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Li J, Wu J, Zhang J, Tang L, Mei H, Hu Y, Li F. A multicompartment mathematical model based on host immunity for dissecting COVID-19 heterogeneity. Heliyon 2022; 8:e09488. [PMID: 35600458 PMCID: PMC9116108 DOI: 10.1016/j.heliyon.2022.e09488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/31/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023] Open
Abstract
The determinants underlying the heterogeneity of coronavirus disease 2019 (COVID-19) remain to be elucidated. To systemically analyze the immunopathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we built a multicompartment mathematical model based on immunological principles and typical COVID-19-related characteristics. This model integrated the trafficking of immune cells and cytokines among the secondary lymphoid organs, peripheral blood and lungs. Our results suggested that early-stage lymphopenia was related to lymphocyte chemotaxis, while prolonged lymphopenia in critically ill patients was associated with myeloid-derived suppressor cells. Furthermore, our model predicted that insufficient SARS-CoV-2-specific naïve T/B cell pools and ineffective activation of antigen-presenting cells (APCs) would cause delayed immunity activation, resulting in elevated viral load, low immunoglobulin level, etc. Overall, we provided a comprehensive view of the dynamics of host immunity after SARS-CoV-2 infection that enabled us to understand COVID-19 heterogeneity from systemic perspective.
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Affiliation(s)
- Jianwei Li
- School of Physics, Center for Quantitative Biology, Peking University, Beijing 100871, China
| | - Jianghua Wu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, Wuhan, 430022, China
| | - Jingpeng Zhang
- School of Physics, Center for Quantitative Biology, Peking University, Beijing 100871, China
| | - Lu Tang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, Wuhan, 430022, China
| | - Heng Mei
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, Wuhan, 430022, China
- Corresponding author.
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease, Wuhan, 430022, China
- Corresponding author.
| | - Fangting Li
- School of Physics, Center for Quantitative Biology, Peking University, Beijing 100871, China
- Corresponding author.
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202
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SeyedAlinaghi S, Karimi A, Pashaei Z, Afzalian A, Mirzapour P, Ghorbanzadeh K, Ghasemzadeh A, Dashti M, Nazarian N, Vahedi F, Tantuoyir MM, Shamsabadi A, Dadras O, Mehraeen E. Safety and Adverse Events Related to COVID-19 mRNA Vaccines; a Systematic Review. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e41. [PMID: 35765616 PMCID: PMC9206826 DOI: 10.22037/aaem.v10i1.1597] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction Knowledge of vaccine-related adverse events is crucial as they are among the most important factors that cause hesitation in receiving vaccines. Therefore, we aimed to systematically review the adverse events related to the mRNA vaccines reported in the literature.. Method A systematic literature search was carried out in the databases of Scopus, PubMed, Cochrane, and Web of Science. We selected original studies that explored the side effects of mRNA COVID-19 vaccines using a two-phase (title/abstract and full-text) screening process.. Results Cardiac complications were the most commonly reported severe adverse events. It appeared that systemic adverse reactions are more common after the second dose of vaccines. The number of adverse effects reported after the Pfizer vaccine was higher than other vaccines, mostly due to its earlier approval and more widespread use throughout the world. Cardiac adverse events had a higher prevalence but no significant association has been found between COVID-19 mRNA vaccines and cardiac adverse events except for myopericarditis. . Conclusion Vaccines play a crucial role in controlling the COVID-19 pandemic and decreasing mortalities and the results of the present review acknowledge the fact that the benefits outweigh the adverse events of these vaccines..
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pashaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Afzalian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Mirzapour
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Kobra Ghorbanzadeh
- Department of Nursing, Khalkhal University of Medical Sciences; Khalkhal, Iran
| | - Afsaneh Ghasemzadeh
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohsen Dashti
- Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Marcarious M Tantuoyir
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran
| | - Omid Dadras
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
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203
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Kang W, Shami JJP, Yan VKC, Ye X, Blais JE, Li X, Lee VHF, Chui CSL, Lai FTT, Wan EYF, Wong CKH, Wong ICK, Chan EW. Safety of two-dose COVID-19 vaccination (BNT162b2 and CoronaVac) in adults with cancer: a territory-wide cohort study. J Hematol Oncol 2022; 15:66. [PMID: 35590336 PMCID: PMC9117990 DOI: 10.1186/s13045-022-01265-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/14/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The World Health Organization has defined a list of adverse events of special interest (AESI) for safety surveillance of vaccines. AESI have not been adequately assessed following COVID-19 vaccination in patients with cancer contributing to vaccine hesitancy in this population. We aimed to evaluate the association between BNT162b2 and CoronaVac vaccines and the risk of AESI in adults with active cancer or a history of cancer. PATIENTS AND METHODS We conducted a territory-wide cohort study using electronic health records managed by the Hong Kong Hospital Authority and vaccination records provided by the Department of Health. Patients with a cancer diagnosis between January 1, 2018, and September 30, 2021, were included and stratified into two cohorts: active cancer and history of cancer. Within each cohort, patients who received two doses of BNT162b2 or CoronaVac were 1:1 matched to unvaccinated patients using the propensity score. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CIs) for AESI 28 days after the second vaccine dose. RESULTS A total of 74,878 patients with cancer were included (vaccinated: 25,789 [34%]; unvaccinated: 49,089 [66%]). Among patients with active cancer, the incidence of AESI was 0.31 and 1.02 per 10,000 person-days with BNT162b2 versus unvaccinated patients and 0.13 and 0.88 per 10,000 person-days with CoronaVac versus unvaccinated patients. Among patients with history of cancer, the incidence was 0.55 and 0.89 per 10,000 person-days with BNT162b2 versus unvaccinated patients and 0.42 and 0.93 per 10,000 person-days with CoronaVac versus unvaccinated patients. Neither vaccine was associated with a higher risk of AESI for patients with active cancer (BNT162b2: HR 0.30, 95% CI 0.08-1.09; CoronaVac: 0.14, 95% CI 0.02-1.18) or patients with history of cancer (BNT162b2: 0.62, 95% CI 0.30-1.28; CoronaVac: 0.45, 95% CI 0.21-1.00). CONCLUSIONS In this territory-wide cohort study of patients with cancer, the incidence of AESI following vaccination with two doses of either BNT162b2 or CoronaVac vaccines was low. The findings of this study can reassure clinicians and patients with cancer about the overall safety of BNT162b2 and CoronaVac in patients with cancer, which could increase the COVID-19 vaccination rate in this vulnerable group of patients.
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Affiliation(s)
- Wei Kang
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Jessica J P Shami
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Vincent K C Yan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Xuxiao Ye
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
| | - Joseph E Blais
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xue Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong SAR, China
- Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Victor H F Lee
- Department of Clinical Oncology, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China
| | - Celine S L Chui
- Laboratory of Data Discovery for Health, Hong Kong SAR, China
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Francisco T T Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong SAR, China
| | - Eric Y F Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong SAR, China
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Carlos K H Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China
- Laboratory of Data Discovery for Health, Hong Kong SAR, China
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
- Laboratory of Data Discovery for Health, Hong Kong SAR, China.
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK.
- Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
- The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, China.
| | - Esther W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, General Office, L02-56 2/F, Laboratory Block, LKS Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong SAR, China.
- Laboratory of Data Discovery for Health, Hong Kong SAR, China.
- Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
- The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, China.
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204
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Grassi G, Notari S, Gili S, Bordoni V, Casetti R, Cimini E, Tartaglia E, Mariotti D, Agrati C, Sacchi A. Myeloid-Derived Suppressor Cells in COVID-19: The Paradox of Good. Front Immunol 2022; 13:842949. [PMID: 35572540 PMCID: PMC9092297 DOI: 10.3389/fimmu.2022.842949] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/25/2022] [Indexed: 12/26/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Viral replication in the respiratory tract induces the death of infected cells and the release of pathogen- associated molecular patterns (PAMPs). PAMPs give rise to local inflammation, increasing the secretion of pro- inflammatory cytokines and chemokines, which attract immune cells from the blood into the infected lung. In most individuals, lung-recruited cells clear the infection, and the immune response retreats. However, in some cases, a dysfunctional immune response occurs, which triggers a cytokine storm in the lung, leading to acute respiratory distress syndrome (ARDS). Severe COVID-19 is characterized by an impaired innate and adaptive immune response and by a massive expansion of myeloid-derived suppressor cells (MDSCs). MDSCs function as protective regulators of the immune response, protecting the host from over-immunoreactivity and hyper-inflammation. However, under certain conditions, such as chronic inflammation and cancer, MDSCs could exert a detrimental role. Accordingly, the early expansion of MDSCs in COVID-19 is able to predict the fatal outcome of the infection. Here, we review recent data on MDSCs during COVID-19, discussing how they can influence the course of the disease and whether they could be considered as biomarker and possible targets for new therapeutic approaches.
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Affiliation(s)
- Germana Grassi
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Stefania Notari
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Simona Gili
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Veronica Bordoni
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Rita Casetti
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Eleonora Cimini
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Eleonora Tartaglia
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Davide Mariotti
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Chiara Agrati
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Alessandra Sacchi
- Laboratory of Cellular Immunology and Pharmacology, National Institute for infectious Diseases "Lazzaro Spallanzani"-Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
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Iwamoto M, Ukimura A, Ogawa T, Kawanishi F, Osaka N, Kubota M, Mori T, Sawamura R, Nishihara M, Suzuki T, Uchiyama K. Association between history of HBV vaccine response and anti-SARS-CoV-2 spike antibody response to the BioNTech/Pfizer's BNT162b2 mRNA SARS-CoV-2 vaccine among healthcare workers in Japan: A prospective observational study. PLoS One 2022; 17:e0268529. [PMID: 35576209 PMCID: PMC9109930 DOI: 10.1371/journal.pone.0268529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/02/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Inadequate vaccine response is a common concern among healthcare workers at the frontlines of the COVID-19 pandemic. We aimed to investigate if healthcare workers with history of weak immune response to HBV vaccination are more likely to have weak responses against the BioNTech/Pfizer's BNT162b2 mRNA SARS-CoV-2 vaccine. METHODS We prospectively tested 954 healthcare workers for the Anti-SARS-CoV-2 spike (S) protein antibody titers prior to the first and second BNT162b2 vaccination doses and after four weeks after the second dose using Roche's Elecsys® assay. We calculated the percentage of patients who seroconverted after the first and second doses. We estimated the relative risk of non-seroconversion after the first BNT162b2 vaccine (defined as anti-SARS-CoV-2-S titer <15 U/mL) among HBV vaccine non-responders (HBs-Ab titer <10 mIU/mL) and weak responders (≥10 and <100 mIU/mL) compared to normal responders (≥100 mIU/mL). RESULTS Among 954 healthcare workers recruited between March 9 and March 24, 2021 at Osaka Medical and Pharmaceutical University, weak and normal HBV vaccine responders had comparable S-protein titers after the first BNT162b2 dose (51.4 [95% confidence interval 25.2-137.0] versus 59.7 [29.8-138.0] U/mL, respectively). HBV vaccine non-responders were more likely than normal responders to not seroconvert after a single dose (age and sex-adjusted relative risk 1.85 95% confidence interval [1.10-3.13]) although nearly all participants seroconverted after the second dose. After limiting the analysis to 382 patients with baseline comorbidity data, the comorbidity-adjusted relative risk of non-seroconversion among HBV vaccine non-responders to normal responders was 1.32 (95% confidence interval [0.59-2.98]). DISCUSSION Long term follow-up studies are needed to understand if protective immunity against SARS-CoV-2 wanes faster among those with history of HBV vaccine non-response and when booster doses are warranted for these healthcare workers.
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Affiliation(s)
- Momoko Iwamoto
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Hospital, Kyoto, Nakagyo Ward, Japan
| | - Akira Ukimura
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Taku Ogawa
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Fumiko Kawanishi
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Naofumi Osaka
- Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Mari Kubota
- Department of Clinical Laboratory, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Tatsuhiko Mori
- Health Administration Center Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Ritsuko Sawamura
- Health Administration Center Osaka Medical and Pharmaceutical University, Takatsuki City, Osaka, Japan
| | - Masami Nishihara
- Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Tomio Suzuki
- Department of General Medicine, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
| | - Kazuhisa Uchiyama
- Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
- Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University Hospital, Takatsuki City, Osaka, Japan
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206
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Brito-Dellan N, Tsoukalas N, Font C. Thrombosis, cancer, and COVID-19. Support Care Cancer 2022; 30:8491-8500. [PMID: 35567609 PMCID: PMC9106567 DOI: 10.1007/s00520-022-07098-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/28/2022] [Indexed: 01/08/2023]
Abstract
Cancer and coronavirus disease 2019 (COVID-19) have unusual similarities: they both result in a markedly elevated risk of thrombosis, exceptionally high D-dimer levels, and the failure of anticoagulation therapy in some cases. Cancer patients are more vulnerable to COVID-19 infection and have a higher mortality rate. Science has uncovered much about SARS-CoV-2, and made extraordinary and unprecedented progress on the development of various treatment strategies and COVID-19 vaccines. In this review, we discuss known data on cancer-associated thrombosis (CAT), SARS-CoV-2 infection, and COVID-19 vaccines and discuss considerations for managing CAT in patients with COVID-19. Cancer patients should be given priority for COVID-19 vaccination; however, they may demonstrate a weaker immune response to COVID-19 vaccines than the general population. Currently, the Centers for Disease Control and Prevention recommends an additional dose and booster shot of the COVID-19 vaccine after the primary series in patients undergoing active cancer treatment for solid tumors or hematological cancers, recipients of stem cell transplant within the last 2 years, those taking immunosuppressive medications, and those undergoing active treatment with high-dose corticosteroids or other drugs that suppress the immune response. The mainstay of thrombosis treatment in patients with cancer and COVID-19 is anticoagulation therapy.
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Affiliation(s)
- Norman Brito-Dellan
- Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA.
| | - Nikolaos Tsoukalas
- Medical Oncology Department, 401 General Military Hospital of Athens, Athens, Greece
| | - Carme Font
- Medical Oncology Department, Day Hospital for Outpatient Care, Hospital Clinic, Barcelona, Spain
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207
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Baker D, MacDougall A, Kang AS, Schmierer K, Giovannoni G, Dobson R. Seroconversion following COVID-19 vaccination: can we optimize protective response in CD20-treated individuals? Clin Exp Immunol 2022; 207:263-271. [PMID: 35553629 PMCID: PMC9113152 DOI: 10.1093/cei/uxab015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/28/2021] [Accepted: 11/05/2021] [Indexed: 12/14/2022] Open
Abstract
Although there is an ever-increasing number of disease-modifying treatments for relapsing multiple sclerosis (MS), few appear to influence coronavirus disease 2019 (COVID-19) severity. There is concern about the use of anti-CD20-depleting monoclonal antibodies, due to the apparent increased risk of severe disease following severe acute respiratory syndrome corona virus two (SARS-CoV-2) infection and inhibition of protective anti-COVID-19 vaccine responses. These antibodies are given as maintenance infusions/injections and cause persistent depletion of CD20+ B cells, notably memory B-cell populations that may be instrumental in the control of relapsing MS. However, they also continuously deplete immature and mature/naïve B cells that form the precursors for infection-protective antibody responses, thus blunting vaccine responses. Seroconversion and maintained SARS-CoV-2 neutralizing antibody levels provide protection from COVID-19. However, it is evident that poor seroconversion occurs in the majority of individuals following initial and booster COVID-19 vaccinations, based on standard 6 monthly dosing intervals. Seroconversion may be optimized in the anti-CD20-treated population by vaccinating prior to treatment onset or using extended/delayed interval dosing (3-6 month extension to dosing interval) in those established on therapy, with B-cell monitoring until (1-3%) B-cell repopulation occurs prior to vaccination. Some people will take more than a year to replete and therefore protection may depend on either the vaccine-induced T-cell responses that typically occur or may require prophylactic, or rapid post-infection therapeutic, antibody or small-molecule antiviral treatment to optimize protection against COVID-19. Further studies are warranted to demonstrate the safety and efficacy of such approaches and whether or not immunity wanes prematurely as has been observed in the other populations.
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Affiliation(s)
- David Baker
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Amy MacDougall
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Angray S Kang
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Centre for Oral Immunobiology and Regenerative Medicine, Dental Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Klaus Schmierer
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Gavin Giovannoni
- The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Ruth Dobson
- Clinical Board Medicine (Neuroscience), The Royal London Hospital, Barts Health NHS Trust, London, UK
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, Barts and The London School of Medicine & Dentistry, London, UK
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Mencoboni M, Fontana V, Damiani A, Spitaleri A, Raso A, Bottaro LC, Rossi G, Canobbio L, La Camera A, Filiberti RA, Taveggia P, Cavo A. Antibody Response to COVID-19 mRNA Vaccines in Oncologic and Hematologic Patients Undergoing Chemotherapy. Curr Oncol 2022; 29:3364-3374. [PMID: 35621663 PMCID: PMC9139308 DOI: 10.3390/curroncol29050273] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/01/2022] [Accepted: 05/03/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Information on immune responses in cancer patients following mRNA COVID-19 vaccines is still insufficient, but generally, patients had impaired serological responses, especially those with hematological malignancies. We evaluated serological response to COVID-19 mRNA vaccine in cancer patients receiving chemotherapy compared with healthy controls. METHODS In total, 195 cancer patients and 400 randomly selected controls who had been administered a Pfizer-BioNTech or Moderna COVID-19 vaccines in two doses were compared. The threshold of positivity was 4.33 BAU/mL. Patients were receiving anticancer treatment after the first and second dose of the vaccines. RESULTS a TOTAL OF 169 patients (87%) had solid tumors and 26 hemolymphopoietic diseases. Seropositivity rate was lower in patients than controls (91% vs. 96%), with an age/gender-adjusted rate ratio (RR) of 0.95 (95% CL = 0.89-1.02). Positivity was found in 97% of solid cancers and in 50% of hemolymphopoietic tumors. Both advanced and adjuvant therapy seemed to slightly reduce seropositivity rates in patients when compared to controls (RR = 0.97, 95% CL = 0.89-1.06; RR = 0.94, 95% CL = 0.87-1.01). CONCLUSIONS the response to vaccination is similar in patients affected by solid tumors to controls. On the contrary, hemolymphopietic patients show a much lower response than controls.
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Affiliation(s)
- Manlio Mencoboni
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Vincenzo Fontana
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 12, 16100 Genoa, Italy;
| | - Azzurra Damiani
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Antonino Spitaleri
- Analysis Laboratory, ASL 3, Via Bertani 4, 16125 Genoa, Italy; (A.S.); (A.R.)
| | - Alessandro Raso
- Analysis Laboratory, ASL 3, Via Bertani 4, 16125 Genoa, Italy; (A.S.); (A.R.)
| | | | - Giovanni Rossi
- Oncology Unit, Antero Micone Hospital, Largo Nevio Rosso 2, 16100 Genoa, Italy; (G.R.); (L.C.)
| | - Luciano Canobbio
- Oncology Unit, Antero Micone Hospital, Largo Nevio Rosso 2, 16100 Genoa, Italy; (G.R.); (L.C.)
| | - Antonella La Camera
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Rosa Angela Filiberti
- Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 12, 16100 Genoa, Italy;
| | - Paola Taveggia
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
| | - Alessia Cavo
- Oncology Unit, ASL 3, Villa Scassi Hospital, Corso Scassi 1, 16149 Genoa, Italy; (M.M.); (A.D.); (A.L.C.); (P.T.); (A.C.)
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209
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Simsek M, Yasin AI, Besiroglu M, Topcu A, Isleyen ZS, Seker M, Turk HM. The Efficacy of BNT162b2 (Pfizer-BioNTech) and CoronaVac Vaccines in Patients with Cancer. J Med Virol 2022; 94:4138-4143. [PMID: 35513241 PMCID: PMC9348062 DOI: 10.1002/jmv.27835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is efficacious and prevents infection in the general population, there is limited data about Coronavirus disease‐19 (Covid‐19) occurrence after vaccination in cancer patients. It was aimed to evaluate the efficacy of BNT162b2 (Pfizer–BioNTech) and CoronaVac vaccines against Covid‐19 in patients with cancer. In this single‐center, retrospective, cross‐sectional, and descriptive study, the data of cancer patients referred to the medical oncology clinic of a university hospital were analyzed. The sample of the study consisted of cancer patients who had Covid‐19 or were vaccinated against Covid‐19. A total number of 2578 patients were included in the study. Of the patients, 2000 have never been infected with severe acute respiratory syndrome coronavirus and 578 patients have had a positive reverse‐transcription polymerase chain reaction (RT‐PCR) for Covid‐19. It was found that 2094 patients (81.2%) were fully vaccinated, and 484 patients (18.8%) did not receive full‐dose vaccination. A statistically significant difference in Covid‐19 occurrence was found between the patients who had full‐dose vaccination or not (p = 0.000). In in‐group comparisons of full‐dose vaccinated patients, while no difference was observed between two doses of BNT162b2 (Pfizer–BioNTech) and three doses of CoronaVac (p = 0.432), a statistically significant difference was observed between all other groups (p < 0.005). When the data of 578 patients who experienced Covid‐19 was analyzed, a statistically significant difference was observed between the groups who were full‐dose vaccinated and those who were not (p = 0.000). It is recommended that this vulnerable patient group should be prioritized in vaccination programs, and full‐dose vaccination (at least two doses of vaccines) should be completed as soon as possible.
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Affiliation(s)
- Melih Simsek
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
| | - Ayse Irem Yasin
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
| | - Mehmet Besiroglu
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
| | - Atakan Topcu
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
| | - Zehra Sucuoglu Isleyen
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
| | - Mesut Seker
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
| | - H Mehmet Turk
- BezmialemVakif University, Faculty of Medicine, Departments of Medical Oncology, Fatih/Istanbul, Turkey
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210
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Ogura W, Ohtsuka K, Matsuura S, Okuyama T, Matsushima S, Yamasaki S, Miyagi H, Sekiguchi K, Ohnishi H, Watanabe T. Can Individuals with Suboptimal Antibody Responses to Conventional Antiviral Vaccines Acquire Adequate Antibodies from SARS-CoV-2 mRNA Vaccination? Viruses 2022; 14:956. [PMID: 35632698 PMCID: PMC9147467 DOI: 10.3390/v14050956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 02/04/2023] Open
Abstract
In Japan, healthcare workers (HCWs) are vaccinated against measles, rubella, chickenpox, mumps, and hepatitis B to prevent nosocomial infection; however, some do not produce sufficient antibodies ("suboptimal responders"). This study compared immune responses to a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 mRNA) vaccine among HCWs with normal and suboptimal responses to conventional vaccines. In this prospective cohort study, 50 HCWs received two doses of BNT162b2 mRNA vaccine 3 weeks apart. SARS-CoV-2 anti-spike antibodies were measured 11 times, starting before the first vaccination and ending 5 months after the second vaccination. Antibody titers of four suboptimal and 46 normal responders were compared. SARS-CoV-2 neutralizing antibody activity was measured twice in suboptimal responders, 1 week/1 month and 5 months after the second vaccination. The SARS-CoV-2 anti-spike antibody was detectable in the samples from suboptimal and normal responders at each timepoint after vaccination. Suboptimal responders exhibited SARS-CoV-2 neutralizing antibody activity 1 week/1 month as well as 5 months after the second vaccination; however, activity was slightly reduced at 5 months. Our findings show that suboptimal responders do acquire adequate SARS-CoV-2 anti-spike and SARS-CoV-2 neutralizing antibodies from vaccination to prevent SARS-CoV-2. SARS-CoV-2 mRNA vaccines should thus be recommended for both normal and suboptimal responders to conventional vaccines.
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Affiliation(s)
- Wataru Ogura
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo 181-8611, Japan; (W.O.); (S.M.); (T.O.); (H.M.); (K.S.)
| | - Kouki Ohtsuka
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan; (S.M.); (S.Y.); (H.O.); (T.W.)
| | - Sachiko Matsuura
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo 181-8611, Japan; (W.O.); (S.M.); (T.O.); (H.M.); (K.S.)
| | - Takahiro Okuyama
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo 181-8611, Japan; (W.O.); (S.M.); (T.O.); (H.M.); (K.S.)
| | - Satsuki Matsushima
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan; (S.M.); (S.Y.); (H.O.); (T.W.)
| | - Satoko Yamasaki
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan; (S.M.); (S.Y.); (H.O.); (T.W.)
| | - Hiroyuki Miyagi
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo 181-8611, Japan; (W.O.); (S.M.); (T.O.); (H.M.); (K.S.)
| | - Kumiko Sekiguchi
- Department of Clinical Laboratory, Kyorin University Hospital, Mitaka, Tokyo 181-8611, Japan; (W.O.); (S.M.); (T.O.); (H.M.); (K.S.)
| | - Hiroaki Ohnishi
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan; (S.M.); (S.Y.); (H.O.); (T.W.)
| | - Takashi Watanabe
- Department of Laboratory Medicine, Kyorin University School of Medicine, Mitaka, Tokyo 181-8611, Japan; (S.M.); (S.Y.); (H.O.); (T.W.)
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211
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Li M, Wang H, Tian L, Pang Z, Yang Q, Huang T, Fan J, Song L, Tong Y, Fan H. COVID-19 vaccine development: milestones, lessons and prospects. Signal Transduct Target Ther 2022; 7:146. [PMID: 35504917 PMCID: PMC9062866 DOI: 10.1038/s41392-022-00996-y] [Citation(s) in RCA: 176] [Impact Index Per Article: 88.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 12/15/2022] Open
Abstract
With the constantly mutating of SARS-CoV-2 and the emergence of Variants of Concern (VOC), the implementation of vaccination is critically important. Existing SARS-CoV-2 vaccines mainly include inactivated, live attenuated, viral vector, protein subunit, RNA, DNA, and virus-like particle (VLP) vaccines. Viral vector vaccines, protein subunit vaccines, and mRNA vaccines may induce additional cellular or humoral immune regulations, including Th cell responses and germinal center responses, and form relevant memory cells, greatly improving their efficiency. However, some viral vector or mRNA vaccines may be associated with complications like thrombocytopenia and myocarditis, raising concerns about the safety of these COVID-19 vaccines. Here, we systemically assess the safety and efficacy of COVID-19 vaccines, including the possible complications and different effects on pregnant women, the elderly, people with immune diseases and acquired immunodeficiency syndrome (AIDS), transplant recipients, and cancer patients. Based on the current analysis, governments and relevant agencies are recommended to continue to advance the vaccine immunization process. Simultaneously, special attention should be paid to the health status of the vaccines, timely treatment of complications, vaccine development, and ensuring the lives and health of patients. In addition, available measures such as mix-and-match vaccination, developing new vaccines like nanoparticle vaccines, and optimizing immune adjuvant to improve vaccine safety and efficacy could be considered.
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Affiliation(s)
- Maochen Li
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Han Wang
- Laboratory for Clinical Immunology, Harbin Children's Hospital, Harbin, China
| | - Lili Tian
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Zehan Pang
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Qingkun Yang
- College of Materials Science and Engineering, Beijing University of Chemical Technology, Beijing, China
| | - Tianqi Huang
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China
| | - Junfen Fan
- Institute of Cerebrovascular Disease Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Lihua Song
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China.
| | - Yigang Tong
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China. .,Beijing Advanced Innovation Center for Soft Matter Science and Engineering, Beijing University of Chemical Technology, Beijing, China.
| | - Huahao Fan
- College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, China.
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212
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Seow J, Graham C, Hallett SR, Lechmere T, Maguire TJA, Huettner I, Cox D, Khan H, Pickering S, Roberts R, Waters A, Ward CC, Mant C, Pitcher MJ, Spencer J, Fox J, Malim MH, Doores KJ. ChAdOx1 nCoV-19 vaccine elicits monoclonal antibodies with cross-neutralizing activity against SARS-CoV-2 viral variants. Cell Rep 2022; 39:110757. [PMID: 35477023 PMCID: PMC9010245 DOI: 10.1016/j.celrep.2022.110757] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/14/2022] [Accepted: 04/06/2022] [Indexed: 11/29/2022] Open
Abstract
Although the antibody response to COVID-19 vaccination has been studied extensively at the polyclonal level using immune sera, little has been reported on the antibody response at the monoclonal level. Here, we isolate a panel of 44 anti-SARS-CoV-2 monoclonal antibodies (mAbs) from an individual who received two doses of the ChAdOx1 nCoV-19 (AZD1222) vaccine at a 12-week interval. We show that, despite a relatively low serum neutralization titer, Spike-reactive IgG+ B cells are still detectable 9 months post-boost. Furthermore, mAbs with potent neutralizing activity against the current SARS-CoV-2 variants of concern (Alpha, Gamma, Beta, Delta, and Omicron) are present. The vaccine-elicited neutralizing mAbs form eight distinct competition groups and bind epitopes overlapping with neutralizing mAbs elicited following SARS-CoV-2 infection. AZD1222-elicited mAbs are more mutated than mAbs isolated from convalescent donors 1-2 months post-infection. These findings provide molecular insights into the AZD1222 vaccine-elicited antibody response.
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Affiliation(s)
- Jeffrey Seow
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Sadie R Hallett
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Thomas Lechmere
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Thomas J A Maguire
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Isabella Huettner
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Daniel Cox
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Hataf Khan
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Suzanne Pickering
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | | | - Anele Waters
- Harrison Wing, Guy's and St Thomas' NHS Trust, London, UK
| | - Christopher C Ward
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Christine Mant
- Infectious Diseases Biobank, Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Michael J Pitcher
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jo Spencer
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Julie Fox
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK; Harrison Wing, Guy's and St Thomas' NHS Trust, London, UK
| | - Michael H Malim
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK.
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213
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Javadinia SA, Alizadeh K, Mojadadi MS, Nikbakht F, Dashti F, Joudi M, Harati H, Welsh JS, Farahmand SA, Attarian F. COVID-19 Vaccination in Patients With Malignancy; A Systematic Review and Meta-Analysis of the Efficacy and Safety. Front Endocrinol (Lausanne) 2022; 13:860238. [PMID: 35586627 PMCID: PMC9108702 DOI: 10.3389/fendo.2022.860238] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 02/25/2022] [Indexed: 12/20/2022] Open
Abstract
Background Data on the efficacy and safety of COVID-19 vaccines in patients with malignancy are immature. In this paper, we assessed the literature involving the use of COVID-19 vaccines in cancer patients and reported the seroconversion rates as the main outcome and severity of COVID-19 infection and side effects following COVID-19 vaccination as the secondary outcomes. Methods A systematic review with meta-analysis was performed. Searches were conducted in electronic websites, databases, and journals, including Scopus, PubMed, Embase, and Web of Science from January 01, 2019, to November 30, 2021. Studies reporting data on the safety and efficacy of COVID vaccine in cancer patients using any human samples were included. The risk of bias was assessed using the NEWCASTLE-OTTAWA scale in the included studies. Results A total of 724 articles were identified from databases, out of which 201 articles were duplicates and were discarded. Subsequently, 454 articles were excluded through initial screening of the titles and abstracts. Moreover, 41 studies did not report the precise seroconversion rate either based on the type of cancer or after injection of a second dose of COVID vaccine. Finally, 28 articles met all the inclusion criteria and were included in this systematic review. The overall seroconversion rates after receiving a second dose of COVID-19 vaccine, based on type of cancer were 88% (95% CI, 81%-92%) and 70% (95% CI, 60%-79%) in patients with solid tumors and hematologic malignancies, respectively. Conclusion Overall, we conclude that vaccination against COVID-19 in patients with active malignancies using activated and inactivated vaccines is a safe and tolerable procedure that is also accompanied by a high efficacy.
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Affiliation(s)
- Seyed Alireza Javadinia
- Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Kimia Alizadeh
- Department of Diagnostic Medicine & Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, United States
| | | | - Fateme Nikbakht
- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Dashti
- Faculty of Medicine, Birjand University of Medical Science, Birjand, Iran
| | - Maryam Joudi
- Department of Pediatrics, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - Hadi Harati
- Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran
| | - James S. Welsh
- Department of Radiation Oncology, Edward Hines Jr Veterans Administration (VA) Hospital and Loyola University Chicago Stritch School of Medicine, Chicago, IL, United States
| | - Seyed Amir Farahmand
- Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Fahimeh Attarian
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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214
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Whitaker HJ, Tsang RSM, Byford R, Andrews NJ, Sherlock J, Sebastian Pillai P, Williams J, Button E, Campbell H, Sinnathamby M, Victor W, Anand S, Linley E, Hewson J, DArchangelo S, Otter AD, Ellis J, Hobbs RFD, Howsam G, Zambon M, Ramsay M, Brown KE, de Lusignan S, Amirthalingam G, Lopez Bernal J. Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response amongst individuals in clinical risk groups. J Infect 2022; 84:675-683. [PMID: 34990709 PMCID: PMC8720678 DOI: 10.1016/j.jinf.2021.12.044] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/29/2021] [Indexed: 01/30/2023]
Abstract
Background COVID-19 vaccines approved in the UK are highly effective in general population cohorts, however, data on effectiveness amongst individuals with clinical conditions that place them at increased risk of severe disease are limited. Methods We used GP electronic health record data, sentinel virology swabbing and antibody testing within a cohort of 712 general practices across England to estimate vaccine antibody response and vaccine effectiveness against medically attended COVID-19 amongst individuals in clinical risk groups using cohort and test-negative case control designs. Findings There was no reduction in S-antibody positivity in most clinical risk groups, however reduced S-antibody positivity and response was significant in the immunosuppressed group. Reduced vaccine effectiveness against clinical disease was also noted in the immunosuppressed group; after a second dose, effectiveness was moderate (Pfizer: 59.6%, 95%CI 18.0-80.1%; AstraZeneca 60.0%, 95%CI -63.6-90.2%). Interpretation In most clinical risk groups, immune response to primary vaccination was maintained and high levels of vaccine effectiveness were seen. Reduced antibody response and vaccine effectiveness were seen after 1 dose of vaccine amongst a broad immunosuppressed group, and second dose vaccine effectiveness was moderate. These findings support maximising coverage in immunosuppressed individuals and the policy of prioritisation of this group for third doses.
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Affiliation(s)
- Heather J Whitaker
- Statistics, Modelling and Economics Department, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Ruby S M Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Nick J Andrews
- Statistics, Modelling and Economics Department, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK; Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Praveen Sebastian Pillai
- Virus Reference Laboratory, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - John Williams
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Elizabeth Button
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Helen Campbell
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Mary Sinnathamby
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - William Victor
- Royal College of General Practitioners Research and Surveillance Centre, Euston Square, London, NW1 2FB, UK
| | - Sneha Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Ezra Linley
- Vaccine Evaluation Unit, UK Health Security Agency (formerly Public Health England)), Manchester M13 9WL, UK
| | - Jacqueline Hewson
- Diagnostics and Genomics, UK Health Security Agency (formerly Public Health England), Porton Down, Salisbury SP4 0JG, UK
| | - Silvia DArchangelo
- Diagnostics and Genomics, UK Health Security Agency (formerly Public Health England), Porton Down, Salisbury SP4 0JG, UK
| | - Ashley D Otter
- Diagnostics and Genomics, UK Health Security Agency (formerly Public Health England), Porton Down, Salisbury SP4 0JG, UK
| | - Joanna Ellis
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK; Virus Reference Laboratory, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Richard F D Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Gary Howsam
- Royal College of General Practitioners Research and Surveillance Centre, Euston Square, London, NW1 2FB, UK
| | - Maria Zambon
- Virus Reference Laboratory, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Mary Ramsay
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Kevin E Brown
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; Royal College of General Practitioners Research and Surveillance Centre, Euston Square, London, NW1 2FB, UK
| | - Gayatri Amirthalingam
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK
| | - Jamie Lopez Bernal
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency (formerly Public Health England), 61 Colindale Avenue, London NW9 5EQ, UK.
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215
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Sadeghalvad M, Mansourabadi AH, Noori M, Nejadghaderi SA, Masoomikarimi M, Alimohammadi M, Rezaei N. Recent developments in SARS-CoV-2 vaccines: A systematic review of the current studies. Rev Med Virol 2022; 33:e2359. [PMID: 35491495 PMCID: PMC9348268 DOI: 10.1002/rmv.2359] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 01/28/2023]
Abstract
Designing and manufacturing efficient vaccines against coronavirus disease 2019 (COVID-19) is a major objective. In this systematic review, we aimed to evaluate the most important vaccines under construction worldwide, their efficiencies and clinical results in healthy individuals and in those with specific underlying diseases. We conducted a comprehensive search in PubMed, Scopus, EMBASE, and Web of Sciences by 1 December 2021 to identify published research studies. The inclusion criteria were publications that evaluated the immune responses and safety of COVID-19 vaccines in healthy individuals and in those with pre-existing diseases. We also searched the VAERS database to estimate the incidence of adverse events of special interest (AESI) post COVID-19 vaccination. Almost all investigated vaccines were well tolerated and developed good levels of both humoural and cellular responses. A protective and efficient humoural immune response develops after the second or third dose of vaccine and a longer interval (about 28 days) between the first and second injections of vaccine could induce higher antibody responses. The vaccines were less immunogenic in immunocompromised patients, particularly those with haematological malignancies. In addition, we found that venous and arterial thrombotic events, Bell's palsy, and myocarditis/pericarditis were the most common AESI. The results showed the potency of the SARS-CoV-2 vaccines to protect subjects against disease. The provision of further effective and safe vaccines is necessary in order to reach a high coverage of immunisation programs across the globe and to provide protection against infection itself.
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Affiliation(s)
- Mona Sadeghalvad
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran
| | | | - Maryam Noori
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran,Urology Research CenterTehran University of Medical SciencesTehranIran
| | - Seyed Aria Nejadghaderi
- Systematic Review and Meta‐Analysis Expert Group (SRMEG)Universal Scientific Education and Research Network (USERN)TehranIran,School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Masoomeh Masoomikarimi
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran
| | - Masoumeh Alimohammadi
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA)Universal Scientific Education and Research Network (USERN)TehranIran,Research Center for ImmunodeficienciesChildren's Medical CenterTehran University of Medical SciencesTehranIran
| | - Nima Rezaei
- Department of ImmunologySchool of MedicineTehran University of Medical SciencesTehranIran,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA)Universal Scientific Education and Research Network (USERN)TehranIran,Research Center for ImmunodeficienciesChildren's Medical CenterTehran University of Medical SciencesTehranIran
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Gavriatopoulou M, Terpos E, Kastritis E, Briasoulis A, Gumeni S, Ntanasis-Stathopoulos I, Sklirou AD, Malandrakis P, Eleutherakis-Papaiakovou E, Migkou M, Trougakos IP, Dimopoulos MA. Low neutralizing antibody responses in WM, CLL and NHL patients after the first dose of the BNT162b2 and AZD1222 vaccine. Clin Exp Med 2022; 22:319-323. [PMID: 34283338 PMCID: PMC8290394 DOI: 10.1007/s10238-021-00746-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/12/2021] [Indexed: 12/27/2022]
Abstract
Vaccination against SARS-CoV-2 is considered as the most important preventive strategy against COVID-19, but its efficacy in patients with hematological malignancies is largely unknown. We investigated the development of neutralizing antibodies (NAbs) against SARS-CoV-2 in patients with Waldenstrom Macroglobulinemia (WM), Chronic Lymphocytic Leukemia (CLL) and Non-Hodgkin Lymphoma (NHL). After the first dose of the vaccine, on D22, WM/CLL/NHL patients had lower NAb titers compared to controls: the median NAb inhibition titer was 17% (range 0-91%, IQR 8-27%) for WM/CLL/NHL patients versus 32% (range 2-98%, IQR 19-48%) for controls (P < 0.001). Only 8 (14%) patients versus 114 (54%) controls developed NAb titers ≥ 30% on D22 (p < 0.001). Our data indicate that the first dose of both BNT162b2 and AZD1222 leads to lower production of NAbs against SARS-CoV-2 in patients with WM/CLL/NHL compared to controls of similar age and gender and without malignant disease. Even though the response rates were not optimal, vaccination is still considered essential and if possible should be performed before treatment initiation. These patients with suboptimal responses should be considered to be prioritized for booster doses.
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Affiliation(s)
- Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece.
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Alexandros Briasoulis
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Sentiljana Gumeni
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Aimilia D Sklirou
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Evangelos Eleutherakis-Papaiakovou
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Magdalini Migkou
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Ioannis P Trougakos
- Department of Cell Biology and Biophysics, Faculty of Biology, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, 80 Vas. Sofias Avenue, 11528, Athens, Greece
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Cortés A, Casado JL, Longo F, Serrano JJ, Saavedra C, Velasco H, Martin A, Chamorro J, Rosero D, Fernández M, Gion M, Martínez Jáñez N, Soria Rivas A, Alonso Gordoa T, Martínez Delfrade Í, Lage Y, López Miranda E, Olmedo ME, Reguera Puertas P, Gajate P, Molina Cerrillo J, Guerra Alia E, Fuentes Mateos R, Romero B, Rodríguez-Domínguez MJ, Vallejo A, Carrato A. Limited T cell response to SARS-CoV-2 mRNA vaccine among patients with cancer receiving different cancer treatments. Eur J Cancer 2022; 166:229-239. [PMID: 35316750 PMCID: PMC8885286 DOI: 10.1016/j.ejca.2022.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/13/2022] [Accepted: 02/18/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Patients with cancer (PC) are at high risk of acquiring COVID-19 and can develop more serious complications. Deeper understanding of vaccines immunogenicity in this population is crucial for adequately planning vaccines programs. The ONCOVac study aimed to comprehensively assess the immunogenicity of mRNA-1273 vaccine in terms of humoral and cellular response. METHODS We conducted a prospective, single-center study including patients with solid tumours treated with cyclin-dependent kinases 4 and 6 inhibitors (CDK4/6i), immunotherapy (IT) or chemotherapy (CT). Patients were enrolled previously to vaccination with mRNA-1273. We also involved health care workers (HCW) to serve as a control group. We took blood samples before first dose administration (BL), after first dose (1D), and after second dose (2D). The primary objective was to compare the rate and magnitude of T cell response after second dose whereas safety and humoral response were defined as secondary objectives. We also collected patient reported outcomes after both the first and second vaccine dose and a six-month follow-up period to diagnose incident COVID-19 cases was planned. RESULTS The rate of specific anti-S serologic positivity (anti-S IgG cut-off point at 7,14 BAU/mL) was significantly higher in HCW compared to PC after 1D (100% versus 83.8%; p = 0.04), but similar after 2D (100% versus 95.8%; p = 0.5). This difference after 1D was driven by PC treated with CT (100% versus 64.5%; p = 0.001). Cellular response after 2D was significantly lower in PC than in HCW for both CD4+ (91.7% versus 59.7%; p = 0.001) and CD8+ (94.4% versus 55.6%; p < 0.001) T cells. We found a difference on pre-existing CD4+ T cell response in HCW comparing to PC (36% and 17%, p = 0.03); without difference in pre-existing CD8+ T cell response (31% and 23%, p = 0.5). After excluding patients with pre-existing T cell response, PC achieved even lower CD4+ (50.9% versus 95.5%, p < 0.001) and CD8+ (45.5% versus 95.5%, p < 0.001) T cell response compared with HCW. Regarding safety, PC reported notably more adverse events than HCW (96.6% versus 69.2%, p < 0.001). CONCLUSION We demonstrated that PC showed a similar humoral response but a lower T cell response following two doses of mRNA-1273 vaccination. Further studies are needed to complement our results and determine the implication of low T cell response on clinical protection of PC against COVID-19.
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Affiliation(s)
- Alfonso Cortés
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - José L Casado
- Infectious Disease Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Federico Longo
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red (CIBERONC), Alcalá de Henares University, Madrid, Spain
| | - Juan J Serrano
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Cristina Saavedra
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Héctor Velasco
- Laboratory of Immunovirology, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Adrián Martin
- Laboratory of Immunovirology, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Jesús Chamorro
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Diana Rosero
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - María Fernández
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - María Gion
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Noelia Martínez Jáñez
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Ainara Soria Rivas
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Teresa Alonso Gordoa
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Íñigo Martínez Delfrade
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Yolanda Lage
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Elena López Miranda
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - María E Olmedo
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Pablo Reguera Puertas
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Pablo Gajate
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Javier Molina Cerrillo
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Eva Guerra Alia
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Raquel Fuentes Mateos
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Beatriz Romero
- Microbiology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Mario J Rodríguez-Domínguez
- Microbiology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red (CIBER) en Epidemiología y Salud Pública, Spain
| | - Alejandro Vallejo
- Laboratory of Immunovirology, Infectious Diseases Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
| | - Alfredo Carrato
- Medical Oncology Department, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain; Centro de Investigación Biomédica en Red (CIBERONC), Alcalá de Henares University, Madrid, Spain.
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Abdul-Jawad S, Beatson R, Lechmere T, Graham R, Alaguthurai T, Graham C, Vidler J, Kulasekararaj A, Patten PEM, Doores KJ, Irshad S. BNT162b2 COVID-19 and ChAdOx1 nCoV-19 vaccination in patients with myelodysplastic syndromes. Haematologica 2022; 107:1181-1184. [PMID: 35045695 PMCID: PMC9052909 DOI: 10.3324/haematol.2021.280337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/10/2022] [Indexed: 12/05/2022] Open
Affiliation(s)
- Sultan Abdul-Jawad
- Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - Richard Beatson
- Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - Thomas Lechmere
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - Rosalind Graham
- Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, UK
| | - Thanussuyah Alaguthurai
- Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, UK; Breast Cancer Now Research Unit, King's College London, London, UK
| | - Carl Graham
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - Jennifer Vidler
- Department of Haematological Medicine, King's College Hospital, London, UK
| | | | - Piers E M Patten
- Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, UK; Department of Haematological Medicine, King's College Hospital, London, UK
| | - Katie J Doores
- Department of Infectious Diseases, School of Immunology and Microbial Sciences, King's College London, UK
| | - Sheeba Irshad
- Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, UK; Breast Cancer Now Research Unit, King's College London, London, UK; Guy's and St Thomas' NHS Foundation Trust, London, UK; Cancer Research UK (CRUK) Clinician Scientist, London, UK.
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219
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Connors JM, Iba T. Vaccine-induced immune thrombotic thrombocytopenia and patients with cancer. Thromb Res 2022; 213 Suppl 1:S77-S83. [PMID: 36210565 PMCID: PMC9133965 DOI: 10.1016/j.thromres.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 01/17/2023]
Abstract
Vaccines to combat SARS-CoV-2 infection and the COVID-19 pandemic were quickly developed due to significant and combined efforts by the scientific community, government agencies, and private sector pharmaceutical and biotechnology companies. Following vaccine development, which took less than a year to accomplish, randomized placebo controlled clinical trials enrolled almost 100,000 people, demonstrating efficacy and no major safety signals. Vaccination programs were started, but shortly thereafter a small number of patients with a constellation of findings including thrombosis in unusual locations, thrombocytopenia, elevated D-dimer and often low fibrinogen led another intense and concentrated scientific effort to understand this syndrome. It was recognized that this occurred within a short time following administration of adenoviral vector SARS-CoV-2 vaccines. Critical to the rapid understanding of this syndrome was prompt communication among clinicians and scientists and exchange of knowledge. Now known as vaccine-induced immune thrombotic thrombocytopenia syndrome (VITT), progress has been made in understanding the pathophysiology of the syndrome, with the development of diagnostic criteria, and most importantly therapeutic strategies needed to effectively treat this rare complication of adenoviral vector vaccination. This review will focus on the current understanding of the pathophysiology of VITT, the findings that affected patients present with, and the rational for therapies, including for patients with cancer, as prompt recognition, diagnosis, and treatment of this syndrome has resulted in a dramatic decrease in associated mortality.
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Affiliation(s)
- Jean M. Connors
- Hematology Division, Brigham and Women's Hospital, Dana Farber Cancer institute, 75 Francis Street, Boston, MA 02115, United States of America,Corresponding author
| | - Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Cavalcante FP, Abdala E, Weissmann L, Ferreira CEDS, Amorim G, de Oliveira VM, Guilgen G, Landeiro L, Pinho JRR, Pulchinelli Á, Ribeiro H, Souza R, Rosa DD. Impact of COVID-19 Disease in Early Breast Cancer Management: A Summary of the Current Evidence. JCO Glob Oncol 2022; 8:e2100357. [PMID: 35594492 PMCID: PMC9173577 DOI: 10.1200/go.21.00357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
An expert panel on breast cancer and COVID-19 disease was convened to address the impact of the COVID-19 pandemic for early breast cancer (eBC) management.
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Affiliation(s)
| | - Edson Abdala
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Leonardo Weissmann
- Emílio Ribas Infectious Disease Institute, São Paulo, SP, Brazil
- Unaerp School of Medicine, Guarujá, SP, Brazil
- Brazilian Society of Infectology, São Paulo, SP, Brazil
| | | | - Gilberto Amorim
- Oncologia D'Or, Rio de Janeiro, RJ, Brazil
- Brazilian Breast Cancer Study Group (GBECAM), Porto Alegre, RS, Brazil
| | - Vilmar Marques de Oliveira
- Brazilian Society of Mastology, Rio de Janeiro, RJ, Brazil
- Santa Casa de São Paulo Hospital, São Paulo, SP, Brazil
- Santa Casa de São Paulo School of Medical Sciences, São Paulo, SP, Brazil
| | - Gisah Guilgen
- Brazilian Breast Cancer Study Group (GBECAM), Porto Alegre, RS, Brazil
- Curitiba Cancer and Transplant Institute, Curitiba, PR, Brazil
- Nossa Senhora das Graças Hospital, Curitiba, PR, Brazil
| | - Luciana Landeiro
- Núcleo de Oncologia da Bahia (NOB)—Oncoclínicas Group, Salvador, BA, Brazil
| | - João Renato Rebello Pinho
- Albert Einstein Hospital, São Paulo, SP, Brazil
- Hospital das Clínicas, São Paulo, SP, Brazil
- School of Medicine, Medical Research Laboratories LIM 03/07, University of São Paulo, São Paulo, SP, Brazil
| | - Álvaro Pulchinelli
- Brazilian Society of Clinical Pathology/Laboratory Medicine, Rio de Janeiro, RJ, Brazil
- Fleury Group, São Paulo, SP, Brazil
- School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Heber Ribeiro
- Brazilian Society of Oncology Surgery, Rio de Janeiro, RJ, Brazil
- AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Rafael Souza
- Cancer Treatment Institute (ITC), Campo Grande, MS, Brazil
| | - Daniela Dornelles Rosa
- Brazilian Breast Cancer Study Group (GBECAM), Porto Alegre, RS, Brazil
- Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
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221
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Couderc AL, Ninove L, Nouguerède E, Rey D, Rebroin M, Daumas A, Tomasini P, Greillier L, Salas S, Duffaud F, Dahan L, Duluc M, Garcia ME, Pluvy J, Chaléat S, Farnault L, Venton G, Fourié T, Nurtop E, de Lamballerie X, Villani P, Charrel R, Correard F. Acceptance, efficacy, and safety of COVID-19 vaccination in older patients with cancer. J Geriatr Oncol 2022; 13:850-855. [PMID: 35589542 PMCID: PMC9108027 DOI: 10.1016/j.jgo.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 01/08/2023]
Abstract
Purpose The COVID-19 vaccination campaign began in December 2020, in France, and primarily targeted the oldest people. Our study aimed to determine the level of acceptance of vaccination in a population of older patients with cancer. Methods From January 2021, we offered vaccination with the BNT162b2 COVID-19 vaccine to all patients 70 years and older referred to our geriatric oncology center in Marseille University Hospital (AP-HM) for geriatric assessment before initiation of an oncological treatment. Objectives were to evaluate acceptance rate of COVID-19 vaccination and to assess vaccine safety, reactogenicity, and efficacy two months after the first dose. Results Between January 18, 2021 and May 7, 2021, 150 older patients with cancer were offered vaccination after a geriatric assessment. The majority were men (61.3%), with a mean age of 81 years. The two most frequent primary tumors were digestive (29.4%) and thoracic (18%). The vaccine acceptance rate was 82.6% and the complete vaccination rate (2 doses) reached 75.3%. Among the vaccinated patients, 15.9% reported mild side effects after the first dose and 23.4% after the second dose, mostly arm pain and fatigue. COVID-19 cases were observed in 5.1% of vaccinated patients compared with 16.7% in unvaccinated patients. Of the 22 vaccinated patients who agreed to have their serum tested, 15 had antibodies against the spike protein at day 21 after the first dose. Conclusion Our study showed a high acceptance rate of COVID-19 vaccination, with good tolerance in this frail population. These results highlight the benefits of organizing vaccination campaigns at the very beginning of oncological management in older patients. Clinical trial registration: This study was registered May 23, 2019 in ClinicalTrials.gov (NCT03960593).
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Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille University, CNRS, EFS, ADES, Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France.
| | - Laetitia Ninove
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Emilie Nouguerède
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France
| | - Dominique Rey
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Coordination Unit for Geriatric Oncology (UCOG), PACA West, France
| | | | - Aurélie Daumas
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Pascale Tomasini
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Laurent Greillier
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | | | | | - Laetitia Dahan
- Hepato-Gastro-Enterolgy Unit, CHU Timone, AP-HM, Marseille, France
| | - Muriel Duluc
- Hepato-Gastro-Enterolgy Unit, CHU Timone, AP-HM, Marseille, France
| | - Marie-Eve Garcia
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Johan Pluvy
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Solène Chaléat
- Multidisciplinary Oncology and Therapeutic Innovations Department, AP-HM, Marseille, France
| | - Laure Farnault
- Haematology and Cellular Therapy Department, AP-HM, Marseille, France
| | - Geoffroy Venton
- Haematology and Cellular Therapy Department, AP-HM, Marseille, France
| | - Toscane Fourié
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Elif Nurtop
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
| | - Patrick Villani
- Internal Medicine, Geriatrics and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille University, CNRS, EFS, ADES, Marseille, France
| | - Remi Charrel
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, 13005 Marseille, France
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Song Q, Bates B, Shao YR, Hsu FC, Liu F, Madhira V, Mitra AK, Bergquist T, Kavuluru R, Li X, Sharafeldin N, Su J, Topaloglu U. Risk and Outcome of Breakthrough COVID-19 Infections in Vaccinated Patients With Cancer: Real-World Evidence From the National COVID Cohort Collaborative. J Clin Oncol 2022; 40:1414-1427. [PMID: 35286152 PMCID: PMC9061155 DOI: 10.1200/jco.21.02419] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/07/2022] [Accepted: 02/18/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To provide real-world evidence on risks and outcomes of breakthrough COVID-19 infections in vaccinated patients with cancer using the largest national cohort of COVID-19 cases and controls. METHODS We used the National COVID Cohort Collaborative (N3C) to identify breakthrough infections between December 1, 2020, and May 31, 2021. We included patients partially or fully vaccinated with mRNA COVID-19 vaccines with no prior SARS-CoV-2 infection record. Risks for breakthrough infection and severe outcomes were analyzed using logistic regression. RESULTS A total of 6,860 breakthrough cases were identified within the N3C-vaccinated population, among whom 1,460 (21.3%) were patients with cancer. Solid tumors and hematologic malignancies had significantly higher risks for breakthrough infection (odds ratios [ORs] = 1.12, 95% CI, 1.01 to 1.23 and 4.64, 95% CI, 3.98 to 5.38) and severe outcomes (ORs = 1.33, 95% CI, 1.09 to 1.62 and 1.45, 95% CI, 1.08 to 1.95) compared with noncancer patients, adjusting for age, sex, race/ethnicity, smoking status, vaccine type, and vaccination date. Compared with solid tumors, hematologic malignancies were at increased risk for breakthrough infections (adjusted OR ranged from 2.07 for lymphoma to 7.25 for lymphoid leukemia). Breakthrough risk was reduced after the second vaccine dose for all cancers (OR = 0.04; 95% CI, 0.04 to 0.05), and for Moderna's mRNA-1273 compared with Pfizer's BNT162b2 vaccine (OR = 0.66; 95% CI, 0.62 to 0.70), particularly in patients with multiple myeloma (OR = 0.35; 95% CI, 0.15 to 0.72). Medications with major immunosuppressive effects and bone marrow transplantation were strongly associated with breakthrough risk among the vaccinated population. CONCLUSION Real-world evidence shows that patients with cancer, especially hematologic malignancies, are at higher risk for developing breakthrough infections and severe outcomes. Patients with vaccination were at markedly decreased risk for breakthrough infections. Further work is needed to assess boosters and new SARS-CoV-2 variants.
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Affiliation(s)
| | | | | | - Fang-Chi Hsu
- Wake Forest School of Medicine, Winston-Salem, NC
| | - Feifan Liu
- University of Massachusetts Chan Medical School, Boston, MA
| | | | | | | | | | - Xiaochun Li
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Noha Sharafeldin
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Jing Su
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
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Lazăr DE, Munteanu A. COVID-19 immunization in people with cancer-Is it safe and efficient? What do we know? TUMORI JOURNAL 2022; 108:420-430. [PMID: 35426773 DOI: 10.1177/03008916221090544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Prior to the COVID-19 pandemic, vaccination of people with cancer or a recent history of cancer was advisable under specific conditions, depending on the type of vaccine (inactivated or live attenuated virus or bacterium), type of cancer, and whether they had undergone treatment for cancer. Some malignancies, especially hematological malignancies, and cancer treatments such as chemotherapy, radiotherapy, and splenectomy negatively impact the immune response. The clinical trials of currently used vaccines against COVID-19 did not include people with active cancer; thus, there is an important gap in the knowledge of safety and efficiency data for COVID-19 immunization in this population. However, considering the risk of mortality and morbidity due to possible infection with SARS-CoV-2, medical experts recommend immunization on an individual basis. As the worldwide prevalence of malignancies is high, reliable information on COVID-19 vaccination is expected to be revealed in future clinical trials. In this review, we examine the key aspects of cancer that may be affected by COVID-19 and summarize the current literature on COVID-19 immunization.
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Affiliation(s)
| | - Anca Munteanu
- Radiotherapy Department, Regional Institute of Oncology, Iasi, Romania.,Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
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224
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Livanou E, Rouka E, Sinis S, Dimeas I, Pantazopoulos I, Papagiannis D, Malli F, Kotsiou O, Gourgoulianis KI. Predictors of SARS-CoV-2 IgG Spike Antibody Responses on Admission and Clinical Outcomes of COVID-19 Disease in Fully Vaccinated Inpatients: The CoVax Study. J Pers Med 2022; 12:640. [PMID: 35455756 PMCID: PMC9027658 DOI: 10.3390/jpm12040640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 vaccines have shown high efficacy in protecting against COVID-19, although the determinants of vaccine effectiveness and breakthrough rates are yet to be determined. We aimed at investigating several factors affecting the SARS-CoV-2 IgG Spike (S) antibody responses on admission and clinical outcomes of COVID-19 disease in fully vaccinated, hospitalized patients. METHODS 102 subjects were enrolled in the study. Blood serum samples were collected from each patient upon admission for the semiquantitative determination of the SARS-CoV-2 IgG S levels with lateral flow assays. Factors influencing vaccine responses were documented. RESULTS 27 subjects had a negative antibody test upon hospital admission. Out of the 102 patients admitted to the hospital, 88 were discharged and 14 died. Both the absence of anti-S SARS-CoV-2 antibodies and poor clinical outcomes of COVID-19 disease were associated with older age, lower Ct values, and a shorter period between symptom onset and hospital admission. Ct values and time between symptom onset and hospitalization were independently associated with SARS-CoV-2 IgG S responses upon admission. The PaO2/FiO2 ratio was identified as an independent predictor of in-hospital mortality. CONCLUSIONS Host- and disease-associated factors can predict SARS-CoV-2 IgG S responses and mortality in hospitalized patients with breakthrough SARS-CoV-2 Infection.
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Affiliation(s)
- Eleni Livanou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (E.L.); (S.S.); (I.D.); (I.P.); (K.I.G.)
| | - Erasmia Rouka
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (E.L.); (S.S.); (I.D.); (I.P.); (K.I.G.)
| | - Sotirios Sinis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (E.L.); (S.S.); (I.D.); (I.P.); (K.I.G.)
| | - Ilias Dimeas
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (E.L.); (S.S.); (I.D.); (I.P.); (K.I.G.)
| | - Ioannis Pantazopoulos
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (E.L.); (S.S.); (I.D.); (I.P.); (K.I.G.)
| | - Dimitrios Papagiannis
- Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece; (D.P.); (F.M.); (O.K.)
| | - Foteini Malli
- Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece; (D.P.); (F.M.); (O.K.)
| | - Ourania Kotsiou
- Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece; (D.P.); (F.M.); (O.K.)
| | - Konstantinos I. Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece; (E.L.); (S.S.); (I.D.); (I.P.); (K.I.G.)
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225
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Chen L, Cai X, Zhao T, Han B, Xie M, Cui J, Zhang J, Wang C, Liu B, Lu Q, Cui F. Safety of Global SARS-CoV-2 Vaccines, a Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10040596. [PMID: 35455344 PMCID: PMC9030038 DOI: 10.3390/vaccines10040596] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from 1 January 2020 to 20 October 2021. Information of adverse events (AEs) of each selected work was collected. The quality and bias of studies was evaluated, and meta-analysis was carried out by using Stata 17.0. (3) Results: Totally, 11,451 articles were retrieved, and 53 of them were included for analysis. The incidence rate of AEs was 20.05–94.48%. The incidence rate of vascular events increased after viral vector vaccination, while the incidence rate of vascular events decreased after mRNA vaccination. Viral vector vaccine had a higher AE rate compared to mRNA vaccines and inactivated vaccines. In most circumstances, the incidence of AEs was higher in older people, female and after the second dose. The sensitivity of meta-analysis was acceptable; however, the literature was subject to a certain publication bias. (4) Conclusions: The safety of SARS-CoV-2 vaccines was acceptable. The incidence of allergic symptoms and cardiovascular and cerebrovascular symptoms was low. Viral vector vaccine had a higher risk of leading to thrombosis events. The understanding of SARS-CoV-2 vaccine AEs should be enhanced, so as to promote the vaccination.
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Affiliation(s)
- Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Xianming Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Bingfeng Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Mingzhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Jiahao Cui
- Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Jiayu Zhang
- Bioinformatics Program, School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China;
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
- Correspondence: ; Tel./Fax: +86-10-8280-1518
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226
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Zacharopoulou E, Orfanoudaki E, Tzouvala M, Tribonias G, Kokkotis G, Kitsou V, Almpani F, Christidou A, Viazis N, Mantzaris GJ, Tsafaridou M, Karmiris K, Theodoropoulou A, Papathanasiou E, Zampeli E, Michopoulos S, Tigkas S, Michalopoulos G, Laoudi E, Karatzas P, Mylonas I, Kyriakos N, Liatsos C, Kafetzi T, Theocharis G, Taka S, Panagiotopoulou K, Koutroubakis IE, Bamias G. Patients With Inflammatory Bowel Diseases Have Impaired Antibody Production After Anti-SARS-CoV-2 Vaccination: Results From a Panhellenic Registry. Inflamm Bowel Dis 2022; 29:228-237. [PMID: 35394529 PMCID: PMC9051580 DOI: 10.1093/ibd/izac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Four EMA-approved vaccines against SARS-CoV-2 are currently available. Data regarding antibody responses to initial vaccination regimens in patients with inflammatory bowel diseases (IBD) are limited. METHODS We conducted a prospective, controlled, multicenter study in tertiary Greek IBD centers. Participating patients had completed the initial vaccination regimens (1 or 2 doses, depending on the type of COVID-19 vaccine) at least 2 weeks before study enrolment. Anti-S1 IgG antibody levels were measured. Demographic and adverse events data were collected. RESULTS We tested 403 patients (Crohn's disease, 58.9%; male, 53.4%; median age, 45 years) and 124 healthy controls (HCs). Following full vaccination, 98% of patients seroconverted, with mRNA vaccines inducing higher seroconversion rates than viral vector vaccines (P = .021). In total, IBD patients had lower anti-S1 levels than HCs (P < .001). In the multivariate analysis, viral vector vaccines (P < .001), longer time to antibody testing (P < .001), anti-TNFα treatment (P = .013), and age (P = .016) were independently associated with lower anti-S1 titers. Vedolizumab monotherapy was associated with higher antibody levels than anti-TNFα or anti-interleukin-12/IL-23 monotherapy (P = .023 and P = .032). All anti- SARS-CoV-2 vaccines were safe. CONCLUSIONS Patients with IBD have impaired antibody responses to anti-SARS-CoV-2 vaccination, particularly those receiving viral vector vaccines and those on anti-TNFα treatment. Older age also hampers antibody production after vaccination. For those low-response groups, administration of accelerated or prioritized booster vaccination may be considered.
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Affiliation(s)
- Eirini Zacharopoulou
- Department of Gastroenterology, General Hospital of Nikaia Piraeus “Agios Panteleimon,” General Hospital Dytikis Attikis “Agia Varvara,”Athens, Greece
| | - Eleni Orfanoudaki
- Department of Gastroenterology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion Crete, Greece
| | - Maria Tzouvala
- Department of Gastroenterology, General Hospital of Nikaia Piraeus “Agios Panteleimon,” General Hospital Dytikis Attikis “Agia Varvara,”Athens, Greece
| | - George Tribonias
- Department of Gastroenterology, General Hospital of Nikaia Piraeus “Agios Panteleimon,” General Hospital Dytikis Attikis “Agia Varvara,”Athens, Greece
| | - Georgios Kokkotis
- GI Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian Univeristy of Athens- “Sotiria” General Hospital, Athens, Greece
| | - Vassiliki Kitsou
- GI Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian Univeristy of Athens- “Sotiria” General Hospital, Athens, Greece
| | - Foteini Almpani
- Department of Gastroenterology, General Hospital of Athens, Evaggelismos, Opthalmiatreion Athinon, Polykliniki, Athens, Greece
| | - Aggeliki Christidou
- Department of Gastroenterology, General Hospital of Athens, Evaggelismos, Opthalmiatreion Athinon, Polykliniki, Athens, Greece
| | - Nikolaos Viazis
- Department of Gastroenterology, General Hospital of Athens, Evaggelismos, Opthalmiatreion Athinon, Polykliniki, Athens, Greece
| | - Gerassimos J Mantzaris
- Department of Gastroenterology, General Hospital of Athens, Evaggelismos, Opthalmiatreion Athinon, Polykliniki, Athens, Greece
| | - Maria Tsafaridou
- Department of Gastroenterology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion Crete, Greece
| | | | | | - Evgenia Papathanasiou
- Department of Gastroenterology, General Hospital of Athens “Alexandra,”Athens, Greece
| | - Evanthia Zampeli
- Department of Gastroenterology, General Hospital of Athens “Alexandra,”Athens, Greece
| | - Spyridon Michopoulos
- Department of Gastroenterology, General Hospital of Athens “Alexandra,”Athens, Greece
| | - Stefanos Tigkas
- **Department of Gastroenterology, General Hospital of Piraeus “Tzaneio,”Piraeus, Greece
| | | | - Efrossini Laoudi
- Department of Gastroenterology, National and Kapodistrian University of Athens, General Hospital of Athens “Laiko,”Athens, Greece
| | - Pantelis Karatzas
- Department of Gastroenterology, National and Kapodistrian University of Athens, General Hospital of Athens “Laiko,”Athens, Greece
| | - Iordanis Mylonas
- Department of Gastroenterology, 401 General Army Hospital of Athens, Athens, Greece
| | - Nikolaos Kyriakos
- Department of Gastroenterology, 401 General Army Hospital of Athens, Athens, Greece
| | - Christos Liatsos
- Department of Gastroenterology, 401 General Army Hospital of Athens, Athens, Greece
| | - Theodora Kafetzi
- Department of Gastroenterology, University Hospital of Patras, Patra, Greece
| | - Georgios Theocharis
- Department of Gastroenterology, University Hospital of Patras, Patra, Greece
| | - Styliani Taka
- StArtBio PC Molecular Diagnostics and Biotechnology Services, Athens, Greece
| | | | - Ioannis E Koutroubakis
- Department of Gastroenterology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion Crete, Greece
| | - Giorgos Bamias
- GI Unit, 3rd Academic Department of Internal Medicine, National and Kapodistrian Univeristy of Athens- “Sotiria” General Hospital, Athens, Greece,Address correspondence to: Giorgos Bamias, MD, PhD, Associate Professor of Gastroenterology, GI Unit, 3rd Academic Dpt. of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 152 Mesogeion av. 11527, Tel +30 2107763100, Athens, Greece ()
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227
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Jarisch A, Wiercinska E, Daqiq-Mirdad S, Hellstern H, Ajib S, Cremer A, Nguyen NTT, Dukat A, Ullrich E, Ciesek S, Chow KU, Serve H, Seifried E, Bader P, Bönig H, Bug G. SARS-CoV-2 specific T-cells are generated in less than half of allogeneic HSCT recipients failing to seroconvert after COVID-19 vaccination. Eur J Immunol 2022; 52:1194-1197. [PMID: 35389515 PMCID: PMC9087431 DOI: 10.1002/eji.202149771] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/15/2022] [Accepted: 03/31/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Andrea Jarisch
- Division of Pediatric Stem Cell Transplantation and Immunology, Goethe University, Frankfurt, Germany
| | | | | | | | - Salem Ajib
- Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - Anjali Cremer
- Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK) Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Alexandra Dukat
- Outpatient Cancer Clinic AKS Schaubstraße, Frankfurt, Germany
| | - Evelyn Ullrich
- Division of Pediatric Stem Cell Transplantation and Immunology, Goethe University, Frankfurt, Germany.,Experimental Immunology, Department for Children and Adolescent Medicine, Goethe University, Frankfurt, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK) Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sandra Ciesek
- Institute for Medical Virology, Goethe University, Frankfurt, Germany
| | - Kai-Uwe Chow
- Outpatient Cancer Clinic AKS Schaubstraße, Frankfurt, Germany
| | - Hubert Serve
- Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK) Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Erhard Seifried
- German Red Cross Blood Service BaWüHe, Frankfurt, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany
| | - Peter Bader
- Division of Pediatric Stem Cell Transplantation and Immunology, Goethe University, Frankfurt, Germany
| | - Halvard Bönig
- German Red Cross Blood Service BaWüHe, Frankfurt, Germany.,Institute for Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany
| | - Gesine Bug
- Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany.,Frankfurt Cancer Institute (FCI), Goethe University, Frankfurt, Germany.,German Cancer Consortium (DKTK) Frankfurt/Mainz and German Cancer Research Center (DKFZ), Heidelberg, Germany
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228
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Furlong E, Kotecha RS, Conyers R, O'Brien TA, Hansford JR, Super L, Downie P, Eisenstat DD, Haeusler G, McMullan B, Phillips MB, Padhye B, Dalla-Pozza L, Alvaro F, Fraser CJ, Nicholls W, Clark JE, O'Connor M, Saxon BR, Tapp H, Heath J, Hunter SE, Tsui K, Winstanley M, Lyver A, Best EJ, Wadia U, Yeoh D, Blyth CC, Gottardo NG. COVID-19 vaccination in children and adolescents aged 5 years and older undergoing treatment for cancer and non-malignant haematological conditions: Australian and New Zealand Children's Haematology/Oncology Group consensus statement. Med J Aust 2022; 216:312-319. [PMID: 35201615 PMCID: PMC9115069 DOI: 10.5694/mja2.51444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The Australian Technical Advisory Group on Immunisation and New Zealand Ministry of Health recommend all children aged ≥ 5 years receive either of the two mRNA COVID-19 vaccines: Comirnaty (Pfizer), available in both Australia and New Zealand, or Spikevax (Moderna), available in Australia only. Both vaccines are efficacious and safe in the general population, including children. Children and adolescents undergoing treatment for cancer and immunosuppressive therapy for non-malignant haematological conditions are particularly vulnerable, with an increased risk of severe or fatal COVID-19. There remains a paucity of data regarding the immune response to COVID-19 vaccines in immunosuppressed paediatric populations, with data suggestive of reduced immunogenicity of the vaccine in immunocompromised adults. RECOMMENDATIONS Considering the safety profile of mRNA COVID-19 vaccines and the increased risk of severe COVID-19 in immunocompromised children and adolescents, COVID-19 vaccination is strongly recommended for this at-risk population. We provide a number of recommendations regarding COVID-19 vaccination in this population where immunosuppressive, chemotherapeutic and/or targeted biological agents are used. These include the timing of vaccination in patients undergoing active treatment, management of specific situations where vaccination is contraindicated or recommended under special precautions, and additional vaccination recommendations for severely immunocompromised patients. Finally, we stress the importance of upcoming clinical trials to identify the safest and most efficacious vaccination regimen for this population. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT This consensus statement provides recommendations for COVID-19 vaccination in children and adolescents aged ≥ 5 years with cancer and immunocompromising non-malignant haematological conditions, based on evidence, national and international guidelines and expert opinion. ENDORSED BY The Australian and New Zealand Children's Haematology/Oncology Group.
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Affiliation(s)
- Eliska Furlong
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA
| | - Rishi S Kotecha
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA.,Curtin University, Perth, WA
| | - Rachel Conyers
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Tracey A O'Brien
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW.,University of New South Wales, Sydney, NSW
| | - Jordan R Hansford
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Leanne Super
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,Monash University, Melbourne, VIC
| | - Peter Downie
- Monash University, Melbourne, VIC.,Monash Children's Hospital, Melbourne, VIC.,Hudson Institute of Medical Research, Melbourne, VIC
| | - David D Eisenstat
- Murdoch Children's Research Institute, Melbourne, VIC.,Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC.,University of Melbourne, Melbourne, VIC
| | - Gabrielle Haeusler
- Murdoch Children's Research Institute, Melbourne, VIC.,Paediatric Integrated Cancer Service, Melbourne, VIC.,National Centre for Infections in Cancer, Melbourne, VIC
| | - Brendan McMullan
- University of New South Wales, Sydney, NSW.,National Centre for Infections in Cancer, Melbourne, VIC.,Sydney Children's Hospital, Sydney, NSW
| | | | - Bhavna Padhye
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW
| | - Luciano Dalla-Pozza
- Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW
| | - Frank Alvaro
- John Hunter Children's Hospital, Newcastle, NSW.,University of Newcastle, Newcastle, NSW
| | | | - Wayne Nicholls
- Queensland Children's Hospital, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Julia E Clark
- Queensland Children's Hospital, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| | - Matthew O'Connor
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - Benjamin R Saxon
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - Heather Tapp
- Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA
| | - John Heath
- Children's and Adolescent/Young Adult Cancer Centre, Royal Hobart Hospital, Hobart, TAS
| | - Sarah E Hunter
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Karen Tsui
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Mark Winstanley
- Blood and Cancer Centre, Starship Children's Hospital, Auckland, NZ
| | - Amanda Lyver
- Children's Haematology Oncology Centre, Christchurch Hospital, Christchurch, NZ
| | - Emma J Best
- Starship Children's Hospital, Auckland, NZ.,Immunisation Advisory Centre, University of Auckland, Auckland, NZ.,University of Auckland, Auckland, NZ
| | - Ushma Wadia
- Perth Children's Hospital, Perth, WA.,Fiona Stanley Hospital, Perth, WA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
| | - Daniel Yeoh
- Perth Children's Hospital, Perth, WA.,National Centre for Infections in Cancer, Melbourne, VIC
| | - Christopher C Blyth
- Perth Children's Hospital, Perth, WA.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
| | - Nicholas G Gottardo
- Perth Children's Hospital, Perth, WA.,Telethon Kids Cancer Centre, Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
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229
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Ladoire S, Rederstorff E, Goussot V, Parnalland S, Briot N, Ballot E, Truntzer C, Ayati S, Bengrine-Lefevre L, Bremaud N, Coudert B, Desmoulins I, Favier L, Fraisse C, Fumet JD, Hennequin A, Hervieu A, Ilie S, Kaderbhai C, Lagrange A, Martin N, Mazilu I, Mayeur D, Palmier R, Simonet-Lamm AL, Vincent J, Zanetta S, Arnould L, Coutant C, Bertaut A, Ghiringhelli F. Parallel evolution and differences in seroprevalence of SARS-CoV-2 antibody between patients with cancer and health care workers in a tertiary cancer centre during the first and second wave of COVID-19 pandemic: canSEROcov-II cross-sectional study. Eur J Cancer 2022; 165:13-24. [PMID: 35189537 PMCID: PMC8806022 DOI: 10.1016/j.ejca.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/06/2022] [Accepted: 01/12/2022] [Indexed: 12/12/2022]
Abstract
Background Patients with cancer are a population at high risk of severe infection from SARS-CoV-2. Patients with cancer regularly attend specialised healthcare centres for management and treatment, where they are in contact with healthcare workers (HCWs). Numerous recommendations target both patients with cancer and HCWs to minimise the spread of SARS-CoV-2 during these interactions. Objective To investigate the parallel evolution of the COVID-19 epidemic in these 2 populations over time, we studied the seroprevalence of anti-SARS-CoV-2 antibodies after both the first and second waves of the pandemic, and in both cancer patients and HCWs from a single specialised anti-cancer centre. Factors associated with seropositivity were identified in both populations. Methods We conducted a cross-sectional study after the second wave of the COVID pandemic in France. All participants were invited to undergo serological testing for SARS-CoV-2 and complete a questionnaire collecting data about their working conditions (for HCWs) or medical management (for patients) during this period. Results after the second wave were compared to those of a previous study among 1011 patients with cancer and 663 HCWs performed in the same centre after the first wave, using the same evaluations. Findings We included 502 HCWs and 507 patients with cancer. Seroprevalence of anti-SARS-CoV-2 antibodies was higher after the second wave than after the first wave in both HCWs (15.1% versus 1.8%; p < 0.001), and patients (4.1% versus 1.7%; p = 0.038). By multivariate analysis, the factors found to be associated with seropositivity after the second wave for HCWs were: working in direct patient care (p = 0.050); having worked in a dedicated COVID-19 unit (p = 0.0036); contact with a person with COVID-19-positive in the workplace (p = 0.0118) or outside of the workplace (p = 0.0297). Among patients with cancer, only a contact with someone who tested positive for COVID-19 was found to be significantly associated with positive serology. The proportion of reported contacts with individuals with COVID-19-positive was significantly lower among patients with cancer than among HCWs (7.6% versus 40.7%, respectively; p < 0.0001) Interpretation Between the first and second waves of the epidemic in France, the seroprevalence of anti-SARS-CoV-2 antibodies increased to a lesser extent among patients with cancer than among their HCWs, possibly due to better self-protection, notably social distancing. The risk factors for infection identified among HCWs plead in favour of numerous intra-hospital contaminations, especially for HCWs in contact with high-risk patients. This underlines the compelling need to pursue efforts to implement strict hygiene and personal protection measures (including vaccination) to protect HCWs and patients with cancer.
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Affiliation(s)
- Sylvain Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; University of Burgundy-Franche Comté, France.
| | - Emilie Rederstorff
- Clinical Research Center (CRC), Centre Georges François Leclerc, Dijon, France
| | - Vincent Goussot
- Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Sophie Parnalland
- Clinical Research Center (CRC), Centre Georges François Leclerc, Dijon, France
| | - Nathalie Briot
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
| | - Elise Ballot
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; Bioinformatic Core Facility Georges-François Leclerc Cancer Center, Dijon, France
| | - Caroline Truntzer
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; Bioinformatic Core Facility Georges-François Leclerc Cancer Center, Dijon, France
| | - Siavoshe Ayati
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Nathalie Bremaud
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Bruno Coudert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Isabelle Desmoulins
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Laure Favier
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Cléa Fraisse
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Jean-David Fumet
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Audrey Hennequin
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Alice Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Silvia Ilie
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Courèche Kaderbhai
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Aurélie Lagrange
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Nils Martin
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Irina Mazilu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Didier Mayeur
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Rémi Palmier
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Julie Vincent
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Sylvie Zanetta
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Laurent Arnould
- Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Department of Pathology and Tumor Biology, Centre Georges François Leclerc, Dijon, France
| | - Charles Coutant
- University of Burgundy-Franche Comté, France; Department of Oncologic Surgery, Centre Georges François Leclerc, Dijon, France
| | - Aurélie Bertaut
- Methodology and Biostatistics Unit, Centre Georges François Leclerc, Dijon, France
| | - François Ghiringhelli
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France; Research Platform in Biological Oncology, Georges François Leclerc Cancer Center, Dijon, France; Centre de Recherche INSERM LNC-UMR1231, Dijon, France; University of Burgundy-Franche Comté, France
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García-Botella A, García-Lledó A, Gómez-Pavón J, González Del Castillo J, Hernández-Sampelayo T, Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Ruiz-Galiana J, Cantón R, De Lucas Ramos P, Bouza E. Booster or additional vaccination doses in patients vaccinated against COVID-19. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:105-114. [PMID: 34775740 PMCID: PMC8972704 DOI: 10.37201/req/149.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 12/28/2022]
Abstract
Several health organizations, mainly in Western countries, have recently authorized the use of a booster dose of the COVID-19 vaccine for patients previously vaccinated with mRNA vaccines, with criteria that do not always coincide. The COVID Scientific Committee of the Illustrious College of Physicians of Madrid (ICOMEM) has received and asked several questions about this situation, to which the group has tried to give answers, after deliberation and consensus. The efficacy of the vaccines administered so far is beyond doubt and they have managed to reduce, fundamentally, the severe forms of the disease. The duration of this protection is not well known, is different in different individuals and for different variants of the virus and is not easily predictable with laboratory tests. Data on the real impact of a supplementary or "booster" dose in the scientific literature are scarce for the moment and its application in large populations such as those in the state of Israel may be associated with a decrease in the risk of new and severe episodes in the short observation period available. We also lack sufficient data on the safety and potential adverse effects of these supplementary doses and we do not know the ideal time to administer them in different situations. In this state of affairs, it seems prudent to administer supplemental doses to those exposed to a higher risk, such as immunocompromised individuals and the elderly. On the other hand, we consider that this is not the time to accelerate, on the spur of the moment, a massive administration of a third dose to other population groups that are less exposed and at lower risk, without waiting for adequate scientific information, which will undoubtedly arrive gradually. We do not believe that this position is incompatible with the practical and ethical warnings made by the World Health Organization in this respect.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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231
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Echavarria I, Carrión Galindo JR, Corral J, Diz Taín MP, Henao Carrasco F, Iranzo González-Cruz V, Mielgo-Rubio X, Quintanar T, Rivas Corredor C, Pérez Segura P. SEOM clinical guidelines for the prophylaxis of infectious diseases in cancer patients (2021). Clin Transl Oncol 2022; 24:724-732. [PMID: 35230619 PMCID: PMC8886704 DOI: 10.1007/s12094-022-02800-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 12/14/2022]
Abstract
Infections are still a major cause of morbi-mortality in patients with cancer. Some of these infections are preventable through specific measures, such as vaccination or prophylaxis. This guideline aims to summarize the evidence and recommendations for the prevention of infections in cancer patients, devoting special attention to the most prevalent preventable infectious disease. All the evidences will be graded according to The Infectious Diseases Society of America grading system.
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Affiliation(s)
- Isabel Echavarria
- Department of Medical Oncology, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañon (IiSGM), CIBERONC, C/ Dr. Esquerdo, 46, 28007 Madrid, Spain
| | | | - Jesús Corral
- Department of Medical Oncology, Clínica Universidad de Navarra, Madrid, Spain
| | | | | | - Vega Iranzo González-Cruz
- Department of Medical Oncology, Hospital General Universitario de Valencia, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
- Centro de Investigación Biomédica en Red en Cáncer (CIBERONC), Valencia, Spain
| | - Xabier Mielgo-Rubio
- Department of Medical Oncology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Teresa Quintanar
- Department of Medical Oncology, Hospital General Universitario de Elche, Elche, Spain
| | | | - Pedro Pérez Segura
- Department of Medical Oncology, Hospital Clínico San Carlos, Madrid, Spain
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232
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Brockman MA, Mwimanzi F, Lapointe HR, Sang Y, Agafitei O, Cheung PK, Ennis S, Ng K, Basra S, Lim LY, Yaseen F, Young L, Umviligihozo G, Omondi FH, Kalikawe R, Burns L, Brumme CJ, Leung V, Montaner JSG, Holmes D, DeMarco ML, Simons J, Pantophlet R, Niikura M, Romney MG, Brumme ZL. Reduced Magnitude and Durability of Humoral Immune Responses to COVID-19 mRNA Vaccines Among Older Adults. J Infect Dis 2022; 225:1129-1140. [PMID: 34888688 PMCID: PMC8689804 DOI: 10.1093/infdis/jiab592] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The magnitude and durability of immune responses to coronavirus disease 2019 (COVID-19) mRNA vaccines remain incompletely characterized in the elderly. METHODS Anti-spike receptor-binding domain (RBD) antibodies, angiotensin-converting enzyme 2 (ACE2) competition, and virus neutralizing activities were assessed in plasma from 151 health care workers and older adults (range, 24-98 years of age) 1 month following the first vaccine dose, and 1 and 3 months following the second dose. RESULTS Older adults exhibited significantly weaker responses than younger health care workers for all humoral measures evaluated and at all time points tested, except for ACE2 competition activity after 1 vaccine dose. Moreover, older age remained independently associated with weaker responses even after correction for sociodemographic factors, chronic health condition burden, and vaccine-related variables. By 3 months after the second dose, all humoral responses had declined significantly in all participants, and remained significantly lower among older adults, who also displayed reduced binding antibodies and ACE2 competition activity towards the Delta variant. CONCLUSIONS Humoral responses to COVID-19 mRNA vaccines are significantly weaker in older adults, and antibody-mediated activities in plasma decline universally over time. Older adults may thus remain at elevated risk of infection despite vaccination.
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Affiliation(s)
- Mark A Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Francis Mwimanzi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Hope R Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Yurou Sang
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Olga Agafitei
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Peter K Cheung
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Siobhan Ennis
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Kurtis Ng
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Simran Basra
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
- Department of Chemistry, Simon Fraser University, Burnaby, Canada
| | - Li Yi Lim
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Fatima Yaseen
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Landon Young
- Division of Medical Microbiology and Virology, St Paul’s Hospital, Vancouver, Canada
| | | | - F Harrison Omondi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Rebecca Kalikawe
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Laura Burns
- Division of Medical Microbiology and Virology, St Paul’s Hospital, Vancouver, Canada
| | - Chanson J Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Victor Leung
- Division of Medical Microbiology and Virology, St Paul’s Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel Holmes
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
| | - Mari L DeMarco
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
| | - Janet Simons
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
| | - Ralph Pantophlet
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Masahiro Niikura
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Marc G Romney
- Division of Medical Microbiology and Virology, St Paul’s Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Zabrina L Brumme
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
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233
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Glenthøj A, Jakobsen LH, Bjørn ME, Poulsen CB, Sengeløv H, Severinsen MT, Qvist K, Overgaard UM, Ahmad SA, Rewes A, Mølle I, Strandholdt CN, Kodahl AR, Ryg J, Brieghel C, Johansen IS, Kannik K, Jensen-Fangel S, Wiese L, Kirk O, Clausen MR, Helleberg M, Frederiksen H. Severity and 90-day survival of SARS-CoV-2 infection among patients with haematological disorders. Acta Oncol 2022; 61:500-504. [PMID: 35038967 DOI: 10.1080/0284186x.2022.2026464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | - Lasse H. Jakobsen
- Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Mads Emil Bjørn
- Department of Haematology, Zeeland University Hospital Roskilde, Roskilde, Denmark
| | - Christian B. Poulsen
- Department of Haematology, Zeeland University Hospital Roskilde, Roskilde, Denmark
| | | | - Marianne T. Severinsen
- Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Kristian Qvist
- Section of hematology, Department of Internal Medicine, Hospital Union West, Holstebro, Denmark
| | | | | | - Annika Rewes
- Department of Haematology, Odense University Hospital, Odense, Denmark
| | - Ingolf Mølle
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Annette R. Kodahl
- Department of Oncology, Odense University Hospital, Odense, Denmark
- OPEN, Odense University Hospital, Odense, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Christian Brieghel
- Department of Internal Medicine, Section for Infectious Diseases, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Isik S. Johansen
- OPEN, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Karina Kannik
- Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Jensen-Fangel
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Lothar Wiese
- Department of Infectious Diseases, Zeeland University Hospital Roskilde, Roskilde, Denmark
| | - Ole Kirk
- Department of Infectious Diseases, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Henrik Frederiksen
- Department of Haematology, Odense University Hospital, Odense, Denmark
- OPEN, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
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234
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Bungaro M, Passiglia F, Scagliotti GV. COVID-19 and Lung Cancer: A Comprehensive Overview from Outbreak to Recovery. Biomedicines 2022; 10:776. [PMID: 35453526 PMCID: PMC9027516 DOI: 10.3390/biomedicines10040776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Lung cancer patients have been associated with an increased risk of COVID-19 infection, pulmonary complications, and worse survival outcomes compared to the general population. The world's leading professional organizations provided new recommendations for the diagnosis, treatment, and follow-up of lung cancer patients during the pandemic as a guide for prioritizing cancer care issues. Telemedicine was preferred for non-urgent consultations, and screening programs were temporarily suspended, leading to possible diagnostic delays along with an estimated increase in cause-specific mortality. A vaccine campaign has recently emerged as the main weapon to fight the COVID-19 pandemic, inverting this negative trend. This work aims to provide a comprehensive overview of the epidemiology and immune-pathophysiology of SARS-CoV-2 infection in cancer patients, highlighting the most relevant changes in the clinical management of lung cancer patients during the pandemic.
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Affiliation(s)
| | - Francesco Passiglia
- Department of Oncology, University of Turin, San Luigi Hospital, 10043 Orbassano, Italy; (M.B.); (G.V.S.)
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235
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Seneviratne SL, Yasawardene P, Wijerathne W, Somawardana B. COVID-19 vaccination in cancer patients: a narrative review. J Int Med Res 2022; 50:3000605221086155. [PMID: 35313761 PMCID: PMC8943636 DOI: 10.1177/03000605221086155] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), has affected over 220 million individuals worldwide,
and has been shown to cause increased disease severity and mortality in patients
with active cancer versus healthy individuals. Vaccination is important in
reducing COVID-19-associated morbidity and mortality. Thus, the aim of this
article was to review the existing knowledge on effectiveness, immunogenicity
and safety of COVID-19 vaccines in patients with cancer. Fifty-four articles
were included following a search of PubMed and Google Scholar databases for
studies published between January 2020 and September 2021 that investigated
humoral and cell-mediated immune responses following COVID-19 vaccination in
patients with cancer. Immunogenicity of vaccines was found to be lower in
patients with cancer versus healthy individuals, and humoral immune responses
were inferior in those with haematological versus solid cancers. Patient-,
disease-, and treatment-related factors associated with poorer vaccine responses
should be identified and corrected or mitigated when possible. Consideration
should be given to offering patients with cancer second doses of COVID vaccine
at shorter intervals than in healthy individuals. Patients with cancer warrant a
third vaccine dose and must be prioritized in vaccination schedules. Vaccine
adverse effect profiles are comparable between patients with cancer and healthy
individuals.
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Affiliation(s)
- Suranjith L Seneviratne
- Department of Clinical Immunology and Allergy, Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka
| | - Pamodh Yasawardene
- Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka
| | | | - Buddhika Somawardana
- Department of Haemato-Oncology, National Cancer Institute, Maharagama, Sri Lanka
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236
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Vanderpool RC, Gaysynsky A, Chou WYS, Tonorezos ES. Using Behavioral Science to Address COVID-19 Vaccine Hesitancy Among Cancer Survivors: Communication Strategies and Research Opportunities. J Behav Med 2022; 46:366-376. [PMID: 35305205 PMCID: PMC8933612 DOI: 10.1007/s10865-022-00304-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
Abstract
Due to cancer survivors’ increased vulnerability to complications from COVID-19, addressing vaccine hesitancy and improving vaccine uptake among this population is a public health priority. However, several factors may complicate efforts to increase vaccine confidence in this population, including the underrepresentation of cancer patients in COVID-19 vaccine trials and distinct recommendations for vaccine administration and timing for certain subgroups of survivors. Evidence suggests vaccine communication efforts targeting survivors could benefit from strategies that consider factors such as social norms, risk perceptions, and trust. However, additional behavioral research is needed to help the clinical and public health community better understand, and more effectively respond to, drivers of vaccine hesitancy among survivors and ensure optimal protection against COVID-19 for this at-risk population. Knowledge generated by this research could also have an impact beyond the current COVID-19 pandemic by informing future vaccination efforts and communication with cancer survivors more broadly.
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Affiliation(s)
- Robin C Vanderpool
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 20850, Rockville, MD, USA.
| | - Anna Gaysynsky
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 20850, Rockville, MD, USA.,ICF Next, Rockville, MD, USA
| | - Wen-Ying Sylvia Chou
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 20850, Rockville, MD, USA
| | - Emily S Tonorezos
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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237
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Jotschke S, Schulze S, Jaekel N, Ludwig-Kraus B, Engelmann R, Kraus FB, Zahn C, Nedlitz N, Prange-Krex G, Mohm J, Peuser B, Schwarz M, Spohn C, Behlendorf T, Binder M, Junghanss C, Böttcher S, Al-Ali HK. Longitudinal Humoral and Cellular Immune Responses Following SARS-CoV-2 Vaccination in Patients with Myeloid and Lymphoid Neoplasms Compared to a Reference Cohort: Results of a Prospective Trial of the East German Study Group for Hematology and Oncology (OSHO). Cancers (Basel) 2022; 14:cancers14061544. [PMID: 35326695 PMCID: PMC8946280 DOI: 10.3390/cancers14061544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose: To assess humoral responses longitudinally and cellular immunogenicity following SARS-CoV-2-vaccination in patients with hematologic and oncologic malignancies receiving checkpoint-inhibitors. Methods: This prospective multicenter trial of the East-German-Study-Group-for-Hematology-and-Oncology, enrolled 398 adults in a two (patients; n = 262) to one (controls; n = 136) ratio. Pre-vaccination, day 35 (d35), and day 120 (d120) blood samples were analyzed for anti-spike antibodies and d120 IL-2+IFNγ+TNFα+-CD4+- and CD8+-cells. Laboratories were blinded for patients and controls. Results: Patients belonged to the myeloid (n = 131), lymphoid (n = 104), and checkpoint-inhibitor (n = 17) cohorts. While d35 seroconversion was higher in controls (98%) compared to patients (68%) (p < 0.001), d120 seroconversion improved across all patient cohorts [checkpoint-inhibitors (81% to 100%), myeloid (82% to 97%), lymphoid (48% to 66%)]. CD4+- and CovCD8+-cells in the lymphoid (71%/31%) and control (74%/42%) cohorts were comparable but fewer in the myeloid cohort (53%, p = 0.003 /24%, p = 0.03). In patients with hematologic malignancies, no correlation between d120 humoral and cellular responses was found. A sizeable fraction of lymphoid patients demonstrated T-cell responses without detectable spike-specific-IgGs. Conclusions: Evidence of vaccine-elicited humoral and/or cellular immunogenicity in most patients is provided. Both humoral and cellular responses are crucial to determine which patients will generate/maintain immunity. The findings have implications on public health policy regarding recommendations for SARS-CoV-2 booster doses.
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Affiliation(s)
- Sabrina Jotschke
- Krukenberg Cancer Center Halle, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (S.J.); (S.S.); (N.N.)
| | - Susann Schulze
- Krukenberg Cancer Center Halle, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (S.J.); (S.S.); (N.N.)
| | - Nadja Jaekel
- University Clinic and Outpatient Clinic for Internal Medicine IV, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (N.J.); (C.Z.); (M.B.)
| | - Beatrice Ludwig-Kraus
- Central Laboratory, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (B.L.-K.); (F.B.K.)
| | - Robby Engelmann
- Clinic III—Hematology, Oncology, and Palliative Care, Rostock University Medical Center, 18057 Rostock, Germany; (R.E.); (C.J.); (S.B.)
| | - Frank Bernhard Kraus
- Central Laboratory, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (B.L.-K.); (F.B.K.)
| | - Christina Zahn
- University Clinic and Outpatient Clinic for Internal Medicine IV, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (N.J.); (C.Z.); (M.B.)
| | - Nicole Nedlitz
- Krukenberg Cancer Center Halle, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (S.J.); (S.S.); (N.N.)
| | | | - Johannes Mohm
- Gemeinschaftspraxis Mohm/Prange-Krex, 01307 Dresden, Germany; (G.P.-K.); (J.M.)
| | - Bettina Peuser
- Internistisch-Onkologische Ärztegemeinschaft, 04179 Leipzig, Germany;
| | - Maik Schwarz
- Paracelsus Medizinisches Versorgungszentrum, Schwerpunktpraxis für Hämatologie und Onkologie, 08261 Schoeneck, Germany;
| | - Claudia Spohn
- Hämatologisch-Onkologische Gemeinschaftspraxis, 06110 Halle (Saale), Germany;
| | - Timo Behlendorf
- Gemeinschaftspraxis für Hämatologie, Onkologie und Gastroenterologie, 06110 Halle (Saale), Germany;
| | - Mascha Binder
- University Clinic and Outpatient Clinic for Internal Medicine IV, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (N.J.); (C.Z.); (M.B.)
| | - Christian Junghanss
- Clinic III—Hematology, Oncology, and Palliative Care, Rostock University Medical Center, 18057 Rostock, Germany; (R.E.); (C.J.); (S.B.)
| | - Sebastian Böttcher
- Clinic III—Hematology, Oncology, and Palliative Care, Rostock University Medical Center, 18057 Rostock, Germany; (R.E.); (C.J.); (S.B.)
| | - Haifa Kathrin Al-Ali
- Krukenberg Cancer Center Halle, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (S.J.); (S.S.); (N.N.)
- University Clinic and Outpatient Clinic for Internal Medicine IV, University Hospital Halle (Saale), 06120 Halle (Saale), Germany; (N.J.); (C.Z.); (M.B.)
- Correspondence: ; Tel.: +49-345-5657-7712
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Lupo-Stanghellini MT, Di Cosimo S, Costantini M, Monti S, Mantegazza R, Mantovani A, Salvarani C, Zinzani PL, Inglese M, Ciceri F, Apolone G, Ciliberto G, Baldanti F, Morrone A, Sinno V, Locatelli F, Notari S, Turola E, Giannarelli D, Silvestris N. mRNA-COVID19 Vaccination Can Be Considered Safe and Tolerable for Frail Patients. Front Oncol 2022; 12:855723. [PMID: 35371993 PMCID: PMC8969577 DOI: 10.3389/fonc.2022.855723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/21/2022] [Indexed: 01/04/2023] Open
Abstract
Background Frail patients are considered at relevant risk of complications due to coronavirus disease 2019 (COVID-19) infection and, for this reason, are prioritized candidates for vaccination. As these patients were originally not included in the registration trials, fear related to vaccine adverse events and disease worsening was one of the reasons for vaccine hesitancy. Herein, we report the safety profile of the prospective, multicenter, national VAX4FRAIL study (NCT04848493) to evaluate vaccines in a large trans-disease cohort of patients with solid or hematological malignancies and neurological and rheumatological diseases. Methods Between March 3 and September 2, 2021, 566 patients were evaluable for safety endpoint: 105 received the mRNA-1273 vaccine and 461 the BNT162b2 vaccine. Frail patients were defined per protocol as patients under treatment with hematological malignancies (n = 131), solid tumors (n = 191), immune-rheumatological diseases (n = 86), and neurological diseases (n = 158), including multiple sclerosis and generalized myasthenia. The impact of the vaccination on the health status of patients was assessed through a questionnaire focused on the first week after each vaccine dose. Results The most frequently reported moderate-severe adverse events were pain at the injection site (60.3% after the first dose, 55.4% after the second), fatigue (30.1%-41.7%), bone pain (27.4%-27.2%), and headache (11.8%-18.9%). Risk factors associated with the occurrence of severe symptoms after vaccine administration were identified through a multivariate logistic regression analysis: age was associated with severe fever presentation (younger patients vs. middle-aged vs. older ones), female individuals presented a higher probability of severe pain at the injection site, fatigue, headache, and bone pain; and the mRNA-1237 vaccine was associated with a higher probability of severe pain at the injection site and fever. After the first dose, patients presenting a severe symptom were at a relevant risk of recurrence of the same severe symptom after the second one. Overall, 11 patients (1.9%) after the first dose and 7 (1.2%) after the second one required postponement or suspension of the disease-specific treatment. Finally, two fatal events occurred among our 566 patients. These two events were considered unrelated to the vaccine. Conclusions Our study reports that mRNA-COVID-19 vaccination is safe also in frail patients; as expected, side effects were manageable and had a minimum impact on patient care path.
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Affiliation(s)
| | - Serena Di Cosimo
- Biomarkers Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | - Sara Monti
- Department of Rheumatology, Policlinico San Matteo IRCCS Fondazione, University of Pavia, Pavia, Italy
| | - Renato Mantegazza
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Isitituto Neurologico Carlo Besta, Milano, Italy
| | - Alberto Mantovani
- Humanitas Scientific Directorate, IRCCS Humanitas, Clinical and Research Center, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Milano, Italy
- William Harvey Research Institute, Queen Mary University, London, United Kingdom
| | - Carlo Salvarani
- Unità di Reumatologia, Azienda unità sanitaria locale-IRCCS, Reggio Emilia, Italy
- Unità di Reumatologia, Università degli Studi di Modena e Reggio Emilia, Reggio Emilia, Italy
| | - Pier Luigi Zinzani
- Istituto di Ematologia “Seràgnoli” Azienda Ospedaliero-Universitaria di Bologna, IRCCS, Bologna, Italy
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
| | - Matilde Inglese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health and Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabio Ciceri
- Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, Milano, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Gennaro Ciliberto
- Scientific Directorate, IRCCS Regina Elena, National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Fausto Baldanti
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostics and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Aldo Morrone
- Scientific Directorate, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Valentina Sinno
- Department of Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
- Department of Gynecology-Obstetrics and Pediatrics, University “La Sapienza”, Roma, Italy
| | - Stefania Notari
- Cellular Immunology Laboratory, National Institute for Infectious Diseases L Spallanzani–IRCCS, Rome, Italy
| | - Elena Turola
- Infrastruttura Ricerca e Statistica, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Diana Giannarelli
- Biostatistical Unit, Istituto Nazionale Tumori Regina Elena IRCCS-IFO, Rome, Italy
| | - Nicola Silvestris
- Medical Oncology Department, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, Italy
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, Bari, Italy
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Guven DC, Sahin TK, Akın S, Uckun FM. Impact of Therapy in Patients with Hematologic Malignancies on Seroconversion Rates After SARS-CoV-2 Vaccination. Oncologist 2022; 27:e357-e361. [PMID: 35274729 PMCID: PMC8982368 DOI: 10.1093/oncolo/oyac032] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/16/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION The leading professional organizations in the field of hematology have recommended severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) vaccination for all patients with hematologic malignancies notwithstanding efficacy concerns. Here we report a systematic literature review regarding the antibody response to SARS-CoV-2 vaccination in patients with hematologic malignancies and its key determinants. METHODS We conducted a systematic search of original articles evaluating the seroconversion rates with SARS-CoV-2 vaccines in hematological malignancies from the PubMed database published between April 1, 2021 and December 4, 2021. Calculated risk differences (RD) and 95% confidence intervals (CI) to compare seroconversion rates between patients with hematologic malignancies versus healthy control subjects used the Review Manager software, version 5.3. RESULTS In our meta-analysis, we included 26 studies with control arms. After the first dose of vaccination, patients with hematologic malignancies had significantly lower seroconversion rates than controls (33.3% vs 74.9%; RD: -0.48%, 95% CI: -0.60%, -0.36%, P < .001). The seroconversion rates increased after the second dose, although a significant difference remained between these 2 groups (65.3% vs 97.8%; RD: -0.35%, 95% CI: -0.42%, -0.28%, P < .001). This difference in seroconversion rates was particularly pronounced for Chronic Lymphocytic Leukemia (CLL) patients (RD: -0.46%, 95% CI: -0.56, -0.37, P < .001), and for patients with B-lineage leukemia/lymphoma treated with anti-CD20 antibodies (RD: -0.70%, 95% CI: -0.88%, -0.51%, P < .001) or Bruton Tyrosine Kinase Inhibitors (BTKi; RD: -0.63%, 95% CI: -0.85%, -0.41%, P < .001). The RD was lower for patients under remission (RD: -0.10%, 95% CI: -0.18%, -0.02%, P = .01). CONCLUSION The seroconversion rates following SARS-CoV-2 vaccination in patients with hematologic malignancies, especially in CLL patients and patients treated with anti-CD20 antibodies or BTKi, were significantly lower than the seroconversion rates in healthy control subjects. Effective strategies capable of improving vaccine efficacy in these vulnerable patient populations are urgently needed.
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Affiliation(s)
- Deniz C Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey,Corresponding author: Deniz Can Guven, Department of Medical Oncology, Hacettepe University Cancer Institute, 06100 Sıhhıye, Ankara, Turkey. Tel: +90 312 305 43 30;
| | - Taha K Sahin
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Serkan Akın
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey,Bone Marrow Transplantation Unit, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Fatih M Uckun
- Immuno-Oncology Program and COVID-19 Task Force, Ares Pharmaceuticals, St. Paul, MN 55110, USA
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Amodio E, Vella G, Restivo V, Casuccio A, Vitale F. Effectiveness of mRNA COVID-19 Vaccination on SARS-CoV-2 Infection and COVID-19 in Sicily over an Eight-Month Period. Vaccines (Basel) 2022; 10:426. [PMID: 35335058 PMCID: PMC8949048 DOI: 10.3390/vaccines10030426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 01/27/2023] Open
Abstract
In order to reduce the spread of SARS-CoV-2 infection and the burden of disease, since 27 December 2020, Sicily has introduced a regional COVID-19 vaccination campaign. This study aimed at estimating the effectiveness of mRNA COVID-19 vaccines on SARS-CoV-2 infections and COVID-19. A retrospective cohort study was carried out on 3,966,976 Sicilian adults aged 18 years or more, who were followed-up from 1 January 2021 to 30 September 2021. The risk of SARS-CoV-2 infection, severe COVID-19, and COVID-19 death or intubation during the study period was compared among vaccinated with two mRNA doses and unvaccinated individuals. Cox regression, adjusted for age and sex, and a joint-point analysis on rate trends were performed. Overall, 2,469,320 (62.2%) subjects have been vaccinated and a total of 103,078 (2.6% of the entire population) SARS-CoV-2-positive subjects have been observed including 4693 (0.12%) severe COVID-19, 277 (0.01%) intubated, and 2649 (0.07%) deaths. After two months from vaccination, adjusted vaccine effectiveness was 81.3% against SARS-CoV-2 infection, 96.1% against severe COVID-19, and 93.4% against intubation/death. During the eight-month follow-up, statistically significant decreasing effectiveness trends were observed for all the evaluated outcomes (-4.76% per month against SARS-CoV-2 infection; -2.27% per month against severe COVID-19 and -2.26% per month against COVID-19 intubation/death). The study results confirm that mRNA COVID-19 vaccines have high real-world effectiveness, especially in the first months after vaccination. The vaccine effectiveness decreases over time and, even if the decrease is relatively small against severe outcomes, the increasing protection wane suggests the need for booster vaccination campaigns.
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Affiliation(s)
- Emanuele Amodio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Piazza, Italy; (G.V.); (V.R.); (A.C.); (F.V.)
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Loo YM, McTamney PM, Arends RH, Abram ME, Aksyuk AA, Diallo S, Flores DJ, Kelly EJ, Ren K, Roque R, Rosenthal K, Streicher K, Tuffy KM, Bond NJ, Cornwell O, Bouquet J, Cheng LI, Dunyak J, Huang Y, Rosenbaum AI, Reddy VP, Andersen H, Carnahan RH, Crowe JE, Kuehne AI, Herbert AS, Dye JM, Bright H, Kallewaard NL, Pangalos MN, Esser MT. The SARS-CoV-2 monoclonal antibody combination, AZD7442, is protective in nonhuman primates and has an extended half-life in humans. Sci Transl Med 2022; 14:eabl8124. [PMID: 35076282 PMCID: PMC8939769 DOI: 10.1126/scitranslmed.abl8124] [Citation(s) in RCA: 140] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/18/2022] [Indexed: 12/14/2022]
Abstract
Despite the success of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, there remains a need for more prevention and treatment options for individuals remaining at risk of coronavirus disease 2019 (COVID-19). Monoclonal antibodies (mAbs) against the viral spike protein have potential to both prevent and treat COVID-19 and reduce the risk of severe disease and death. Here, we describe AZD7442, a combination of two mAbs, AZD8895 (tixagevimab) and AZD1061 (cilgavimab), that simultaneously bind to distinct, nonoverlapping epitopes on the spike protein receptor binding domain to neutralize SARS-CoV-2. Initially isolated from individuals with prior SARS-CoV-2 infection, the two mAbs were designed to extend their half-lives and reduce effector functions. The AZD7442 mAbs individually prevent the spike protein from binding to angiotensin-converting enzyme 2 receptor, blocking virus cell entry, and neutralize all tested SARS-CoV-2 variants of concern. In a nonhuman primate model of SARS-CoV-2 infection, prophylactic AZD7442 administration prevented infection, whereas therapeutic administration accelerated virus clearance from the lung. In an ongoing phase 1 study in healthy participants (NCT04507256), a 300-mg intramuscular injection of AZD7442 provided SARS-CoV-2 serum geometric mean neutralizing titers greater than 10-fold above those of convalescent serum for at least 3 months, which remained threefold above those of convalescent serum at 9 months after AZD7442 administration. About 1 to 2% of serum AZD7442 was detected in nasal mucosa, a site of SARS-CoV-2 infection. Extrapolation of the time course of serum AZD7442 concentration suggests AZD7442 may provide up to 12 months of protection and benefit individuals at high-risk of COVID-19.
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Affiliation(s)
- Yueh-Ming Loo
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Patrick M. McTamney
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Rosalinda H. Arends
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Michael E. Abram
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Anastasia A. Aksyuk
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Seme Diallo
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Daniel J. Flores
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Elizabeth J. Kelly
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Kuishu Ren
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Richard Roque
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Kim Rosenthal
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Katie Streicher
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Kevin M. Tuffy
- Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Nicholas J. Bond
- Analytical Sciences, BioPharmaceuticals R&D, AstraZeneca, Granta Park, Cambridge, CB21 6GH, UK
| | - Owen Cornwell
- Analytical Sciences, BioPharmaceuticals R&D, AstraZeneca, Granta Park, Cambridge, CB21 6GH, UK
| | - Jerome Bouquet
- Integrated Bioanalysis, Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, San Francisco, CA, 94080, USA
| | - Lily I. Cheng
- Oncology Safety Pathology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - James Dunyak
- Clinical Pharmacology and Pharmacometrics, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Yue Huang
- Integrated Bioanalysis, Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, San Francisco, CA, 94080, USA
| | - Anton I. Rosenbaum
- Integrated Bioanalysis, Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, San Francisco, CA, 94080, USA
| | - Venkatesh Pilla Reddy
- Clinical Pharmacology and Pharmacometrics, BioPharmaceuticals R&D, AstraZeneca, Granta Park, Cambridge, CB21 6GH, UK
| | | | - Robert H. Carnahan
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - James E. Crowe
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
- The Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN 37232, USA
| | | | | | | | - Helen Bright
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | - Nicole L. Kallewaard
- Virology and Vaccine Discovery, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, 20878, USA
| | | | - Mark T. Esser
- Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
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Lee ARYB, Wong SY, Chai LYA, Lee SC, Lee MX, Muthiah MD, Tay SH, Teo CB, Tan BKJ, Chan YH, Sundar R, Soon YY. Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis. BMJ 2022; 376:e068632. [PMID: 35236664 PMCID: PMC8889026 DOI: 10.1136/bmj-2021-068632] [Citation(s) in RCA: 223] [Impact Index Per Article: 111.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the efficacy of covid-19 vaccines between immunocompromised and immunocompetent people. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Embase, Central Register of Controlled Trials, COVID-19 Open Research Dataset Challenge (CORD-19), and WHO covid-19 databases for studies published between 1 December 2020 and 5 November 2021. ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched in November 2021 to identify registered but as yet unpublished or ongoing studies. STUDY SELECTION Prospective observational studies comparing the efficacy of covid-19 vaccination in immunocompromised and immunocompetent participants. METHODS A frequentist random effects meta-analysis was used to separately pool relative and absolute risks of seroconversion after the first and second doses of a covid-19 vaccine. Systematic review without meta-analysis of SARS-CoV-2 antibody titre levels was performed after first, second, and third vaccine doses and the seroconversion rate after a third dose. Risk of bias and certainty of evidence were assessed. RESULTS 82 studies were included in the meta-analysis. Of these studies, 77 (94%) used mRNA vaccines, 16 (20%) viral vector vaccines, and 4 (5%) inactivated whole virus vaccines. 63 studies were assessed to be at low risk of bias and 19 at moderate risk of bias. After one vaccine dose, seroconversion was about half as likely in patients with haematological cancers (risk ratio 0.40, 95% confidence interval 0.32 to 0.50, I2=80%; absolute risk 0.29, 95% confidence interval 0.20 to 0.40, I2=89%), immune mediated inflammatory disorders (0.53, 0.39 to 0.71, I2=89%; 0.29, 0.11 to 0.58, I2=97%), and solid cancers (0.55, 0.46 to 0.65, I2=78%; 0.44, 0.36 to 0.53, I2=84%) compared with immunocompetent controls, whereas organ transplant recipients were 16 times less likely to seroconvert (0.06, 0.04 to 0.09, I2=0%; 0.06, 0.04 to 0.08, I2=0%). After a second dose, seroconversion remained least likely in transplant recipients (0.39, 0.32 to 0.46, I2=92%; 0.35, 0.26 to 0.46), with only a third achieving seroconversion. Seroconversion was increasingly likely in patients with haematological cancers (0.63, 0.57 to 0.69, I2=88%; 0.62, 0.54 to 0.70, I2=90%), immune mediated inflammatory disorders (0.75, 0.69 to 0.82, I2=92%; 0.77, 0.66 to 0.85, I2=93%), and solid cancers (0.90, 0.88 to 0.93, I2=51%; 0.89, 0.86 to 0.91, I2=49%). Seroconversion was similar between people with HIV and immunocompetent controls (1.00, 0.98 to 1.01, I2=0%; 0.97, 0.83 to 1.00, I2=89%). Systematic review of 11 studies showed that a third dose of a covid-19 mRNA vaccine was associated with seroconversion among vaccine non-responders with solid cancers, haematological cancers, and immune mediated inflammatory disorders, although response was variable in transplant recipients and inadequately studied in people with HIV and those receiving non-mRNA vaccines. CONCLUSION Seroconversion rates after covid-19 vaccination were significantly lower in immunocompromised patients, especially organ transplant recipients. A second dose was associated with consistently improved seroconversion across all patient groups, albeit at a lower magnitude for organ transplant recipients. Targeted interventions for immunocompromised patients, including a third (booster) dose, should be performed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021272088.
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Affiliation(s)
| | - Shi Yin Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Louis Yi Ann Chai
- Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Synthetic Biology for Clinical and Technological Innovation, National University of Singapore, Singapore
- National University Cancer Institute, Singapore
| | - Soo Chin Lee
- Department of Haematology-Oncology, National University Cancer Institute, National University Hospital, 119228, Singapore
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Matilda Xinwei Lee
- Department of Haematology-Oncology, National University Cancer Institute, National University Hospital, 119228, Singapore
| | - Mark Dhinesh Muthiah
- Department of Gastroenterology and Hepatology, National University Health System, Singapore
- National University Centre for Organ Transplantation, Singapore
| | - Sen Hee Tay
- Division of Rheumatology, Department of Medicine, National University Hospital, Singapore
| | - Chong Boon Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Raghav Sundar
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Haematology-Oncology, National University Cancer Institute, National University Hospital, 119228, Singapore
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
- The N.1 Institute for Health, National University of Singapore, Singapore
- Singapore Gastric Cancer Consortium, Singapore
| | - Yu Yang Soon
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Radiation Oncology, National University Cancer Institute, Singapore
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Peluso MJ, Donatelli J, Henrich TJ. Long-term immunologic effects of SARS-CoV-2 infection: leveraging translational research methodology to address emerging questions. Transl Res 2022; 241:1-12. [PMID: 34780969 PMCID: PMC8588584 DOI: 10.1016/j.trsl.2021.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/01/2022]
Abstract
The current era of COVID-19 is characterized by emerging variants of concern, waning vaccine- and natural infection-induced immunity, debate over the timing and necessity of vaccine boosting, and the emergence of post-acute sequelae of SARS-CoV-2 infection. As a result, there is an ongoing need for research to promote understanding of the immunology of both natural infection and prevention, especially as SARS-CoV-2 immunology is a rapidly changing field, with new questions arising as the pandemic continues to grow in complexity. The next phase of COVID-19 immunology research will need focus on clearer characterization of the immune processes defining acute illness, development of a better understanding of the immunologic processes driving protracted symptoms and prolonged recovery (ie, post-acute sequelae of SARS-CoV-2 infection), and a growing focus on the impact of therapeutic and prophylactic interventions on the long-term consequences of SARS-CoV-2 infection. In this review, we address what is known about the long-term immune consequences of SARS-CoV-2 infection and propose how experience studying the translational immunology of other infections might inform the approach to some of the key questions that remain.
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Affiliation(s)
- Michael J Peluso
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, California
| | - Joanna Donatelli
- Division Experimental Medicine, University of California, San Francisco, California
| | - Timothy J Henrich
- Division Experimental Medicine, University of California, San Francisco, California.
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Schmidt AL, Labaki C, Hsu CY, Bakouny Z, Balanchivadze N, Berg SA, Blau S, Daher A, El Zarif T, Friese CR, Griffiths EA, Hawley JE, Hayes-Lattin B, Karivedu V, Latif T, Mavromatis BH, McKay RR, Nagaraj G, Nguyen RH, Panagiotou OA, Portuguese AJ, Puc M, Santos Dutra M, Schroeder BA, Thakkar A, Wulff-Burchfield EM, Mishra S, Farmakiotis D, Shyr Y, Warner JL, Choueiri TK. COVID-19 vaccination and breakthrough infections in patients with cancer. Ann Oncol 2022; 33:340-346. [PMID: 34958894 PMCID: PMC8704021 DOI: 10.1016/j.annonc.2021.12.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Vaccination is an important preventive health measure to protect against symptomatic and severe COVID-19. Impaired immunity secondary to an underlying malignancy or recent receipt of antineoplastic systemic therapies can result in less robust antibody titers following vaccination and possible risk of breakthrough infection. As clinical trials evaluating COVID-19 vaccines largely excluded patients with a history of cancer and those on active immunosuppression (including chemotherapy), limited evidence is available to inform the clinical efficacy of COVID-19 vaccination across the spectrum of patients with cancer. PATIENTS AND METHODS We describe the clinical features of patients with cancer who developed symptomatic COVID-19 following vaccination and compare weighted outcomes with those of contemporary unvaccinated patients, after adjustment for confounders, using data from the multi-institutional COVID-19 and Cancer Consortium (CCC19). RESULTS Patients with cancer who develop COVID-19 following vaccination have substantial comorbidities and can present with severe and even lethal infection. Patients harboring hematologic malignancies are over-represented among vaccinated patients with cancer who develop symptomatic COVID-19. CONCLUSIONS Vaccination against COVID-19 remains an essential strategy in protecting vulnerable populations, including patients with cancer. Patients with cancer who develop breakthrough infection despite full vaccination, however, remain at risk of severe outcomes. A multilayered public health mitigation approach that includes vaccination of close contacts, boosters, social distancing, and mask-wearing should be continued for the foreseeable future.
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Affiliation(s)
- A L Schmidt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C Labaki
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C-Y Hsu
- Department of Biostatistics, Vanderbilt University, Nashville, USA
| | - Z Bakouny
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - N Balanchivadze
- Hematology and Oncology Fellowship Program, Henry Ford Cancer Institute, Detroit, USA
| | - S A Berg
- Department of Internal Medicine and Cancer Biology, Division of Hematology and Oncology, Cardinal Bernardin Cancer Centre, Loyola University Chicago, Maywood, USA
| | - S Blau
- Division of Oncology, Northwest Medical Specialties, Tacoma, USA; Division of Hematology, University of Washington, Seattle, USA
| | - A Daher
- Hartford HealthCare Medical Group, Hartford, USA
| | - T El Zarif
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C R Friese
- University of Michigan School of Nursing, School of Public Health, and Rogel Cancer Centre, Ann Arbor, USA
| | - E A Griffiths
- Leukemia Section, Roswell Park Comprehensive Cancer Centre, Buffalo, USA
| | - J E Hawley
- Herbert Irving Comprehensive Cancer Centre, Columbia University Irving Medical Centre, New York, USA; University of Washington/Fred Hutchinson Cancer Research Center, Seattle, USA
| | - B Hayes-Lattin
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, USA
| | - V Karivedu
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Wexner Medical Centre, Columbus, USA
| | - T Latif
- Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, USA
| | - B H Mavromatis
- Department of Cancer, Oncology, Hematology, UPMC Western Maryland, Cumberland, USA
| | - R R McKay
- Department of Medicine, Division of Hematology/Oncology, University of California San Diego, San Diego, USA
| | - G Nagaraj
- Division of Medical Oncology & Hematology, Department of Medicine, Loma Linda University Cancer Centre, Loma Linda, USA
| | - R H Nguyen
- Department of Medicine, Division of Hematology and Oncology, University of Illinois at Chicago, Chicago, USA
| | - O A Panagiotou
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, USA
| | - A J Portuguese
- Division of Hematology, University of Washington, Seattle, USA
| | - M Puc
- Department of Surgery, Section of Thoracic Surgery, Virtua Health, Marlton, USA
| | - M Santos Dutra
- Segal Cancer Centre of the Jewish General Hospital, Montréal, Canada
| | | | - A Thakkar
- Division of Oncology, Montefiore Medical Centre, Bronx, USA
| | - E M Wulff-Burchfield
- Department of Medicine, Divisions of Medical Oncology and Palliative Medicine, The University of Kansas Health System, Westwood, USA
| | - S Mishra
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA
| | - D Farmakiotis
- Department of Medicine, Division of Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University, Nashville, USA; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA
| | - J L Warner
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, USA; Department of Medicine, Division of Hematology/Oncology, Vanderbilt University, Nashville, USA; Department of Biomedical Informatics, Vanderbilt University, Nashville, USA.
| | - T K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA.
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Roel E, Pistillo A, Recalde M, Fernández-Bertolín S, Aragón M, Soerjomataram I, Jenab M, Puente D, Prieto-Alhambra D, Burn E, Duarte-Salles T. Cancer and the risk of coronavirus disease 2019 diagnosis, hospitalisation and death: A population-based multistate cohort study including 4 618 377 adults in Catalonia, Spain. Int J Cancer 2022; 150:782-794. [PMID: 34655476 PMCID: PMC8652827 DOI: 10.1002/ijc.33846] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/31/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022]
Abstract
The relationship between cancer and coronavirus disease 2019 (COVID-19) infection and severity remains poorly understood. We conducted a population-based cohort study between 1 March and 6 May 2020 describing the associations between cancer and risk of COVID-19 diagnosis, hospitalisation and COVID-19-related death. Data were obtained from the Information System for Research in Primary Care (SIDIAP) database, including primary care electronic health records from ~80% of the population in Catalonia, Spain. Cancer was defined as any primary invasive malignancy excluding non-melanoma skin cancer. We estimated adjusted hazard ratios (aHRs) for the risk of COVID-19 (outpatient) clinical diagnosis, hospitalisation (with or without a prior COVID-19 diagnosis) and COVID-19-related death using Cox proportional hazard regressions. Models were estimated for the overall cancer population and by years since cancer diagnosis (<1 year, 1-5 years and ≥5 years), sex, age and cancer type; and adjusted for age, sex, smoking status, deprivation and comorbidities. We included 4 618 377 adults, of which 260 667 (5.6%) had a history of cancer. A total of 98 951 individuals (5.5% with cancer) were diagnosed, and 6355 (16.4% with cancer) were directly hospitalised with COVID-19. Of those diagnosed, 6851 were subsequently hospitalised (10.7% with cancer), and 3227 died without being hospitalised (18.5% with cancer). Among those hospitalised, 1963 (22.5% with cancer) died. Cancer was associated with an increased risk of COVID-19 diagnosis (aHR: 1.08; 95% confidence interval [1.05-1.11]), direct COVID-19 hospitalisation (1.33 [1.24-1.43]) and death following hospitalisation (1.12 [1.01-1.25]). These associations were stronger for patients recently diagnosed with cancer, aged <70 years, and with haematological cancers. These patients should be prioritised in COVID-19 vaccination campaigns and continued non-pharmaceutical interventions.
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Affiliation(s)
- Elena Roel
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrea Pistillo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Martina Recalde
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergio Fernández-Bertolín
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - María Aragón
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | | | - Mazda Jenab
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Diana Puente
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Edward Burn
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
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Mohanraj D, Baldwin S, Singh S, Gordon A, Whitelegg A. Cellular and humoral responses to SARS-CoV-2 vaccination in immunosuppressed patients. Cell Immunol 2022; 373:104501. [PMID: 35299038 PMCID: PMC8920407 DOI: 10.1016/j.cellimm.2022.104501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE SARS-CoV-2 vaccinations have demonstrated vaccine-immunogenicity in healthy volunteers, however, efficacy in immunosuppressed patients is less well characterised. There is an urgent need to address the impact of immunosuppression on vaccine immunogenicity. METHODS Serological, T-cell ELISpot, cytokines and immunophenotyping were used to assess vaccine responses (either BNT162b2 mRNA or ChAdOx1 nCoV-19) in double-vaccinated patients receiving immunosuppression for renal transplants or haematological malignancies (n = 13). Immunological responses in immunosuppressed patients (VACC-IS) were compared to immunocompetent vaccinated (VACC-IC, n = 12), unvaccinated (UNVACC, n = 11) and infection-naïve unvaccinated (HC, n = 3) cohorts. RESULTS No significant different differences in T-cell responses were observed between VACC-IS and VACC-IC (92%) to spike-peptide (S) stimulation. UNVACC had the highest T-cell non-responders (n = 3), whereas VACC-IC and VACC-IS both had one T-cell non-responder. No significant differences in humoral responses were observed between VACC-IC and VACC-IS, with 92% (12/13) of VACC-IS patients demonstrating seropositivity. One VACC-IS failed to seroconvert, however had detectable T-cell responses. All VACC-IC participants were seropositive for anti-spike antibodies. VACC-IS and VACC-IC participants elicited strong Th1 cytokine response with immunodominance towards S-peptide. Differences in T-cell immunophenotyping were seen between VACC-IS and VACC-IC, with lower CD8+ activation and T-effector memory phenotype observed in VACC-IS. CONCLUSION SARS-CoV-2 vaccines are immunogenic in patients receiving immunosuppressive therapy, with responses comparable to vaccinated immunocompetent participants. Lower humoral responses were seen in patients treated with B-cell depleting therapeutics, but with preserved T-cell responses. We suggest further work to correlate both protective immunity and longevity of these responses in both healthy and immunosuppressed patients.
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Affiliation(s)
- Dinesh Mohanraj
- Faculty of Medicine, Biology and Health, The University of Manchester, Manchester, UK,Corresponding author
| | - Samuel Baldwin
- Department of Blood Sciences, Portsmouth Hospital University NHS Trust, Portsmouth, UK
| | - Satbeer Singh
- Department of Blood Sciences, Portsmouth Hospital University NHS Trust, Portsmouth, UK
| | - Alun Gordon
- Department of Blood Sciences, Portsmouth Hospital University NHS Trust, Portsmouth, UK
| | - Alison Whitelegg
- Department of Clinical Immunology, University Hospital Southampton NHS Trust, Southampton, UK
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247
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Marra AR, Kobayashi T, Suzuki H, Alsuhaibani M, Tofaneto BM, Bariani LM, Auler MDA, Salinas JL, Edmond MB, Doll M, Kutner JM, Pinho JRR, Rizzo LV, Miraglia JL, Schweizer ML. Short-term effectiveness of COVID-19 vaccines in immunocompromised patients: A systematic literature review and meta-analysis. J Infect 2022; 84:297-310. [PMID: 34982962 PMCID: PMC8720049 DOI: 10.1016/j.jinf.2021.12.035] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We aimed to assess the short-term effectiveness of COVID-19 vaccines among immunocompromised patients to prevent laboratory-confirmed symptomatic COVID-19 infection. METHODS Systematic review and meta-analysis. We calculated the pooled diagnostic odds ratio [DOR] (95% CI) for COVID-19 infection between immunocompromised patients and healthy people or those with stable chronic medical conditions. VE was estimated as 100% x (1-DOR). We also investigated the rates of developing anti-SARS-CoV-2 spike protein IgG between the 2 groups. RESULTS Twenty studies evaluating COVID-19 vaccine response, and four studies evaluating VE were included in the meta-analysis. The pooled DOR for symptomatic COVID-19 infection in immunocompromised patients was 0.296 (95% CI: 0.108-0.811) with an estimated VE of 70.4% (95% CI: 18.9%- 89.2%). When stratified by diagnosis, IgG antibody levels were much higher in the control group compared to immunocompromised patients with solid organ transplant (pOR 232.3; 95% Cl: 66.98-806.03), malignant diseases (pOR 42.0, 95% Cl: 11.68-151.03), and inflammatory rheumatic diseases (pOR 19.06; 95% Cl: 5.00-72.62). CONCLUSIONS We found COVID-19 mRNA vaccines were effective against symptomatic COVID-19 among the immunocompromised patients but had lower VE compared to the controls. Further research is needed to understand the discordance between antibody production and protection against symptomatic COVID-19 infection.
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Affiliation(s)
- Alexandre R Marra
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil; Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa, IA, USA.
| | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Hiroyuki Suzuki
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa, IA, USA
| | - Mohammed Alsuhaibani
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Pediatrics, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | | | | | | | | | - Michael B Edmond
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Michelle Doll
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | | | | | - Luiz Vicente Rizzo
- Hospital Israelita Albert Einstein, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
| | - João Luiz Miraglia
- Saúde Populacional, Diretoria de Medicina Diagnóstica Ambulatorial, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marin L Schweizer
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, Iowa, IA, USA
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248
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Brumme ZL, Mwimanzi F, Lapointe HR, Cheung PK, Sang Y, Duncan MC, Yaseen F, Agafitei O, Ennis S, Ng K, Basra S, Lim LY, Kalikawe R, Speckmaier S, Moran-Garcia N, Young L, Ali H, Ganase B, Umviligihozo G, Omondi FH, Atkinson K, Sudderuddin H, Toy J, Sereda P, Burns L, Costiniuk CT, Cooper C, Anis AH, Leung V, Holmes D, DeMarco ML, Simons J, Hedgcock M, Romney MG, Barrios R, Guillemi S, Brumme CJ, Pantophlet R, Montaner JSG, Niikura M, Harris M, Hull M, Brockman MA. Humoral immune responses to COVID-19 vaccination in people living with HIV receiving suppressive antiretroviral therapy. NPJ Vaccines 2022; 7:28. [PMID: 35228535 PMCID: PMC8885829 DOI: 10.1038/s41541-022-00452-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/19/2022] [Indexed: 12/30/2022] Open
Abstract
Humoral responses to COVID-19 vaccines in people living with HIV (PLWH) remain incompletely characterized. We measured circulating antibodies against the SARS-CoV-2 spike protein receptor-binding domain (RBD), ACE2 displacement and viral neutralization activities one month following the first and second COVID-19 vaccine doses, and again 3 months following the second dose, in 100 adult PLWH and 152 controls. All PLWH were receiving suppressive antiretroviral therapy, with median CD4+ T-cell counts of 710 (IQR 525-935) cells/mm3, though nadir CD4+ T-cell counts ranged as low as <10 cells/mm3. After adjustment for sociodemographic, health and vaccine-related variables, HIV infection was associated with lower anti-RBD antibody concentrations and ACE2 displacement activity after one vaccine dose. Following two doses however, HIV was not significantly associated with the magnitude of any humoral response after multivariable adjustment. Rather, older age, a higher burden of chronic health conditions, and dual ChAdOx1 vaccination were associated with lower responses after two vaccine doses. No significant correlation was observed between recent or nadir CD4+ T-cell counts and responses to two vaccine doses in PLWH. These results indicate that PLWH with well-controlled viral loads and CD4+ T-cell counts in a healthy range generally mount strong initial humoral responses to dual COVID-19 vaccination. Factors including age, co-morbidities, vaccine brand, response durability and the rise of new SARS-CoV-2 variants will influence when PLWH will benefit from additional doses. Further studies of PLWH who are not receiving antiretroviral treatment or who have low CD4+ T-cell counts are needed, as are longer-term assessments of response durability.
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Affiliation(s)
- Zabrina L Brumme
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
| | - Francis Mwimanzi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Hope R Lapointe
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Peter K Cheung
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Yurou Sang
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Maggie C Duncan
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Fatima Yaseen
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Olga Agafitei
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Siobhan Ennis
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Kurtis Ng
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Simran Basra
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
- Department of Chemistry, Simon Fraser University, Burnaby, Canada
| | - Li Yi Lim
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Rebecca Kalikawe
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Sarah Speckmaier
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | | | - Landon Young
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
| | - Hesham Ali
- John Ruedy Clinic, St, Paul's Hospital, Vancouver, Canada
| | - Bruce Ganase
- AIDS Research Program, St. Paul's Hospital, Vancouver, Canada
| | | | - F Harrison Omondi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Kieran Atkinson
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Hanwei Sudderuddin
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Junine Toy
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Paul Sereda
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Laura Burns
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
| | - Cecilia T Costiniuk
- Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre and Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Curtis Cooper
- Department of Medicine, University of Ottawa, Ottawa, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Aslam H Anis
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- CIHR Canadian HIV Trials Network, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, Canada
| | - Victor Leung
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Daniel Holmes
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Mari L DeMarco
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Janet Simons
- Department of Pathology and Laboratory Medicine, Providence Health Care, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | | | - Marc G Romney
- Division of Medical Microbiology and Virology, St. Paul's Hospital, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Silvia Guillemi
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Chanson J Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Ralph Pantophlet
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Masahiro Niikura
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Mark Hull
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Mark A Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, Canada
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249
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Mwimanzi F, Lapointe HR, Cheung PK, Sang Y, Yaseen F, Umviligihozo G, Kalikawe R, Datwani S, Omondi FH, Burns L, Young L, Leung V, Agafitei O, Ennis S, Dong W, Basra S, Lim LY, Ng K, Pantophlet R, Brumme CJ, Montaner JS, Prystajecky N, Lowe CF, DeMarco ML, Holmes DT, Simons J, Niikura M, Romney MG, Brumme ZL, Brockman MA. Older Adults Mount Less Durable Humoral Responses to a Two-dose COVID-19 mRNA Vaccine Regimen, but Strong Initial Responses to a Third Dose. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.01.06.22268745. [PMID: 35018381 PMCID: PMC8750654 DOI: 10.1101/2022.01.06.22268745] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Third COVID-19 vaccine doses are broadly recommended, but immunogenicity data remain limited, particularly in older adults. METHODS We measured circulating antibodies against the SARS-CoV-2 spike protein receptor-binding domain, ACE2 displacement, and virus neutralization against ancestral and Omicron (BA.1) strains from pre-vaccine up to one month following the third dose, in 151 adults aged 24-98 years who received COVID-19 mRNA vaccines. RESULTS Following two vaccine doses, humoral immunity was weaker, less functional and less durable in older adults, where a higher number of chronic health conditions was a key correlate of weaker responses and poorer durability. Third doses boosted antibody binding and function to higher levels than second-doses, and induced responses in older adults that were comparable in magnitude to those in younger adults. Humoral responses against Omicron were universally weaker than against the ancestral strain after both second and third doses; nevertheless, after three doses, anti-Omicron responses in older adults reached equivalence to those in younger adults. After three vaccine doses, the number of chronic health conditions, but not age per se, was the strongest consistent correlate of weaker humoral responses. CONCLUSION Results underscore the immune benefits of third COVID-19 vaccine doses, particularly in older adults.
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Affiliation(s)
| | | | - Peter K. Cheung
- Faculty of Health Sciences, Simon Fraser University, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Canada
| | - Yurou Sang
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - Fatima Yaseen
- Faculty of Health Sciences, Simon Fraser University, Canada
| | | | | | - Sneha Datwani
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - F. Harrison Omondi
- Faculty of Health Sciences, Simon Fraser University, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Canada
| | - Laura Burns
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
| | - Landon Young
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
| | - Victor Leung
- Department of Medicine, University of British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Olga Agafitei
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - Siobhan Ennis
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - Winnie Dong
- British Columbia Centre for Excellence in HIV/AIDS, Canada
| | - Simran Basra
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - Li Yi Lim
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - Kurtis Ng
- Faculty of Health Sciences, Simon Fraser University, Canada
| | | | - Chanson J. Brumme
- British Columbia Centre for Excellence in HIV/AIDS, Canada
- Department of Medicine, University of British Columbia, Canada
| | - Julio S.G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Canada
- Department of Medicine, University of British Columbia, Canada
| | - Natalie Prystajecky
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, Canada
| | - Christopher F. Lowe
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Mari L. DeMarco
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Daniel T. Holmes
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Janet Simons
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | | | - Marc G. Romney
- Division of Medical Microbiology and Virology, St. Paul’s Hospital, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Canada
| | - Zabrina L. Brumme
- Faculty of Health Sciences, Simon Fraser University, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Canada
| | - Mark A. Brockman
- Faculty of Health Sciences, Simon Fraser University, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Canada
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Tu MK, Chiang SH, Bender RA, Wong DTW, Strom CM. The Kinetics of COVID-19 Vaccine Response in a Community-Vaccinated Population. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 208:819-826. [PMID: 35039333 DOI: 10.4049/jimmunol.2100919] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/29/2021] [Indexed: 01/01/2023]
Abstract
We used a noninvasive electrochemical quantitative assay for IgG Abs to SARS-CoV-2 S1 Ag in saliva to investigate the kinetics of Ab response in a community-based population that had received either the Pfizer or Moderna mRNA-based vaccine. Samples were received from a total of 97 individuals, including a subset of 42 individuals who collected samples twice weekly for 3 mo or longer. In all, >840 samples were collected and analyzed. In all individuals, salivary SARS-CoV-2 S1 IgG Ab levels rose sharply in the 2-wk period after their second vaccination, with peak Ab levels seen at 10-20 d after vaccination. We observed that 20%, 10%, and 2.4% of individuals providing serial samples had a 90%, 95%, and 99% drop, respectively, from peak levels during the duration of monitoring, and in two patients, Abs fell to prevaccination levels (5%). The use of noninvasive quantitative salivary Ab measurement can allow widespread, cost-effective monitoring of vaccine response.
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