1Division of Infectious diseases, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea 2Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea 3Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea 4Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea 5Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Correspondence
Minkyu Jung ,Tel: 82-2-2228-8130, Fax: 82-2-2227-8073, Email: minkjung@yuhs.ac Jin Young Ahn ,Tel: 82-2-2228-2267, Fax: 82-2-393-6884, Email: comebacktosea@yuhs.ac
Received: November 23, 2022; Accepted: February 8, 2023. Published online: February 9, 2023.
ABSTRACT
Purpose
We aimed to assess the humoral response to and reactogenicity of COVID-19 vaccination according to the vaccine type and to analyze factors associated with immunogenicity in actively treated solid cancer patients (CPs).
Method
Prospective cohorts of CPs, undergoing anticancer treatment, and healthcare workers (HCWs) were established. The participants had no history of previous COVID-19 and received either mRNA-based or adenovirus vector-based (AdV) vaccines as the primary series. Blood samples were collected before the first vaccination and after 2 weeks for each dose vaccination. Spike-specific binding antibodies (bAbs) in all participants and neutralizing antibodies (nAbs) against SARS-CoV-2 wild-type, Delta, and Omicron variants in CPs were analyzed and presented as the geometric mean titer (GMT).
Results
Age-mateched twenty HCWs and 118 CPs were included in the analysis. The bAb seroconversion rate and antibody concentrations after the first vaccination were significantly lower in CPs than in HCWs. After the third vaccination, antibody levels in CPs with a primary series of AdV were comparable to those in HCWs, but nAb titers against the Omicron variant did not quantitatively increase in cancer patients with AdV vaccine as the primary series. The incidence and severity of adverse reactions post-vaccination were similar between CPs and HCWs.
Conclusion
CPs displayed delayed humoral immune response after SARS-CoV-2 vaccination. The booster dose elicited comparable bAb concentrations between CPs and HCWs, regardless of the primary vaccine type. Neutralization against the Omicron variant was not robustly elicited following the booster dose in some CPs, implying the need for additional interventions to protect them from COVID-19.
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