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.