Source/Disclosures
Published by:
sources:
Wijaya R, et al. lancet 2023;doi:10.1016/S0140-6736(23)01180-7.
Disclosures:
Lim reports honoraria from AstraZeneca. Please see the study for all other authors’ relevant financial disclosures.
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Key takeaways:
- Following two vaccine doses, 6% of study participants developed a breakthrough infection.
- Although 13% of participants with breakthrough infections visited a hospital, none died due to COVID-19.
Continued administration of COVID-19 booster vaccine among patients with lymphoma appeared associated with lower COVID-19 breakthrough infection rates, according to data published in The Lancet.
Among individuals in the study who received the COVID-19 booster shots, 13% visited a hospital due to breakthrough infection, with 5% requiring oxygen supplementation; however, no patients stayed in intensive care or died due to their disease, researchers wrote.
Data from a study of patients with lymphoma in England supporting COVID-19 booster vaccine uptake for those who are immunocompromised. Image: Adobe Stock
“The findings are highly reassuring,” Sean H.Lin the, PhD, associate professor and consultant of hematological oncology at the Center for Cancer Immunology at University of Southampton, England, told Healio. “Most of the participants have a cancer affecting their B cells, the cells responsible for producing antibodies. The fact that lower antibody levels are protective against COVID-19 infection after four vaccine doses compared with three, suggests that the antibody responses in these patients are maturing and improving like healthy individuals.”
Background and methodology
Patients with blood cancers, including individuals with highly heterogenous immune responses to vaccination, are at an increased risk for severe COVID-19 disease.
The PROSECO study assessed the correlation between antibody levels following COVID-19 vaccination and infection risk among 592 patients with lymphoma.
Study participants received up to four vaccination doses and underwent longitudinal peripheral blood sampling before and after each dose. Researchers defined a breakthrough infection as SARS-CoV-2 infection occurring 2 weeks or more following vaccine administration, as confirmed by antigen or polymerase chain reaction testing.
The investigators contacted 524 eligible study participants for postvaccination analysis and received responses from 396 (76%). These included 334 eligible for analysis following two vaccination doses, 315 eligible after three vaccination doses and 266 eligible after four vaccination doses.
results
Among those who received two vaccine doses, 20 (6%) developed a breakthrough infection. Forty (13%) of 315 developed a breakthrough infection after three doses and 36 (14%) of 266 developed a breakthrough infection after all four vaccine doses.
Researchers reported median intervals of 22.2 weeks (interquartile range [IQR]17.3-30.7) between the second vaccine dose and a breakthrough infection, 12.5 weeks (IQR, 8.2-19.7) between the third dose and a breakthrough infection, and 11 weeks (IQR, 5.2-13.7) between the fourth vaccine dose and a breakthrough infection.
Patients with a breakthrough infection had lower anti-spike immunoglobulin G levels than those who did not after three vaccine doses and four vaccine doses. In addition, five of nine hospitalized patients (56%) had no T-cell responses compared with seven of 45 infected patients (16%) not hospitalized.
Next steps
The study represents the first individuals to establish a correlation between antibody and T-cell responses and clinical outcomes among immunocompromised from COVID-19 disease, according to researchers.
The data support booster vaccine uptake among those who are immunocompromised while also providing insight into the benefits of routine antibody testing among this patient population, they wrote.
“People who are immunocompromised should continue having booster vaccine doses to maximize protection against severe COVID-19 disease,” Lim told Healio. “We need to understand what antibody levels are protective with increasing vaccine doses, and in other immunocompromised populations. The STRAVINSKY study will help address this.”
For more information:
Sean H. Lim, PhD, can be reached at [email protected].
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