4.7 Review

Booster doses of COVID-19 vaccines for patients with haematological and solid cancer: a systematic review and individual patient data meta-analysis

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Summary: This systematic review investigates the immunogenicity of COVID-19 vaccines in patients with cancer (PsC). The results show that vaccination against COVID-19 is generally safe and immunogenic for PsC. However, the seroconversion rate in PsC is lower, lagged, or both compared to the general population. Patients with hematologic malignancies, especially those receiving B-cell-depleting agents in the past 12 months, are at the highest risk of poor seroconversion.

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The effect of a third-dose BNT162b2 vaccine on anti-SARS-CoV-2 antibody levels in immunosuppressed patients

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Immunogenicity and risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection after Coronavirus Disease 2019 (COVID-19) vaccination in patients with cancer: a systematic review and meta-analysis

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Summary: A meta-analysis showed that COVID-19 vaccines have high efficacy in real-world settings, providing significant protection against SARS-CoV-2-related diseases. Fully vaccinated individuals had vaccine effectiveness of 89.1% against infection, 97.2% against hospitalization, 97.4% against ICU admission, and 99.0% against death.

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Summary: The study found that SARS-CoV-2 vaccines were effective in patients with thoracic cancer, with the majority being immunized after two doses. Administering a third vaccine dose to 1% of patients with persistently low antibody titers resulted in an 88% immunization rate.

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SARS-CoV-2 Antibody Response to 2 or 3 Doses of the BNT162b2 Vaccine in Patients Treated With Anticancer Agents

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Summary: This study aimed to assess the immune humoral response to the BNT162b2 vaccine in patients treated with anticancer agents. The results showed that the majority of patients had a good humoral response 28 days after the second dose of vaccine, but it gradually decreased over time. The study also found that the time between vaccine and chemotherapy did not interfere with the humoral response.

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Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

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Summary: This systematic review and meta-analysis compared the efficacy of covid-19 vaccines between immunocompromised and immunocompetent individuals. The results showed that immunocompromised patients, especially organ transplant recipients, had significantly lower rates of seroconversion after covid-19 vaccination. A second dose of the vaccine consistently improved seroconversion in all patient groups, although the improvement was smaller for organ transplant recipients. Targeted interventions, including a third dose (booster) of the vaccine, should be performed for immunocompromised patients.

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Booster COVID-19 Vaccines for Immune-Mediated Inflammatory Disease Patients: A Systematic Review and Meta-Analysis of Efficacy and Safety

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Summary: The COVID-19 pandemic caused by SARS-CoV-2 has led to significant morbidity and mortality globally. The impact of the disease on immunosuppressed patients, such as cancer patients and transplant recipients, remains unclear. Further research is needed to determine the risk of COVID-19 severity and death in immunocompromised patients.

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Are All Patients with Cancer at Heightened Risk for Severe Coronavirus Disease 2019 (COVID-19)?

Georgios Chamilos et al.

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Mortality in hospitalized patients with cancer and coronavirus disease 2019: A systematic review and meta-analysis of cohort studies

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Summary: The analysis of 2922 cancer patients with COVID-19 from primarily inpatient studies showed a 30-day mortality rate of 30%, while the overall rate was 15% among 624 patients from studies including both inpatient and outpatient populations. Factors such as male sex, older age, cancer subtype, and recent active cancer therapy partially explained the heterogeneity in mortality reporting, with male sex and an interaction between patient age and recent therapy accounting for most of the variance in mortality rates between studies.

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Predictors of poor seroconversion and adverse events to SARS-CoV-2 mRNA BNT162b2 vaccine in cancer patients on active treatment

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Immune responses to two and three doses of the BNT162b2 mRNA vaccine in adults with solid tumors

Rachna T. Shroff et al.

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Summary: Within less than a year of the COVID-19 pandemic, ten vaccines for SARS-CoV-2 have been approved, with two mRNA-based vaccines showing promising results. Concerns arise about the safety and efficacy of these vaccines for cancer patients undergoing immunomodulatory treatments, but most cancer therapies should not hinder the generation of protective immunity. Additional research in this area is needed and it is recommended that the majority of cancer patients receive COVID vaccinations when possible.

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Summary: Severe COVID-19 caused by SARS-CoV-2 has a greater impact on immunocompromised patients such as cancer and solid organ transplant recipients, leading to higher comorbidities and poorer hospital outcomes. However, hematopoietic cell transplant recipients and pediatric cancer patients tend to have clinical presentations and outcomes similar to the general population.

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BNT162b2 COVID-19 vaccine is significantly less effective in patients with hematologic malignancies

Katrin Herzog Tzarfati et al.

Summary: Patients with hematologic malignancies have a reduced immune response to the COVID-19 vaccine, with lower seropositivity rates and antibody titers, increasing their risk for severe infection.

AMERICAN JOURNAL OF HEMATOLOGY (2021)

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Seroconversion rates following COVID-19 vaccination among patients with cancer

Astha Thakkar et al.

Summary: Most cancer patients show high seroconversion rates after receiving COVID-19 vaccines, but those with hematologic malignancies, especially after highly immunosuppressive therapies, exhibit lower conversion rates. Patients on immune checkpoint inhibitor therapy or hormonal therapy display high conversion rates.

CANCER CELL (2021)

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Cancer or COVID-19? A Review of Recommendations for COVID-19 Vaccination in Cancer Patients

Manit K. Gundavda et al.

Summary: The safety and efficacy of COVID-19 vaccines in cancer patients remain limited, but may be extrapolated from clinical trials and population data. Concerns about efficacy due to variable immune response and immunosuppression in cancer patients may impact vaccine effectiveness.

CURRENT TREATMENT OPTIONS IN ONCOLOGY (2021)

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Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement

Matthew J. Page et al.

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Effectiveness of COVID-19 vaccines: findings from real world studies

David A. Henry et al.

Summary: Community-based studies in five countries consistently show strong benefits from early rollouts of COVID-19 vaccines.

MEDICAL JOURNAL OF AUSTRALIA (2021)

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Vaccination of cancer patients against COVID-19: towards the end of a dilemma

Avik Mandal et al.

Summary: With the global emergence of the second wave of COVID-19 infections, vaccination has become crucial. Vaccines have shown to reduce severe illness risk, while cancer patients face added vulnerability to the infection. However, doubts and misconceptions about vaccination during cancer treatment exist.

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Economic value of vaccines to address the COVID-19 pandemic: a US cost-effectiveness and budget impact analysis

William V. Padula et al.

Summary: The study found that COVID-19 vaccines have a high probability of reducing healthcare costs and increasing QALYs compared to doing nothing. It also suggests that investing in vaccines could potentially save up to 60% or more in program costs, with high uptake rates.

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