Abstract
Background: Due to potentially immune-escaping virus variants and waning immunity, a third SARS-CoV-2 vaccination dose is increasingly recommended. However, data in patients with cancer are limited.
Patients and methods: We measured anti-SARS-CoV-2 spike protein antibody levels after the third vaccination dose in 439 patients with cancer and 41 health care workers (HCW) at an academic centre in Austria and a rural community hospital in Italy. Adverse events were retrieved from questionnaires.
Results: Overall, 439 patients and 41 HCW were included. SARS-CoV-2 infections were observed in 62/439 (14.1%) patients before vaccination and in 5/439 (1.1%) patients after ≥1 dose. Longitudinal analysis revealed a decrease of antibody levels between 3 and 6 months after second vaccination in patients with solid tumours (p < 0.001) and haematological malignancies without anti-B cell therapies (p < 0.001). After the third dose, anti-S levels increased compared to the first/second dose. Patients receiving B cell-targeted agents had lower antibody levels than patients with haematological malignancies undergoing other treatments (p < 0.001) or patients with solid tumours (p < 0.001). Moreover, anti-S levels correlated with CD19+ (B cell) and CD56+ (NK cell) counts in peripheral blood. The most frequent adverse events after the third dose were local pain (75/160, 46.9%), fatigue (25/160, 15.6%) and fever/chills (16/160, 10.0%). Patients with cancer had lower anti-S levels than HCW (p = 0.015).
Conclusions: This study in patients with cancer shows improved antibody levels after the third vaccination dose at an acceptable side-effect profile. Lower antibody levels than in controls underline the need for further follow-up studies and dedicated trials.
Keywords: COVID-19; Cancer; Oncology; SARS-CoV-2; Vaccination.
【저자키워드】 COVID-19, SARS-CoV-2, vaccination, Cancer, oncology, 【초록키워드】 vaccination, therapy, Health care, fatigue, antibody, SARS-COV-2 infection, hospital, NK cell, haematological malignancies, Italy, anti-SARS-CoV-2, Spike protein, Peripheral blood, B cell, adverse events, adverse event, Patient, Control, Community, Health care worker, antibody levels, longitudinal, SARS-CoV-2 infections, trials, SARS-CoV-2 vaccination, longitudinal analysis, Analysis, dose, waning immunity, malignancy, CD19, HCW, Tumours, follow-up study, community hospital, Patients with cancer, Questionnaires, Side-effect, oncology, Adverse, second vaccination, solid tumour, local pain, other treatments, chills, CD56, anti-S, CD19+, Lower, haematological malignancy, CD56+, Cell, event, decrease, receiving, correlated, increasingly, other treatment, patients with haematological, retrieved, virus variant, 【제목키워드】 immune response, Health, adverse event, Patient, Care, SARS-CoV-2 vaccination, dose, retrospective cohort study,