학술논문

Third dose of SARS-CoV-2 vaccination in hemato-oncological patients and health care workers: immune responses and adverse events – a retrospective cohort study.
Document Type
Article
Source
European Journal of Cancer. Apr2022, Vol. 165, p184-194. 11p.
Subject
*THERAPEUTIC use of antineoplastic agents
*PROTEINS
*RURAL hospitals
*HOSPITALS
*COVID-19
*ACADEMIC medical centers
*B cells
*PAIN
*FEVER
*COVID-19 vaccines
*RETROSPECTIVE studies
*KILLER cells
*ANTIBODY formation
*CANCER patients
*COMPARATIVE studies
*SHIVERING
*HEMATOLOGIC malignancies
*QUESTIONNAIRES
*DESCRIPTIVE statistics
*FATIGUE (Physiology)
*LONGITUDINAL method
Language
ISSN
0959-8049
Abstract
Due to potentially immune-escaping virus variants and waning immunity, a third SARS-CoV-2 vaccination dose is increasingly recommended. However, data in patients with cancer are limited. We measured anti-SARS-CoV-2 spike protein antibody levels after the third vaccination dose in 439 patients with cancer and 41 health care workers (HCW) at an academic centre in Austria and a rural community hospital in Italy. Adverse events were retrieved from questionnaires. Overall, 439 patients and 41 HCW were included. SARS-CoV-2 infections were observed in 62/439 (14.1%) patients before vaccination and in 5/439 (1.1%) patients after ≥1 dose. Longitudinal analysis revealed a decrease of antibody levels between 3 and 6 months after second vaccination in patients with solid tumours (p < 0.001) and haematological malignancies without anti-B cell therapies (p < 0.001). After the third dose, anti-S levels increased compared to the first/second dose. Patients receiving B cell-targeted agents had lower antibody levels than patients with haematological malignancies undergoing other treatments (p < 0.001) or patients with solid tumours (p < 0.001). Moreover, anti-S levels correlated with CD19+ (B cell) and CD56+ (NK cell) counts in peripheral blood. The most frequent adverse events after the third dose were local pain (75/160, 46.9%), fatigue (25/160, 15.6%) and fever/chills (16/160, 10.0%). Patients with cancer had lower anti-S levels than HCW (p = 0.015). This study in patients with cancer shows improved antibody levels after the third vaccination dose at an acceptable side-effect profile. Lower antibody levels than in controls underline the need for further follow-up studies and dedicated trials. • Anti-SARS-CoV-2 antibody levels diminished over time after the second vaccination. • Antibody levels increased after the third dose, supporting its administration. • Patients under B cell-targeting therapy showed considerably lower antibody levels. • Antibody levels correlated with CD19+ and CD56+ peripheral blood cell counts. • Lower antibody levels than in controls underline the need for further studies. [ABSTRACT FROM AUTHOR]