Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients
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Published:2023-01-30
Issue:1
Volume:52
Page:8-16
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ISSN:0304-4602
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Container-title:Annals of the Academy of Medicine, Singapore
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language:en
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Short-container-title:Ann Acad Med Singap
Author:
Lee Matilda Xinwei1, Peng Siyu2, Lee Ainsley Ryan Yan Bin3, Wong Shi Yin3, Tay Ryan Yong Kiat3, Li Jiaqi4, Tariq Areeba3, Goh Claire Xin Yi3, Tan Ying Kiat3, Tan Benjamin Kye Jyn3, Teo Chong Boon3, Chan Esther1, Ooi Melissa1, Chng Wee Joo1, Chee Cheng Ean1, Ho Carol LF1, Walsh Robert John1, Wong Maggie1, Su Yan5, Alexander Lezhava5, Sethi Sunil Kumar2, Tan Shaun Shi Yan2, Chan Yiong Huak3, Tan Kelvin Bryan6, Lee Soo-Chin1, Chai Louis Yi Ann2, Sundar Raghav1
Affiliation:
1. National University Cancer Institute, Singapore, Singapore 2. National University Hospital, Singapore 3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore 4. School of Clinical Medicine, University of Cambridge, United Kingdom 5. Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 6. Ministry of Health, Singapore
Abstract
Introduction: Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity.
Method: Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases.
Results: A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, P<0.05) and chemotherapy (92.8%±18.1, P<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection.
Conclusion: This study demonstrates the benefit of early administration of the third dose among cancer patients.
Keywords: Cancer, oncology, SARS-CoV-2, third dose, vaccination
Funder
National University Cancer Institute, Singapore
Publisher
Academy of Medicine, Singapore
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