Vaccine effectiveness against COVID-19 breakthrough infections in patients with cancer (UKCCEP): a population-based test-negative case-control study
- Lennard Y W Lee 1, Thomas Starkey 2, Maria C Ionescu 3, Martin Little 4, Michael Tilby 5, Arvind R Tripathy 5, Hayley S Mckenzie 6, Youssra Al-Hajji 7, Matthew Barnard 3, Liza Benny 3, Alexander Burnett 8, Emma L Cattell 9, Jackie Charman 10, James J Clark 11, Sam Khan 12, Qamar Ghafoor 5, George Illsley 3, Catherine Harper-Wynne 13, Rosie J Hattersley 14, Alvin J X Lee 15, Pauline C Leonard 16, Justin K H Liu 17, , Matthew Pang 18, Jennifer S Pascoe 5, James R Platt 17, Vanessa A Potter 19, Amelia Randle 20, Anne S Rigg 21, Tim M Robinson 22, Tom W Roques 23, René L Roux 4, Stefan Rozmanowski 18, Mark H Tuthill 4, Isabella Watts 24, Sarah Williams 5, Tim Iveson 25, Siow Ming Lee 26, Gary Middleton 27, Mark Middleton 28, Andrew Protheroe 4, Matthew W Fittall 29, Tom Fowler 3, Peter Johnson 30
- 1Department of Oncology, University of Oxford, Oxford, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
- 2Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
- 3UK Health Security Agency, London, UK.
- 4Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
- 5Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- 6Oncology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- 7Birmingham Medical School, University of Birmingham, Birmingham, UK.
- 8NHS England, London, UK; NHS Improvement, London, UK.
- 9Department of Cancer, Taunton and Somerset NHS Foundation Trust, Taunton, UK.
- 10National Disease Registration Service, NHS Digital, London, UK.
- 11Department of Surgery and Cancer, Imperial College London, London, UK.
- 12Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
- 13Kent Oncology Centre, University of Kent and Kent and Medway Medical School, Maidstone, UK.
- 14Department of Oncology, Torbay Hospital NHS Foundation Trust, Torquay, UK.
- 15UCL Cancer Institute, University College London Hospitals NHS Trust and University College London, London, UK.
- 16Cancer Services, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
- 17Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
- 18Department of Health and Social Care, London, UK.
- 19Department of Oncology, University Hospital Coventry and Warwickshire, Coventry, UK.
- 20Royal College of Physicians, London, UK.
- 21Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
- 22Population Health Sciences, University of Bristol, Bristol, UK.
- 23Cancer Services, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
- 24Department of Academic Oncology, Royal Free Hospital, London, UK.
- 25Cancer Sciences, University of Southampton, Southampton, UK.
- 26UCL Cancer Institute, University College London Hospitals NHS Trust and University College London, London, UK; CRUK Lung Cancer Centre of Excellence, University College London Hospitals NHS Trust and University College London, London, UK.
- 27Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
- 28Department of Oncology, University of Oxford, Oxford, UK.
- 29Cancer Services, The Royal Marsden NHS Foundation Trust, London, UK.
- 30NHS England, London, UK; Cancer Sciences, University of Southampton, Southampton, UK.
- 0Department of Oncology, University of Oxford, Oxford, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
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View abstract on PubMed
Summary
This summary is machine-generated.COVID-19 vaccination is effective for cancer patients, but protection against breakthrough infections is lower than in the general population. Continued vaccination and public health measures are crucial for this vulnerable group.
Area Of Science
- Immunology
- Oncology
- Public Health
Background
- Individuals with cancer face higher risks of severe outcomes from SARS-CoV-2 infection.
- Evaluating COVID-19 vaccine effectiveness in cancer patients is critical due to their increased vulnerability.
Purpose Of The Study
- To assess COVID-19 vaccine effectiveness against SARS-CoV-2 breakthrough infections in a large population of cancer patients.
- To compare vaccine effectiveness in cancer patients versus the general population.
Main Methods
- A population-based, test-negative case-control study using UK Coronavirus Cancer Evaluation Project (UKCCEP) data.
- Inclusion of PCR test results, vaccination records, demographics, and cancer data from England (Dec 2020–Oct 2021).
- Comparison of vaccine effectiveness after the second dose, and at 3–6 months post-second dose, between cancer patients and a control group.
Main Results
- Overall vaccine effectiveness was 65.5% in cancer patients and 69.8% in the control population.
- Effectiveness waned to 47.0% in cancer patients at 3–6 months, compared to 61.4% in controls.
- A substantial number of breakthrough infections occurred in both cohorts, highlighting ongoing transmission.
Conclusions
- COVID-19 vaccination provides protection for individuals with cancer, though effectiveness is reduced compared to the general population.
- Lower vaccine effectiveness in cancer patients necessitates continued use of non-pharmacological interventions and antiviral programs.
- Further research into optimizing vaccination strategies for immunocompromised populations is warranted.
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