Vaccines for preventing infections in adults with solid tumours

Area of Science:

• Oncology
• Infectious Diseases
• Vaccinology

Background:

• Infections are frequent complications in adults with cancer, exacerbated by immunosuppression.
• Vaccination can prevent specific infections like influenza and pneumococcal disease.
• Adults with solid tumors may have altered immune responses to vaccines.

Purpose of the Study:

• To evaluate the benefits and risks of vaccines for preventing infectious diseases in adults with solid tumors.
• To assess vaccine efficacy and safety in a vulnerable cancer patient population.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) and controlled non-randomized studies of interventions (NRSIs) up to December 2, 2024.
• Included vaccines against herpes zoster, influenza, and COVID-19; excluded live-attenuated vaccines.
• Assessed risk of bias and certainty of evidence using Cochrane RoB 2, ROBINS-I, and GRADE approaches.

Main Results:

• Herpes zoster vaccines significantly reduced herpes zoster incidence (high-certainty evidence) but increased localized injection site reactions (high-certainty evidence).
• COVID-19 vaccines likely decreased COVID-19 incidence in unvaccinated individuals (moderate-certainty evidence) but increased adverse events (moderate-certainty evidence).
• Evidence for influenza vaccines was very uncertain; no studies evaluated vaccines for pneumococcal, meningococcal, or other common preventable infections.

Conclusions:

• Herpes zoster vaccines are effective in reducing disease incidence in adults with solid tumors, despite increased local reactions.
• COVID-19 vaccines show potential for preventing infection but require further monitoring for adverse events.
• Significant gaps exist in evidence for other crucial vaccines in this population, necessitating further research.