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Vaccine effectiveness against COVID-19 breakthrough infections in patients with cancer (UKCCEP): a population-based test-negative case-control study.
Lee, Lennard Y W; Starkey, Thomas; Ionescu, Maria C; Little, Martin; Tilby, Michael; Tripathy, Arvind R; Mckenzie, Hayley S; Al-Hajji, Youssra; Barnard, Matthew; Benny, Liza; Burnett, Alexander; Cattell, Emma L; Charman, Jackie; Clark, James J; Khan, Sam; Ghafoor, Qamar; Illsley, George; Harper-Wynne, Catherine; Hattersley, Rosie J; Lee, Alvin J X; Leonard, Pauline C; Liu, Justin K H; Pang, Matthew; Pascoe, Jennifer S; Platt, James R; Potter, Vanessa A; Randle, Amelia; Rigg, Anne S; Robinson, Tim M; Roques, Tom W; Roux, René L; Rozmanowski, Stefan; Tuthill, Mark H; Watts, Isabella; Williams, Sarah; Iveson, Tim; Lee, Siow Ming; Middleton, Gary; Middleton, Mark; Protheroe, Andrew; Fittall, Matthew W; Fowler, Tom; Johnson, Peter.
  • Lee LYW; Department of Oncology, University of Oxford, Oxford, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK. Electronic address: lennard.lee@oncology.ox.ac.uk.
  • Starkey T; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
  • Ionescu MC; UK Health Security Agency, London, UK.
  • Little M; Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Tilby M; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Tripathy AR; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Mckenzie HS; Oncology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
  • Al-Hajji Y; Birmingham Medical School, University of Birmingham, Birmingham, UK.
  • Barnard M; UK Health Security Agency, London, UK.
  • Benny L; UK Health Security Agency, London, UK.
  • Burnett A; NHS England, London, UK; NHS Improvement, London, UK.
  • Cattell EL; Department of Cancer, Taunton and Somerset NHS Foundation Trust, Taunton, UK.
  • Charman J; National Disease Registration Service, NHS Digital, London, UK.
  • Clark JJ; Department of Surgery and Cancer, Imperial College London, London, UK.
  • Khan S; Leicester Cancer Research Centre, University of Leicester, Leicester, UK.
  • Ghafoor Q; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Illsley G; UK Health Security Agency, London, UK.
  • Harper-Wynne C; Kent Oncology Centre, University of Kent and Kent and Medway Medical School, Maidstone, UK.
  • Hattersley RJ; Department of Oncology, Torbay Hospital NHS Foundation Trust, Torquay, UK.
  • Lee AJX; UCL Cancer Institute, University College London Hospitals NHS Trust and University College London, London, UK.
  • Leonard PC; Cancer Services, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK.
  • Liu JKH; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
  • Pang M; Department of Health and Social Care, London, UK.
  • Pascoe JS; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Platt JR; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
  • Potter VA; Department of Oncology, University Hospital Coventry and Warwickshire, Coventry, UK.
  • Randle A; Royal College of Physicians, London, UK.
  • Rigg AS; Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • Robinson TM; Population Health Sciences, University of Bristol, Bristol, UK.
  • Roques TW; Cancer Services, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
  • Roux RL; Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Rozmanowski S; Department of Health and Social Care, London, UK.
  • Tuthill MH; Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Watts I; Department of Academic Oncology, Royal Free Hospital, London, UK.
  • Williams S; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Iveson T; Cancer Sciences, University of Southampton, Southampton, UK.
  • Lee SM; UCL Cancer Institute, University College London Hospitals NHS Trust and University College London, London, UK; CRUK Lung Cancer Centre of Excellence, University College London Hospitals NHS Trust and University College London, London, UK.
  • Middleton G; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK; Department of Oncology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Middleton M; Department of Oncology, University of Oxford, Oxford, UK.
  • Protheroe A; Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
  • Fittall MW; Cancer Services, The Royal Marsden NHS Foundation Trust, London, UK.
  • Fowler T; UK Health Security Agency, London, UK.
  • Johnson P; NHS England, London, UK; Cancer Sciences, University of Southampton, Southampton, UK.
Lancet Oncol ; 23(6): 748-757, 2022 06.
Article in English | MEDLINE | ID: covidwho-1946935
ABSTRACT

BACKGROUND:

People with cancer are at increased risk of hospitalisation and death following infection with SARS-CoV-2. Therefore, we aimed to conduct one of the first evaluations of vaccine effectiveness against breakthrough SARS-CoV-2 infections in patients with cancer at a population level.

METHODS:

In this population-based test-negative case-control study of the UK Coronavirus Cancer Evaluation Project (UKCCEP), we extracted data from the UKCCEP registry on all SARS-CoV-2 PCR test results (from the Second Generation Surveillance System), vaccination records (from the National Immunisation Management Service), patient demographics, and cancer records from England, UK, from Dec 8, 2020, to Oct 15, 2021. Adults (aged ≥18 years) with cancer in the UKCCEP registry were identified via Public Health England's Rapid Cancer Registration Dataset between Jan 1, 2018, and April 30, 2021, and comprised the cancer cohort. We constructed a control population cohort from adults with PCR tests in the UKCCEP registry who were not contained within the Rapid Cancer Registration Dataset. The coprimary endpoints were overall vaccine effectiveness against breakthrough infections after the second dose (positive PCR COVID-19 test) and vaccine effectiveness against breakthrough infections at 3-6 months after the second dose in the cancer cohort and control population.

FINDINGS:

The cancer cohort comprised 377 194 individuals, of whom 42 882 had breakthrough SARS-CoV-2 infections. The control population consisted of 28 010 955 individuals, of whom 5 748 708 had SARS-CoV-2 breakthrough infections. Overall vaccine effectiveness was 69·8% (95% CI 69·8-69·9) in the control population and 65·5% (65·1-65·9) in the cancer cohort. Vaccine effectiveness at 3-6 months was lower in the cancer cohort (47·0%, 46·3-47·6) than in the control population (61·4%, 61·4-61·5).

INTERPRETATION:

COVID-19 vaccination is effective for individuals with cancer, conferring varying levels of protection against breakthrough infections. However, vaccine effectiveness is lower in patients with cancer than in the general population. COVID-19 vaccination for patients with cancer should be used in conjunction with non-pharmacological strategies and community-based antiviral treatment programmes to reduce the risk that COVID-19 poses to patients with cancer.

FUNDING:

University of Oxford, University of Southampton, University of Birmingham, Department of Health and Social Care, and Blood Cancer UK.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Vaccines / COVID-19 / Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adolescent / Adult / Humans Language: English Journal: Lancet Oncol Journal subject: Neoplasms Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Viral Vaccines / COVID-19 / Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Adolescent / Adult / Humans Language: English Journal: Lancet Oncol Journal subject: Neoplasms Year: 2022 Document Type: Article