AI Article Synopsis
- - Cancer patients are at higher risk for severe COVID-19 illness, making effective vaccination strategies—like booster doses—essential for their protection against the virus and its variants.
- - A clinical trial showed that a third mRNA COVID-19 vaccine dose led to a significant immune response in 57% of previously seronegative cancer patients, and that this response remained strong after 6 months.
- - Among severely immunocompromised patients who didn't respond well after the third dose, a fourth dose resulted in a sufficient immune boost for 67% of them, though overall neutralization against the Omicron variant was limited.
Article Abstract
Background: Cancer patients show increased morbidity with COVID-19 and need effective immunization strategies. Many healthcare regulatory agencies recommend administering 'booster' doses of COVID-19 vaccines beyond the standard two-dose series, for this group of patients. Therefore, studying the efficacy of these additional vaccine doses against SARS-CoV-2 and variants of concern is of utmost importance in this immunocompromised patient population.
Methods: We conducted a prospective single arm clinical trial enrolling patients with cancer that had received two doses of mRNA or one dose of AD26.CoV2.S vaccine and administered a third dose of mRNA vaccine. We further enrolled patients that had no or low responses to three mRNA COVID vaccines and assessed the efficacy of a fourth dose of mRNA vaccine. Efficacy was assessed by changes in anti-spike antibody, T-cell activity, and neutralization activity, which were again assessed at baseline and 4 weeks.
Results: We demonstrate that a third dose of COVID-19 vaccine leads to seroconversion in 57% of patients that were seronegative after primary vaccination series. The immune response is durable as assessed by anti-SARS-CoV-2 (anti-S) antibody titers, T-cell activity, and neutralization activity against wild-type (WT) SARS-CoV2 and BA1.1.529 at 6 months of follow-up. A subset of severely immunocompromised hematologic malignancy patients that were unable to mount an adequate immune response (titer <1000 AU/mL) after the third dose and were treated with a fourth dose in a prospective clinical trial which led to adequate immune boost in 67% of patients. Low baseline IgM levels and CD19 counts were associated with inadequate seroconversion. Booster doses induced limited neutralization activity against the Omicron variant.
Conclusions: These results indicate that third dose of COVID vaccine induces durable immunity in cancer patients and an additional dose can further stimulate immunity in a subset of patients with inadequate response.
Funding: Leukemia Lymphoma Society, National Cancer Institute.
Clinical Trial Number: NCT05016622.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129324 | PMC |
| http://dx.doi.org/10.7554/eLife.83694 | DOI Listing |
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