Blood cancers

COVID immunity wanes fastest in people with leukaemia or lymphoma

Vaccine-induced immunity to COVID-19 is lowest and wanes fastest in people with leukaemia or lymphoma compared to other cancers and the general population, latest research shows.

The large scale analysis of population-level data published in Lancet Oncology by the UK Coronavirus Cancer Evaluation Project, confirmed that COVID-19 vaccination is effective in most patients with cancer but that it wanes more quickly than in the general population, with the fastest decline seen in those with certain blood cancers.

The study co-led by the Universities of Oxford, Birmingham and Southampton and the UK Health Security Agency (UKHSA) analysed data on 377,194 individuals with active or recent cancer who had received two doses of the COVID-19 vaccine and taken a SARS-CoV-2 PCR test in England.

The research team then compared the number of breakthrough COVID-19 infections and COVID-19-associated hospitalisations and deaths in the group against that of the control population without cancer.

They found that while COVID-19 vaccine effectiveness in the general population was 69.8%, in the cancer cohort it was slightly less at 65.5%, indicating that, overall, the vaccine is effective for the majority of cancer patients.

However, effectiveness for patients with lymphoma (44.1%) and leukaemia (45.1%) was lower, though conversely that observed in patients with myeloma was much higher (77.5%).

The data also showed that effectiveness waned at a faster rate in the cancer group: 3–6 months after the second vaccine dose effectiveness was 47% compared to 61.4% in the general population.

Again, patients with lymphoma or leukaemia fared worst in this respect, with effectiveness 3–6 months following a second vaccine dose 12.8% and 18.5%, respectively. In myeloma patients the figure was again much higher, at 63.9%.

Treatment also had an impact, with vaccine effectiveness significantly lower in patients who were treated in the prior 12 months with chemotherapy or radiotherapy, and having declined faster than in those who did not have these treatments or were treated more than a year ago, noted the research team, headed by Dr Lennard Lee, from the Department of Oncology at University of Oxford.

“Put into the wider context of the ongoing emergence of highly transmissible COVID-19 strains, such as omicron, our findings support the global prioritisation and evaluation of vaccination booster types and programmes for people with cancer, including analyses on the impact of different treatments,” the authors concluded.

“Patients with cancer should also be encouraged to use non-pharmacological strategies, such as behavioural modifications or personal protective equipment, to prevent transmission when community rates are high,” they added.

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