Willingness to vaccinate and side effects of Covid-19 vaccination in patients with breast cancer and gynecological malignancies

ABSTRACT

Introduction: Cancer patients are at increased risk of developing severe COVID-19 disease. Possible side effects of their systemic therapy and the lack of clinical data on safety and efficacy of COVID-19 vaccination in cancer patients cause uncertainty regarding the vaccination. Here, we evaluated attitude towards and effects of COVID-19 vaccination in patients with breast or gynecological cancer undergoing systemic therapy. The aim was to improve counseling of our patients in clinical routine. Methods: Since March 15th 2021 patients who received one of the approved COVID-19 vaccines were routinely interviewed about immediate (0-2 days) and late side effects (within two weeks after vaccination). Clinical parameters such as current therapy, time interval between therapy administration and vaccination, and changes in the therapy schedule due to the vaccination were documented. Furthermore, the willingness of non-vaccinated patients for vaccination was assessed. The collected data were anonymously analyzed as a part of routine quality assurance. Results: By May 10th 2021, 111 out of the 217 (51.1%) interviewed patients had received at least one shot of two-dose COVID-19 vaccine and 21 patients both shots. More than half of the vaccinated patients were >55y (60.2%;mean 60.7y, range 30-92y). 68.7% had been diagnosed with breast and 25.1% with ovarian cancer;69% presented with UICC/ FIGO stage III/IV cancer. 74.6% received Conmirnaty (BioNTech/ Pfizer), 18.9% Vaxzevria (Astra Zeneca) and 6.5% Covid-19 Vaccine Moderna. After the first shot, 33.3% of the patients described no side effects, 49.1% reported a local reaction (swelling or pain), 23.4% flu-like symptoms, 10.8% headache and 3.6% nausea. 11 patients had symptoms that lasted longer than two days. In 11 cases, COVID-19 vaccination had an impact on delivery of the systemic therapy (n=10 postponements of therapy and n=1 dose reduction in advance to increase the leukocyte count before vaccination). 61.3% of the non-vaccinated patients (in total n=118) were already registered to get vaccinated;32.8% chose to postpone vaccination for various reasons (e.g. until there is more information on side effects in cancer patients);5% refused vaccination. Conclusions: Breast and gynecologic cancer patients appear to tolerate COVID-19 vaccination under systemic therapy and only in few cases the vaccination interfered with the treatment schedule. Updated results will be presented at the DGHO Congress.