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01-10-2021 | COVID-19 Vaccination | Palliative and Supportive Care (MP Davis, Section Editor)

Cancer or COVID-19? A Review of Recommendations for COVID-19 Vaccination in Cancer Patients

Authors: Manit K. Gundavda, DNB Orth, Kaival K. Gundavda, MS, Gen Surg

Published in: Current Treatment Options in Oncology | Issue 10/2021

Opinion statement

While emergency use is authorized for numerous COVID-19 vaccines and the high-risk population including cancer patients or those with immunosuppression due to disease or therapy is prioritized, data on this group’s specific safety and efficacy of these vaccines remains limited. Safety data from clinical trials and population data may be extrapolated, and these vaccines may be used for cancer patients. However, concerns of efficacy due to the variable immune response in patients with active cancers undergoing active therapy and cancer survivors with chronic immunosuppression remain. The authors aim to discuss the current recommendations for use of COVID-19 vaccination in patients with cancer.

•• Gundavda MK, Gundavda KK. Cancer or COVID-19? A review of guidelines for safe cancer care in the wake of the pandemic. SN comprehensive clinical medicine. 2020:1–11. https://doi.org/10.1007/s42399-020-00632-2. Lack of international guidelines leaves healthcare providers with a case-to-case approach for delivering optimal cancer care in the wake of the pandemic.

Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430–6. https://doi.org/10.1038/s41586-020-2521-4.CrossRefPubMedPubMedCentral

Chamilos G, Lionakis MS, Kontoyiannis DP. Are all patients with cancer at heightened risk for severe coronavirus disease 2019 (COVID-19)? Clin Infect Dis. 2021;72(2):351–6. https://doi.org/10.1093/cid/ciaa1079.CrossRefPubMed

Cohen JI, Burbelo PD. Reinfection with SARS-CoV-2: implications for vaccines. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa1866.CrossRefPubMedPubMedCentral

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603–15. https://doi.org/10.1056/NEJMoa2034577.CrossRefPubMed

Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384(5):403–16. https://doi.org/10.1056/NEJMoa2035389.CrossRefPubMed

Sadoff J, Gray G, Vandebosch A, Cárdenas V, Shukarev G, Grinsztejn B, et al. Safety and efficacy of single-dose Ad26.COV2.S vaccine against Covid-19. N Eng J Med. 2021;384(23):2187–201. https://doi.org/10.1056/NEJMoa2101544.CrossRef

Schultz NH, Sørvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384(22):2124–30. https://doi.org/10.1056/NEJMoa2104882.CrossRefPubMed

Pai M, Chan B, Stall NM, Grill A, Ivers N, Maltsev A et al. Vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenovirus vector COVID-19 vaccination. 2021. https://doi.org/10.47326/ocsat.2021.02.17.2.0.

10.

CDC - Centers for Disease Control and Prevention- Vaccines and immunization - myocarditis and pericarditis considerations. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/myocarditis.html.

11.

Górecki DC, Simons JP. The dangers of DNA vaccination. Nat Med. 1999;5(2):126. https://doi.org/10.1038/5473.CrossRefPubMed

12.

World Health Organization. Interim statement of the COVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety on AstraZeneca COVID-19 vaccine. https://www.who.int/news/item/07-04-2021-interim-statement-of-the-covid-19-subcommittee-of-the-who-global-advisory-committee-on-vaccine-safety.

13.

Fanciullino R, Ciccolini J, Milano G. COVID-19 vaccine race: watch your step for cancer patients. Br J Cancer. 2021;124(5):860–1. https://doi.org/10.1038/s41416-020-01219-3.CrossRefPubMed

14.

Kang CK, Kim HR, Song KH, Keam B, Choi SJ, Choe PG, et al. Cell-mediated immunogenicity of influenza vaccination in patients with cancer receiving immune checkpoint inhibitors. J Infect Dis. 2020;222(11):1902–9. https://doi.org/10.1093/infdis/jiaa291.CrossRefPubMed

15.

Korompoki E, Gavriatopoulou M, Kontoyiannis DP. COVID-19 vaccines in patients with cancer—a welcome addition, but there is need for optimization. JAMA Oncol. 2021. https://doi.org/10.1001/jamaoncol.2021.1218.CrossRefPubMed

16.

Thakkar A, Gonzalez-Lugo JD, Goradia N, Gali R, Shapiro LC, Pradhan K, et al. Seroconversion rates following COVID-19 vaccination among patients with cancer. Cancer Cell. 2021. https://doi.org/10.1016/j.ccell.2021.06.002.CrossRefPubMedCentralPubMed

17.

• Herishanu Y, Avivi I, Aharon A, Shefer G, Levi S, Bronstein Y, et al. Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia. Blood. 2021;137(23):3165–73. https://doi.org/10.1182/blood.2021011568. Data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify immunosuppressed cohorts that need novel vaccination or passive immunization strategies.CrossRefPubMedPubMedCentral

18.

Houot R, Levy R, Cartron G, Armand P. Could anti-CD20 therapy jeopardise the efficacy of a SARS-CoV-2 vaccine? European journal of cancer (Oxford. England. 1990;2020(136):4–6. https://doi.org/10.1016/j.ejca.2020.06.017.CrossRef

19.

Pleyer C, Ali MA, Cohen JI, Tian X, Soto S, Ahn IE, et al. Effect of Bruton tyrosine kinase inhibitor on efficacy of adjuvanted recombinant hepatitis B and zoster vaccines. Blood. 2021;137(2):185–9. https://doi.org/10.1182/blood.2020008758.CrossRefPubMed

20.

L’Huillier AG, Kumar D. Immunizations in solid organ and hematopoeitic stem cell transplant patients: a comprehensive review. Hum Vaccin Immunother. 2015;11(12):2852–63. https://doi.org/10.1080/21645515.2015.1078043.CrossRefPubMedCentralPubMed

21.

• Desage AL, Bouleftour W, Rivoirard R, Magne N, Collard O, Fournel P, et al. Vaccination and immune checkpoint inhibitors: does vaccination increase the risk of immune-related adverse events? A systematic review of literature. Am J Clin Oncol. 2021;44(3):109–13. https://doi.org/10.1097/coc.0000000000000788. Vaccination for patients under immune checkpoint inhibitors causes a humoral response and seems to be associated with an increase rate of seroconversion. Interestingly, vaccination may provoke immune-related adverse events in treated patients. So far, inactivated vaccines have not been contraindicated during ICI treatment.CrossRefPubMed

22.

SITC Statement on SARS-CoV-2 vaccination and cancer immunotherapy. https://www.sitcancer.org/aboutsitc/press-releases/2020/sitc-statement-sars-cov-2-vaccination-cancer-immunotherapy.

23.

American Society of Clinical Oncology (ASCO). COVID-19 vaccine & patients with cancer. https://www.asco.org/asco-coronavirus-resources/covid-19-patient-care-information/covid-19-vaccine-patients-cancer. (Accessed on 06 Jan 2021).

24.

Recommendations of the NCCN COVID-19 Vaccination Advisory Committee. https://www.nccn.org/docs/default-source/covid-19/2021_covid-19_vaccination_guidance_v3-0.pdf%3Fsfvrsn%3Db483da2b_60&ved=2ahUKEwiy-on_rdHyAhXwmuAKHVW-DpEQFnoECA0QAQ&usg=AOvVaw0CMQy1OxQxi2WXB4oVJHNb&cshid=1630072730727

25.

ASH-ASTCT COVID-19 vaccination for HCT and CAR T cell recipients. https://www.hematology.org/covid-19/ash-astct-covid-19-vaccination-for-hct-and-car-t-cell-recipients. Accessed 24th June 2021.

26.

Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI. https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-2-december-2020/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-2-december-2020. Accessed 30th Dec 2020.

27.

Giesen N, Sprute R, Rüthrich M, Khodamoradi Y, Mellinghoff SC, Beutel G, et al. 2021 update of the AGIHO guideline on evidence-based management of COVID-19 in patients with cancer regarding diagnostics, viral shedding, vaccination and therapy. Eur J Cancer. 2021;147:154–60. https://doi.org/10.1016/j.ejca.2021.01.033.CrossRefPubMedPubMedCentral

28.

Gauci ML, Coutzac C, Houot R, Marabelle A, Lebbé C. SARS-CoV-2 vaccines for cancer patients treated with immunotherapies: recommendations from the French society for ImmunoTherapy of Cancer (FITC). Eur J Cancer. 2021;148:121–3. https://doi.org/10.1016/j.ejca.2021.02.003.CrossRefPubMedPubMedCentral

29.

Massarweh A, Eliakim-Raz N, Stemmer A, Levy-Barda A, Yust-Katz S, Zer A, et al. Evaluation of seropositivity following BNT162b2 messenger RNA vaccination for SARS-CoV-2 in patients undergoing treatment for cancer. JAMA Oncol. 2021. https://doi.org/10.1001/jamaoncol.2021.2155.CrossRefPubMedPubMedCentral

30.

Yazaki S, Yoshida T, Kojima Y, Yagishita S, Nakahama H, Okinaka K, et al. Difference in SARS-CoV-2 antibody status between patients with cancer and health care workers during the COVID-19 pandemic in Japan. JAMA Oncol. 2021. https://doi.org/10.1001/jamaoncol.2021.2159.CrossRefPubMedPubMedCentral

31.

Sun L, Warner JL, Parikh RB. Immune responses to SARS-CoV-2 among patients with cancer: what can seropositivity tell us? JAMA Oncol. 2021. https://doi.org/10.1001/jamaoncol.2021.2096.CrossRefPubMedCentralPubMed

32.

Centers for Disease Control and Prevention. Interim clinical considerations for use of mRNA COVID-19 vaccines currently authorized in the United States. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html. Accessed 1st June 2021.

33.

•• Desai A, Gainor JF, Hegde A, Schram AM, Curigliano G, Pal S, et al. COVID-19 vaccine guidance for patients with cancer participating in oncology clinical trials. Nat Rev Clin Oncol. 2021;18(5):313–9. https://doi.org/10.1038/s41571-021-00487-z. Continued quality oncological care requires that patients with cancer, including those involved in trials, be prioritized for COVID-19 vaccination, which should not affect trial eligibility.CrossRefPubMedPubMedCentral

Title: Cancer or COVID-19? A Review of Recommendations for COVID-19 Vaccination in Cancer Patients
Authors: Manit K. Gundavda, DNB Orth
Kaival K. Gundavda, MS, Gen Surg
Publication date: 01-10-2021
Publisher: Springer US
Keywords: COVID-19 Vaccination
Vaccination
SARS-CoV-2
COVID-19
Stem Cell Transplantation
Stem Cell Transplantion
Stem Cell Transplantation
Published in: Current Treatment Options in Oncology / Issue 10/2021
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI: https://doi.org/10.1007/s11864-021-00903-7

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