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Lazar Neto F, Mercadé-Besora N, Raventós B, Pérez-Crespo L, Castro Junior G, Ranzani OT, Duarte-Salles T. Effectiveness of COVID-19 vaccines against severe COVID-19 among patients with cancer in Catalonia, Spain. Nat Commun 2024; 15:5088. [PMID: 38898035 PMCID: PMC11187152 DOI: 10.1038/s41467-024-49285-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Patients with cancer were excluded from pivotal randomized clinical trials of COVID-19 vaccine products, and available observational evidence on vaccine effectiveness (VE) focused mostly on mild, and not severe COVID-19, which is the ultimate goal of vaccination for high-risk groups. Here, using primary care electronic health records from Catalonia, Spain (SIDIAP), we built two large cohorts of vaccinated and matched control cancer patients with a primary vaccination scheme (n = 184,744) and a booster (n = 108,534). Most patients received a mRNA-based product in primary (76.2%) and booster vaccination (99.9%). Patients had 51.8% (95% CI 40.3%-61.1%) and 58.4% (95% CI 29.3%-75.5%) protection against COVID-19 hospitalization and COVID-19 death respectively after full vaccination (two-doses) and 77.9% (95% CI 69.2%-84.2%) and 80.2% (95% CI 63.0%-89.4%) after booster. Compared to primary vaccination, the booster dose provided higher peak protection during follow-up. Calibration of VE estimates with negative outcomes, and sensitivity analyses with slight different population and COVID-19 outcomes definitions provided similar results. Our results confirm the role of primary and booster COVID-19 vaccination in preventing COVID-19 severe events in patients with cancer and highlight the need for the additional dose in this population.
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Affiliation(s)
- Felippe Lazar Neto
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Serviço de Oncologia Clínica, Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Núria Mercadé-Besora
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Berta Raventós
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Laura Pérez-Crespo
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Gilberto Castro Junior
- Serviço de Oncologia Clínica, Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Otavio T Ranzani
- Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
| | - Talita Duarte-Salles
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Evans JP, Zeng C, Carlin C, Lozanski G, Saif LJ, Oltz EM, Gumina RJ, Liu SL. Loss of Neutralizing Antibody Response to mRNA Vaccination against SARS-CoV-2 Variants: Differing Kinetics and Strong Boosting by Breakthrough Infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.12.06.471455. [PMID: 34909777 PMCID: PMC8669844 DOI: 10.1101/2021.12.06.471455] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The waning efficacy of SARS-CoV-2 vaccines combined with the continued emergence of variants resistant to vaccine-induced immunity has reignited debate over the need for booster vaccines. To address this, we examined the neutralizing antibody (nAb) response against four major SARS-CoV-2 variants-D614G, Alpha (B.1.1.7), Beta (B.1.351), and Delta (B.1.617.2)-in health care workers (HCWs) at pre-vaccination, post-first and post-second mRNA vaccine dose, and six months post-second mRNA vaccine dose. Neutralizing antibody titers against all variants, especially the Delta variant, declined dramatically from four weeks to six months post-second mRNA vaccine dose. Notably, SARS-CoV-2 infection enhanced vaccine durability, and mRNA-1273 vaccinated HCWs also exhibited ~2-fold higher nAb titers than BNT162b2 vaccinated HCWs. Together these results demonstrate possible waning of protection from infection against SARS-CoV-2 Delta variant based on decreased nAb titers, dependent on COVID-19 status and the mRNA vaccine received.
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Affiliation(s)
- John P. Evans
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Molecular, Cellular, and Developmental Biology Program, The Ohio State University, Columbus, OH 43210, USA
| | - Cong Zeng
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
| | - Claire Carlin
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Gerard Lozanski
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
| | - Linda J. Saif
- Center for Food Animal Health, Animal Sciences Department, OARDC, College of Food, Agricultural and Environmental Sciences, The Ohio State University, Wooster, OH 44691, USA
- Veterinary Preventive Medicine Department, College of Veterinary Medicine, The Ohio State University, Wooster, OH 44691, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
| | - Eugene M. Oltz
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
| | - Richard J. Gumina
- Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Shan-Lu Liu
- Center for Retrovirus Research, The Ohio State University, Columbus, OH 43210, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA
- Viruses and Emerging Pathogens Program, Infectious Diseases Institute, The Ohio State University, Columbus, OH 43210, USA
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
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Rabady S, Altenberger J, Brose M, Denk-Linnert DM, Fertl E, Götzinger F, de la Cruz Gomez Pellin M, Hofbaur B, Hoffmann K, Hoffmann-Dorninger R, Koczulla R, Lammel O, Lamprecht B, Löffler-Ragg J, Müller CA, Poggenburg S, Rittmannsberger H, Sator P, Strenger V, Vonbank K, Wancata J, Weber T, Weber J, Weiss G, Wendler M, Zwick RH. [Guideline S1: Long COVID: Diagnostics and treatment strategies]. Wien Klin Wochenschr 2021; 133:237-278. [PMID: 34851455 PMCID: PMC8633909 DOI: 10.1007/s00508-021-01974-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 02/07/2023]
Abstract
This guideline comprises the state of science at the time of the editorial deadline. In view of the high turnover of knowledge the guideline is designed as a living guideline. The main objective was to provide a tool for the use in primary care, being considered well suited as a first point of entry and for the provision of care. The guideline gives recommendations on the differential diagnosis of symptoms following SARS-CoV‑2 infection, on their therapeutic options, as well as for guidance and care of the patients concerned. It also offers advice concerning return to daily life and rehabilitation. Long COVID being a very variable condition, we chose an interdisciplinary approach.
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Affiliation(s)
- Susanne Rabady
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich.
| | - Johann Altenberger
- Pensionsversicherungsanstalt, Rehabilitationszentrum Großgmain, Großgmain, Österreich
| | - Markus Brose
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich
| | - Doris-Maria Denk-Linnert
- Klinische Abteilung Phoniatrie-Logopädie, Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Österreich
| | - Elisabeth Fertl
- Neurologische Abteilung, Klinik Landstraße, Wiener Gesundheitsverbund, Wien, Österreich
| | - Florian Götzinger
- Abteilung für Kinder- und Jugendheilkunde, Klinik Ottakring, Wiener Gesundheitsverbund, Wien, Österreich
| | - Maria de la Cruz Gomez Pellin
- Unit Versorgungsforschung in der Primärversorgung, Zentrum für Public Health, Medizinische Universität Wien, Wien, Österreich
| | | | - Kathryn Hoffmann
- Unit Health Services Research and Telemedicine in Primary Care, Department of Preventive- and Social Medicine, Center for Public Health, Medical University of Vienna, Wien, Österreich
| | | | - Rembert Koczulla
- Abteilung für Pneumologische Rehabilitation, Philipps Universität Marburg, Marburg, Deutschland
| | - Oliver Lammel
- Praxis Dr Oliver Lammel, Ramsau am Dachstein, Österreich
| | - Bernd Lamprecht
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum, Linz, Österreich
| | | | - Christian A Müller
- Universitätsklinik für Hals‑, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Österreich
| | | | - Hans Rittmannsberger
- Abteilung Psychiatrie und Psychotherapie, Pyhrn-Eisenwurzen-Klinikum, Steyr, Österreich
| | - Paul Sator
- Dermatologische Abteilung, Klinik Hietzing, Wiener Gesundheitsverbund, Wien, Österreich
| | - Volker Strenger
- Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Karin Vonbank
- Klinische Abteilung für Pulmologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Wien, Österreich
| | - Johannes Wancata
- Klinische Abteilung für Sozialpsychiatrie, Medizinische Universität Wien, Wien, Österreich
| | - Thomas Weber
- Abteilung für Innere Medizin 2 (Kardiologie, Intensivmedizin), Klinikum Wels-Grieskirchen, Wels, Österreich
| | - Jörg Weber
- Klinikum Klagenfurt, Feschnigstraße 11, 9020, Klagenfurt, Österreich
| | - Günter Weiss
- Univ.-Klinik für Innere Medizin II, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Maria Wendler
- Department Allgemeine Gesundheitsstudien, Kompetenzzentrum für Allgemein- und Familienmedizin, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Österreich
| | - Ralf-Harun Zwick
- Ambulante internistische Rehabilitation, Therme Wien Med, Wien, Österreich
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