Cancer Patients and Covid-19 mRNA Vaccine: What to Know
April 12, 2022
Many studies have shown that patients with solid and blood cancer did not have adequate immune responses after the second dose of COVID-19 mRNA vaccines. Moreover, the amounts of antibody against the spike protein of SARS-CoV2 were dramatically decreased 3 months after the second dose, especially those who have blood cancer such as lymphoma, chronic lymphocytic leukemia (CLL) and multiple myeloma (MM).
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The recent study by Ehmsen et al, at Odense University Hospital, Denmark has shown that cancer patients will benefit greatly from the third dose of the mRNA vaccine. Of course, the amounts of antibodies in blood are not always a true indication of immune protection from vaccines. Nonetheless, cancer patients show much increased amounts of the antibody against the spike protein of SARS-CoV2 after the third dose compared to those after the second dose, and many more cancer patients, especially those with blood cancer, developed sufficient amounts of antibody after the third dose of the vaccine1.
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The recent analysis by Montefiore Medical Center showed that the mortality rate among cancer patients is 4.9 % (14 out of 285), still higher than 2.57 % (283 out of 10,996) of control group (i.e., those who do not have any other medical problems to contribute to death) during the recent surge in New York City due to omicron variant. This number has gotten much lower than that of the beginning of the pandemic, which was about 29 % among cancer patients, owing to the vaccines and improved treatments.
The mortality rate is higher in cancer patients who were older than 65 and/or have advanced (metastatic) cancer. Five patients who were fully vaccinated with a booster died during this time; however, their death may have been due to their advanced cancer because they did not have any COVID-19 related symptoms such as respiratory distress. Nine cancer patients who died either were not vaccinated, had severe immune suppression or did have poor immune response to COVID-19 vaccines2.
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These two studies clearly underscore the importance of COVID-19 vaccination in cancer patients.
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Recently, a group of physicians at Fox Chase Cancer Center published the results of the safety analysis of the COVID-19 mRNA vaccine, BNT162b2 from Pfizer in 1,183 patients who had cancer or were undergoing treatments for cancer. The most common side effect was injection site pain, and fatigue, joint pain, fever, chills, headaches, and nausea were more common after the second dose in cancer patients. Of note, the rates of all side effects in cancer patients were comparable to those in people without cancer3. Numerous studies including two massive Phase 3 studies with more than 30,000 participants already showed that COVID-19 mRNA vaccines are safe and effective to prevent hospitalization and death from COVID-19.
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In conclusion, COVID-19 mRNA vaccines are safe in cancer patients, and all these studies so far greatly emphasize the importance of COVID-19 vaccination, especially the booster vaccine for cancer patients to prevent COVOD-19-related death.
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If you have cancer, and have not yet vaccinated with COVID-19 vaccines, please ask you doctor if you should get vaccinated because the cancer patients who are undergoing or just completed a stem cell transplant, CAR T-cell therapy or immunosuppressive therapy are recommended to wait 3 months before receiving COVID-19 vaccines. Otherwise, please do not delay getting vaccinated with the COVID-19 vaccines.
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For more information, please check these websites.
http://www.cancer.gov/.../covid-19-vaccines-people-with...
http://www.cancer.org/.../covid-19-vaccines-in-people...
http://www.mesotheliomahope.com/.../mesothelioma-and.../
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Sources
1. Ehmsen, S. et al., Antibody responses following third mRNA COVID-19 vaccination in patients with cancer and potential timing of a fourth vaccination., Cancer Cell, 40: 338-339, 2022
2. Lee, M. et al., Impact of COVID-19 on case fatality rate of patients with cancer during the Omicron wave., Cancer Cell, 40: 343-345, 2022
3. Shulman, R.M. et al., Adverse Events Reported by Patients with Cancer after Administration of a 2-Dose mRNA COVID-19 Vaccine., Journal of National Comprehensive Cancer Network, 20:160-166, 2022
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