Third dose of SARS-CoV-2 vaccination in hemato-oncological patients and health care workers: immune responses and adverse events - a retrospective cohort study
Ce dossier présente un ensemble d'articles concernant la prise en charge des cancers durant la crise sanitaire liée au COVID-19
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 center 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 tumors (p<0.001) and hematological malignancies without anti-B cell therapies (p<0.001). After the third dose, anti-S levels increased as compared to the first/second dose. Patients receiving B cell-targeted agents had lower antibody levels than patients with hematological malignancies undergoing other treatments (p<0.001) or patients with solid tumors (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.
European Journal of Cancer , article en libre accès, 2021