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Evaluation of Antibody Response to SARS-CoV-2 mRNA-1273 Vaccination in Patients With Cancer in Florida.
Giuliano, Anna R; Lancet, Jeffrey E; Pilon-Thomas, Shari; Dong, Ning; Jain, Akriti G; Tan, Elaine; Ball, Somedeb; Tworoger, Shelley S; Siegel, Erin M; Whiting, Junmin; Mo, Qianxing; Cubitt, Christopher L; Dukes, Christopher W; Hensel, Jonathan A; Keenan, Robert J; Hwu, Patrick.
  • Giuliano AR; Moffitt Cancer Center, Tampa, Florida.
  • Lancet JE; Moffitt Cancer Center, Tampa, Florida.
  • Pilon-Thomas S; Moffitt Cancer Center, Tampa, Florida.
  • Dong N; Moffitt Cancer Center, Tampa, Florida.
  • Jain AG; Moffitt Cancer Center, Tampa, Florida.
  • Tan E; Moffitt Cancer Center, Tampa, Florida.
  • Ball S; Moffitt Cancer Center, Tampa, Florida.
  • Tworoger SS; Moffitt Cancer Center, Tampa, Florida.
  • Siegel EM; Moffitt Cancer Center, Tampa, Florida.
  • Whiting J; Moffitt Cancer Center, Tampa, Florida.
  • Mo Q; Moffitt Cancer Center, Tampa, Florida.
  • Cubitt CL; Moffitt Cancer Center, Tampa, Florida.
  • Dukes CW; Moffitt Cancer Center, Tampa, Florida.
  • Hensel JA; Moffitt Cancer Center, Tampa, Florida.
  • Keenan RJ; Moffitt Cancer Center, Tampa, Florida.
  • Hwu P; Moffitt Cancer Center, Tampa, Florida.
JAMA Oncol ; 8(5): 748-754, 2022 05 01.
Article in English | MEDLINE | ID: covidwho-1733818
ABSTRACT
Importance Patients with cancer experience high rates of morbidity and mortality after SARS-CoV-2 infection. Immune response to mRNA-1273 vaccination across multiple cancer types and treatments remains to be established.

Objective:

To quantitate antibody responses after mRNA-1273 vaccination among patients with solid tumors and hematologic cancer and to assess clinical and treatment factors associated with vaccine response. Design, Setting, and

Participants:

This cohort study included patients with cancer who were aged 18 years or older, spoke English or Spanish, had received their first mRNA-1273 dose between January 12 and 25, 2021, and agreed to blood tests before and after vaccination. Exposures Receipt of 1 and 2 mRNA-1273 SARS-CoV-2 vaccine doses. Main Outcomes and

Measures:

Seroconversion after each vaccine dose and IgG levels against SARS-CoV-2 spike protein obtained immediately before the first and second vaccine doses and 57 days (plus or minus 14 days) after the first vaccine dose. Cancer diagnoses and treatments were ascertained by medical record review. Serostatus was assessed via enzyme-linked immunosorbent assay. Paired t tests were applied to examine days 1, 29, and 57 SARS-CoV-2 antibody levels. Binding antibody IgG geometric mean titers were calculated based on log10-transformed values.

Results:

The 515 participants were a mean (SD) age of 64.5 (11.4) years; 262 (50.9%) were women; and 32 (6.2%) were Hispanic individuals and 479 (93.0%) White individuals; race and ethnicity data on 4 (0.7%) participants were missing. Seropositivity after vaccine dose 2 was 90.3% (465; 95% CI, 87.4%-92.7%) among patients with cancer, was significantly lower among patients with hematologic cancer (84.7% [255]; 95% CI, 80.1%-88.6%) vs solid tumors (98.1% [210]; 95% CI, 95.3%-99.5%), and was lowest among patients with lymphoid cancer (70.0% [77]; 95% CI, 60.5%-78.4%). Patients receiving a vaccination within 6 months after anti-CD20 monoclonal antibody treatment had a significantly lower seroconversion (6.3% [1]; 95% CI, 0.2%-30.2%) compared with those treated 6 to 24 months earlier (53.3% [8]; 95% CI, 26.6%-78.7%) or those who never received anti-CD20 treatment (94.2% [456]; 95% CI, 91.7%-96.1%). Low antibody levels after vaccination were observed among patients treated with anti-CD20 within 6 months before vaccination (GM, 15.5 AU/mL; 95% CI, 9.8-24.5 AU/mL), patients treated with small molecules (GM, 646.7 AU/mL; 95% CI, 441.9-946.5 AU/mL), and patients with low lymphocyte (GM, 547.4 AU/mL; 95% CI, 375.5-797.7 AU/mL) and IgG (GM, 494.7 AU/mL; 95% CI, 304.9-802.7 AU/mL) levels. Conclusions and Relevance This cohort study found that the mRNA-1273 SARS-CoV-2 vaccine induced variable antibody responses that differed by cancer diagnosis and treatment received. These findings suggest that patients with hematologic cancer and those who are receiving immunosuppressive treatments may need additional vaccination doses.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / 2019-nCoV Vaccine mRNA-1273 / Antibody Formation / Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: JAMA Oncol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / 2019-nCoV Vaccine mRNA-1273 / Antibody Formation / Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: JAMA Oncol Year: 2022 Document Type: Article