COVID-19 Vaccination and Breakthrough Infections in Patients with Cancer

Among the 54 fully vaccinated patients who developed COVID-19 (data from ClinicalTrials.gov study NCT04354701), 35 (65%) were hospitalized, 10 (19%) were admitted to ICU or required MV, and 7 (13%) died within 30 days. Comparable rates were observed in the unvaccinated group.

The primary endpoint was 30-day all-cause mortality among fully vaccinated patients compared to the unvaccinated population after Inverse Probability of Treatment Weighting (IPTW) to adjust for baseline clinical variables. SFollowing IPTW, there was no statistical difference in 30-day mortality between the fully vaccinated patients compared to the unvaccinated cohort Adjusted Odds Ratio (AOR) 1·08, 95% CI: 0·41-2·82. Increased 30-day mortality was associated with lymphopenia (AOR 1·68, 95% CI: 1·11-2·55), the presence of comorbid conditions (mCCI of 1 vs 0: AOR 1·66, 95% CI: 1·07-2·59 and mCCI ≥2 vs 0: AOR 2·10, 95% CI: 1·36-3·24), worse performance status (ECOG PS 1 vs 0: AOR 2·26, 95% CI: 1·25-4·06 or ECOG PS ≥2 vs 0: AOR 4·34, 95% CI: 2·35-8·02) and baseline cancer status (active and progressing versus not active and progressing, AOR 6·07, 95% CI: 4·00-9·19).


Based on the accumulation of knowledge to date, it appears that patients with hematologic malignancy are less likely to mount an effective immune response.


COVID-19 Vaccination and Breakthrough Infections in Patients with Cancer


Highlights

  • •
    Patients with cancer who develop breakthrough COVID-19 following full vaccination remain susceptible to severe outcomes.
  • •
    Hematologic malignancies are over-represented among vaccinated patients with cancer who develop breakthrough COVID-19.
  • •
    Vaccination of close contacts, masking, boosters, and social distancing are needed to protect patients with cancer.

READ MORE


Comments

Post a Comment

Popular posts from this blog

A New Onset of Ulcerative Colitis post-2nd-breakthrough-COVID-19

Image
A 21-year-old non-smoking Caucasian male with a history of acute pancreatitis but no other medical issues or family history had two doses of the BNT162b2 mRNA COVID-19 vaccine.  Four months after the second dose he had his first episode of COVID-19. Although not hypoxic, he felt pretty unwell for a week, with a severe cough, fever, generalized body ache, headache, and loss of taste. He received the third dose of the vaccine two months after recovering from COVID. Nine months after the third dose, he had the second episode of COVID-19, during which he was mildly unwell for three days, recovered, and did not require any anti-viral medication or antibiotics. One week post the second episode of COVID-19, he developed diarrhea and abdominal pain. It then progressed to bloody diarrhea. Ulcerative colitis was diagnosed based on his clinical symptoms, biopsy changes, and the exclusion of other causes.  There are ten published case reports about the newly diagnosed ulcerative colitis associate
Read more

COVID in May

Image
Concerns about a potential resurgence of COVID-19 are mounting as summer 2024 approaches.  This is driven by several indicators, including social media posts, healthcare data, and wastewater surveillance across different regions. Our study findings corroborate this trend.  While many forecasters anticipate a surge, others expect a gradual increase through the end of May, and then a decline again around early June. Reports from social media suggest emerging clusters of COVID-19 in Texas, several Canadian provinces, the UK, and on cruises in northern regions such as a Norwegian cruise to Alaska.  Data from Alberta's Respiratory virus dashboard   (total weekly laboratory-confirmed COVID-19 cases) and wastewater surveillance in Calgary indicate an uptick in COVID-19 cases starting April 2024. The most recent statistics from Alberta Health reveal a significant increase in hospitalizations due to COVID-19, with 114 individuals currently hospitalized—an increase of more than 20% over two
Read more

Chronic SARS-CoV-2 Shedding

Image
Chronic viral shedding, a condition where the virus continues to be released from an individual's body long after the initial infection, has been observed in many infectious diseases, including COVID-19.  In such cases, individuals may remain asymptomatic or experience only mild symptoms while the virus persists. It remains detectable in repeated tests over an extended period and can still infect others even in nasal swab is negative (which happens quite often ). This was evident in our study.    Recent research by Conway et al. (2024) highlights the possibility of chronic SARS-CoV-2 infection, extending over several months and potentially years. Other studies have documented prolonged asymptomatic infections and extended viral shedding in moderate to severe beyond hospital discharge. Analysis of sequencing data on UK samples taken between 2 November 2020 and 15 August 2022 lead to estimates that 0.1–0.5% of infections may become persistent with typically rebounding high viral load
Read more