Pfizer-BioNTech COVID-19 Vaccine Appears Safe in Cancer Patients on Immunotherapy

NEW YORK (Reuters Health) – A study from Israel supports the short-term safety of the Pfizer-BioNTech mRNA COVID-19 vaccine in patients with cancer being treated with immune-checkpoint inhibitors.

“The most important conclusion from our study is that the administration of the vaccine to cancer patients on immunotherapy is safe from both sides: we did not see immunotherapy-related side effects and did not see severe side effects from the vaccine itself. Thus, we believe that the vaccine should be given to these patients as well, especially in areas of an active Covid-19 outbreak,” Dr. Ido Wolf, chief of oncology at the Tel Aviv Sourasky Medical Center, told Reuters Health by email.

In an article in The Lancet Oncology, Dr. Wolf and colleagues report on 134 adults with cancer receiving immune-checkpoint inhibitor therapy alone (87%) or in combination with chemotherapy (13%) who received two doses of the vaccine.

sAs previously reported in other populations, more systemic and local side effects were observed after the second dose of vaccine than after the first dose. The most common local side effects were injection-site pain, rash and swelling and the most common systemic side effects were muscle pain, fatigue, headache, fever, chills, gastrointestinal complications and flu-like symptoms. None of these side effects required hospital care or any other special intervention.

The rate of systemic side effects was similar in patients treated with immune-checkpoint inhibitors alone or with chemotherapy.

“Most importantly,” write the researchers, there were no new immune-related side effects or exacerbation of existing immune-related side effects.

“Considering the high mortality of patients with cancer who contract COVID-19, which can be as high as 40% in some patient populations, the benefits of vaccination seem to outweigh the potential harms,” Dr. Wolf and colleagues conclude in their paper.

“Although further studies are needed to determine if these data are also applicable to the other COVID-19 vaccines, our findings might provide some reassurance for their use in patients being treated with immune checkpoint inhibitors,” they add.

“We still have two main questions,” Dr. Wolf told Reuters Health. “First, are there any long-term effects? We looked at our patients only few weeks from the second dose and cannot rule out the possibility of long-term side effects.”

“Another question that we are now trying to answer, is what is the efficacy of the vaccine in cancer patients, those on immunotherapy and also those on other cancer drugs? It is possible that chemotherapy, for example, may reduce the efficacy of the vaccine and maybe these patients should continue with ‘extra-care’ (masks, environmental measures etc) even if they are vaccinated,” Dr. Wolf said.

The study had no specific funding. One author has received speaker fees and fees for consultancy from Pfizer.

SOURCE: The Lancet Oncology, online April 1, 2021.

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