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World J Clin Oncol. Sep 24, 2023; 14(9): 343-356
Published online Sep 24, 2023. doi: 10.5306/wjco.v14.i9.343
Effectiveness and safety of COVID-19 vaccines in patients with oncological diseases: State-of-the-art
Nedelcho Ivanov, Boris Krastev, Dimitrina Georgieva Miteva, Hristiana Batselova, Radostina Alexandrova, Tsvetelina Velikova
Nedelcho Ivanov, Department of Clinical Immunology with Stem Cell Bank, University Hospital Alexanrovska, Sofia 1431, Bulgaria
Boris Krastev, Medical Center Nadezhda, Medical Center Nadezhda, Sofia 1407, Bulgaria
Dimitrina Georgieva Miteva, Department of Genetics, Faculty of Biology, Sofia University St. Kliment Ohridski, Sofia 1164, Bulgaria
Hristiana Batselova, Department of Epidemiology and Disaster Medicine, Medical University, Plovdiv, University Hospital St. George, Plovdiv 6000, Bulgaria
Radostina Alexandrova, Department of Pathology, Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Sofia 1000, Bulgaria
Tsvetelina Velikova, Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
Author contributions: Ivanov N and Velikova T contributed to conceptualization; Krastev B contributed to methodology; Miteva DG contributed to software; Ivanov N, Alexandrova R, and Velikova T contributed to validation; Ivanov N contributed to formal analysis; Krastev B contributed to investigation; Batselova H contributed to resources; Miteva DG contributed to data curation; Ivanov N, Krastev B, and Miteva DG contributed to writing-original draft preparation; Batselova H contributed to writing-review & editing; Miteva DG contributed to visualization; Velikova T contributed to supervision, project administration, and funding acquisition; and all authors revised and approved the final version of the manuscript.
Supported by the European Union-Next Generation EU, through the National Recovery and Resilience Plan of the Republic of Bulgaria, No. BG-RRP-2.004-0008.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nedelcho Ivanov, FRCS (Hon), MD, PhD, Assistant Professor, Department of Clinical Immunology with Stem Cell Bank, University Hospital Alexanrovska, St. Georfi Sofiiski 1 str, Sofia 1431, Bulgaria. nedelcho.ivanov93@gmail.com
Received: June 28, 2023
Peer-review started: June 28, 2023
First decision: July 6, 2023
Revised: August 6, 2023
Accepted: September 12, 2023
Article in press: September 12, 2023
Published online: September 24, 2023
Processing time: 83 Days and 5.4 Hours
Abstract

Although the coronavirus disease 2019 (COVID-19) pandemic was declared to be no longer “a public health emergency of international concern” with its wide range of clinical manifestations and late complications, severe acute respiratory syndrome coronavirus 2 infection proved to be a serious threat, especially to the elderly and patients with comorbidities. Patients with oncologic diseases are vulnerable to severe infection and death. Indeed, patients with oncohematological diseases have a higher risk of severe COVID-19 and impaired post-vaccination immunity. Unfortunately, cancer patients are usually excluded from vaccine trials and investigations of post-vaccinal immune responses and the effectiveness of the vaccines. We aimed to elucidate to what extent patients with cancer are at increased risk of developing severe COVID-19 and what is their overall case fatality rate. We also present the current concept and evidence on the effectiveness and safety of COVID-19 vaccines, including boosters, in oncology patients. In conclusion, despite the considerably higher mortality in the cancer patient group than the general population, countries with high vaccination rates have demonstrated trends toward improved survival of cancer patients early and late in the pandemic.

Keywords: COVID-19, COVID-19 vaccines, RNA vaccines, Cancer, Oncological, Safety, Efficacy, Immunogenicity

Core Tip: The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted the lives of cancer patients. Their medical care has been challenging, given the competing risks of death from cancer and serious complications from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Cancer patients are at high risk of severe complications and death from COVID-19. Protective SARS-CoV-2 antibodies and cellular immune response are induced after infection or/and COVID-19 vaccination. Vaccines decrease the risk of hospitalization and death from COVID-19. Therefore, vaccination of specific vulnerable groups, such as oncological patients, and all people in general, will slow the virus spread and save lives.