27 May 2022

The COVID-19 vaccine is effective for cancer patients but its effectiveness wanes rapidly, according to a new analysis.

Patients with lymphoma and leukaemia are among those who lose protection fastest, according to the study.

The study was co-led by the Universities of Oxford, Birmingham and Southampton and the UK Health Security Agency (UKHSA), for the UK Coronavirus Cancer Evaluation Project.

Dr Lennard Lee of the University of Oxford and colleagues looked at patterns of COVID infection among patients at the population level. This group is at a raised risk of hospitalisation and death following infection with SARS-CoV-2.

The researchers analysed information on 377,194 adults with active or recent cancer, who had two doses of COVID vaccine, of whom 42,882 went on to have COVID. This represents the largest analysis so far on the effect of COVID vaccination for people with cancer.

Vaccine effectiveness was 65.5% for cancer patients, compared with 69.8% in a control group of people without cancer. Effectiveness at three to six months was 47.0% in the cancer cohort compared with 61.4% in the comparison group.

In particular, they found that vaccine effectiveness is lowest, and falls faster, among people with lymphoma and leukaemia. Overall vaccine effectiveness for people with lymphoma and leukaemia was 44.1% and 45.1%, respectively. Effectiveness at three to six months was just 12.8% for lymphoma and 18.5% for leukaemia.

In contrast, the vaccines were as effective for people with myeloma as they were for the general population.

Details were published in Lancet Oncology. The authors write: “COVID-19 vaccination for patients with cancer should be used in conjunction with non-pharmacological strategies and community-based antiviral treatment programmes.”

Patients with reduced levels of protective antibody and T-cell responses, especially those with lymphoma and leukaemia, “might have a limited capacity to maintain immunological vaccine memory, in many cases as a consequence of cancer treatments that specifically suppress immune responses,” the authors state.

Helen Rowntree of Blood Cancer UK added: “For our community, COVID-19 very much has not gone away.

“We know how important the vaccines are for people with blood cancer. This study importantly shows that immunity wanes faster in people with blood cancer, who are entitled to five vaccine doses, and we’d encourage everyone with blood cancer to make sure they are getting these doses.”

Source: Lee LYW, Starkey T, Ionescu MC, Little M, Tilby M, Tripathy AR, Mckenzie HS, Al-Hajji Y, Barnard M, Benny L, Burnett A, Cattell EL, Charman J, Clark JJ, Khan S, Ghafoor Q, Illsley G, Harper-Wynne C, Hattersley RJ, Lee AJX, Leonard PC, Liu JKH, NCRI Consumer Forum, Pang M, Pascoe JS, Platt JR, Potter VA, Randle A, Rigg AS, Robinson TM, Roques TW, Roux RL, Rozmanowski S, Tuthill MH, Watts I, Williams S, Iveson T, Lee SM, Middleton G, Middleton M, Protheroe A, Fittall MW, Fowler T, Johnson P. (2022) “Vaccination effectiveness against COVID-19 breakthrough infections in cancer patients: a population-based test-negative control study (UKCCEP). Lancet Oncology, doi: 10.1016/S1470-2045(22)00202-9

Link: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22)00202-9/fulltext

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