Journal Article

SARS-CoV-2 vaccination willingness and humoral vaccination response in radiation oncology patients

Track, Christine, Zauner-Babor, Georgine, Erdei, Mercedesz, Spiegl, Kurt, Weis, Eva Maria, Spindelbalker-Renner, Barbara, Venhoda, Clemens, Hermann, Philipp, Feichtinger, Johann, Geinitz, Hans, Gheju, Ruben, Gruber, Georg, Huppert, Roswitha, Karasek, Nicola, Wagner, Helga, Bräutigam, Elisabeth, Dieplinger, Benjamin, Egger, Margot, Silberberger, Elisabeth, Nyiri, Dalma Viktoria

2024

Overview

•One of the largest prospective studies on covid-19 vaccination in cancer patients.•Wide array of solid tumour entities.•High vaccination acceptance in this prioritised collective.•Most oncologic patients showed a measurable humoral response after vaccination.•Risk factors for non– and low humoral responders in uni/multivariate analysis. SARS-CoV-2 infection has been and, in some parts, still is a threat to oncologic patients, making it crucial to understand perception of vaccination and immunologic responses in this vulnerable patient segment. SARS-CoV-2 vaccines in relation to malignant disease characteristics and therapies have so far not been studied consecutively in larger oncologic patient populations. This study captures SARS-CoV-2 vaccination willingness and humoral immune response in a large consecutive oncologic patient collective at the beginning of 2021. 1142 patients were consecutively recruited over 5.5 months at a tertiary department for radiation oncology and were assessed for vaccination willingness via a standardized interview. In already vaccinated patients total SARS-CoV-2 S antibody titres against the spike protein (Anti-SARS-CoV-2 S) and were evaluated 35 days or later after the first dose of SARS-CoV-2 vaccine. Vaccination willingness was high with a rate of 90 %. The most frequent reasons for rejection were: undecided/potential vaccination after therapy, distrust in the vaccine and fear of interaction with comorbidities. Factors associated with lower vaccination willingness were: worse general condition, lower age and female sex. 80 % of the participants had been previously vaccinated, 8 % reported previous infection and 16 % received vaccination during antineoplastic therapy. In 97.5 % of the vaccinated patients Anti-SARS-CoV-2 S was detected. In a univariable analysis parameters associated with non-conversion were: lower performance status, spread to the local lymphatics (N + ), hematologic disease and diffuse metastases. All patients with oligometastatic disease achieved positive Anti-SARS-CoV-2 S titres. For patients with two vaccinations several risk factors were identified, that were associated with low antibody concentrations. SARS-CoV-2 vaccination willingness among oncologic patients was high in the first months after its availability, and most patients had already received one or two doses. Over 97 % of vaccinated patients had measurable anti-SARS-CoV-2 S titres. Our data supports early identification of low humoral responders after vaccination and could facilitate the design of future oncologic vaccine trials (clinicaltrials.gov Identifier: NCT04918888).

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Allergy and Immunology / Antibodies / Antibodies, Viral / Antibody titres / Blood tests / cancer therapy / Clinical trials / Comorbidity / COVID-19 / COVID-19 - prevention & control / COVID-19 Vaccines / fearfulness / Female / females / hematologic diseases / Hematological diseases / Humans / humoral immunity / Immune response / Immune response (humoral) / Immune system / Infections / Metastases / Metastasis / Oncology / Patients / Population studies / Proteins / Radiation / Radiation Oncology / Regression analysis / risk / Risk factors / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Spike protein / Statistical analysis / Tumors / Vaccination / Vaccination willingness / Vaccines / Viral diseases