Vaccination of COVID-19 for protection of cancer cases
Since Covid-19 can be particularly lethal in patients with
cancer25 and vaccination may maximize the health
benefits26, it’ should be recommended to protect
cancer patients. Clinical trials have demonstrated the safety and
efficacy of specific chemicals, such as Remdesivir27,
and Tocilizumab, an IL‐6 receptor (IL‐6R)
antagonist28, multiple vaccines, such as
Ad26.COV2.S29,30, the
mRNA-127331,32, and neutralizing antibodies, such as
REGEN-COV33, Sotrovimab34, and
Bamlanivimab35 for the prevention and treatment of
Covid-19. Definitely, these protective strategies should be prioritized
for cancer patients during the Covid-19 pandemic.
However, there are increased risks of adverse outcomes or events
(myocarditis, pericarditis, and cardiac arrhythmias) following
vaccination of messenger RNA-based (mRNA) vaccines (BNT162b2 and
mRNA-1273) in the general population, particularly those younger than
4036. Moreover, there is also cytokine release
syndrome (CRS), a vaccine-related adverse event, evidenced by raised
inflammatory markers, thrombocytopenia, elevated cytokine levels
(IFN-γ/IL-2R/IL-18/IL-16/IL-10) and steroid
responsiveness37. But there is also a study which
found that a third dose of BNT162b2 (mRNA vaccine of COVID-19) is safe,
improves humoral immunity against SARS-CoV-2 and could be
immunologically beneficial for patients with cancer (solid tumors) on
active chemotherapy38.
Although patients with Covid-19 have high risk of adverse outcomes
during active cancer care and treatment39,40, e.g.,
deep vein thrombosis, pulmonary embolism, and
bleeding41, cancer patients have lower rates of
SARS-CoV-2 infection after Covid-19 vaccination, especially with
additional vaccination doses (e.g., mRNA-1273)42,43.
On the one hand, treatment of solid cancer needs to follow standardized
guidelines44, and the use of a third vaccine dose can
improve outcomes45. On the other hand, those advanced
age, male, with a hematologic malignant tumor, had low antibody titers
after vaccination46, moreover, 50% of patients with
hematologic cancers and solid cancers, have lost nAbs against major
variants at 6 months after vaccination47. After the
third dose of vaccination, patients with cancer have improved antibody
levels48, even a 20-fold increase in titers from a
third dose46. Currently, mortality in cancer patients
confirmed with Covid-19 has also improved in Europe49due to earlier diagnosis and improved management. In general, the
mRNA-1273 COVID-19 vaccine is safe and beneficial for patients with
cancer50,51, particular in preventing serious illness
and death due to the potential for immune
activation52.