Santoro, Armando, Delfanti, Sara, Queirolo, Paola, Prat, Aleix, Tabernero, Josep, Cortellini, Alessio, Swallow, Judith, Hanbury, Georgina, Chung, Chris, Ottaviani, Diego, Lee, Alvin JX, Shawe-Taylor, Marianne, Sinclair, Alasdair, Belessiotis, Katherine, Bawany, Samira, Newsom-Davis, Thomas, Dolly, Saorise, Sita-Lumsde, Ailsa, Apthorp, Eleanor, Jones, Eleanor, Van Hemelrijck, Mieke, Russell, Beth, Diamantis, Nikolaos, Mukherjee, Uma, Loizidou, Angela, Piccart, Martine, Reyes, Roxana, Segui, Elia, Marco-Hernández, Javier, Viladot, Margarita, Ruiz-Camps, Isabel, Fox, Laura, Garcia Illescas, David, Saoudi, Nadia, Carmona Garcia, MCarmen, Fort-Culillas, Robert, Harbeck, Nadia, Wuerstlein, Rachel, Mahner, Sven, Plaja, Andrea, Cucurull, Marc, Salazar, Ramon, Gennari, Alessandra, D’Avanzo, Francesca, Rossi, Sabrina, Marrari, Andrea, Rimassa, Lorenza, Fusco, Vittorio, Maconi, Antonio, Tondini, Carlo, Fotia, Vittoria, Provenzano, Salvatore, Generali, Daniele, Baggi, Alice, Porzio, Giampiero, Giusti, Raffaele, Cantini, Luca, Guida, Annalisa
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2022; Elsevier Science Ltd
• Subjects: Cancer; Cancer vaccines; Clinical efficacy; Complications; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 Testing; COVID-19 Vaccines; Demographics; Humans; Immunization; Immunogenicity; Morbidity; Mortality; Neoplasms - complications; Neoplasms - therapy; Original Research; Patients; Prevention; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Therapy; Vaccination; Vaccines; COVID-19; Prevention; SARS-CoV-2; Vaccines; Clinical efficacy; Cancer
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2022.04.036

Although SARS-CoV-2 vaccines immunogenicity in patients with cancer has been investigated, whether they can significantly improve the severity of COVID-19 in this specific population is undefined. Capitalizing on OnCovid (NCT04393974) registry data we reported COVID-19 mortality and proxies of COVID-19 morbidity, including post-COVID-19 outcomes, according to the vaccination status of the included patients. 2090 eligible patients diagnosed with COVID-19 between 02/2020 and 11/2021 were included, of whom 1930 (92.3%) unvaccinated, 91 (4.4%) fully vaccinated and 69 (3.3%) partially vaccinated. With the exception of a higher prevalence of patients from the UK (p = 0.0003) and receiving systemic anticancer therapy at COVID-19 diagnosis (p = 0.0082) among fully vaccinated patients, no demographics/oncological features were associated with vaccination status. The 14-days case fatality rate (CFR) (5.5% vs 20.7%, p = 0.0004) and the 28-days CFR (13.2% vs 27.4%, p = 0.0028) demonstrated a significant improvement for fully vaccinated patients in comparison with unvaccinated patients. The receipt of prior full vaccination was also associated with reduced symptomatic COVID-19 (79.1% vs 88.5%, p = 0.0070), need of COVID-19 oriented therapy (34.9% vs 63.2%, p < 0.0001), complications from COVID-19 (28.6% vs 39.4%, p = 0.0379), hospitalizations due to COVID-19 (42.2% vs 52.5%, p = 0.0007) and oxygen therapy requirement (35.7% vs 52%, p = 0.0036). Following Inverse Probability Treatment Weighting (IPTW) procedure no statistically significant difference according to the vaccination status was confirmed; however, all COVID-19 related outcomes were concordantly in favour of full vaccination. Among the 1228 (58.8%) patients who underwent a formal reassessment at participating centres after COVID-19 resolution, fully vaccinated patients experienced less sequelae than unvaccinated patients (6.7% vs 17.2%, p = 0.0320). This analysis provides initial evidence in support of the beneficial effect of SARS-CoV-2 vaccines against morbidity and mortality from COVID-19 in patients with cancer. •Immunogenicity of SARS-CoV-2 vaccines in patients with cancer has been investigated.•There is a need for evidence of SARS-CoV-2 vaccines’ efficacy from large populations.•In this analysis, vaccinated patients experienced improved COVID-19 outcomes.•SARS-CoV-2 vaccines are effective in reducing severe COVID-19 in patients with cancer.