COVID-19 vaccination effective for most cancer patients but protection wanes more quickly

COVID-19 vaccines are effective for most cancer patients but the level of protection offered by vaccines against infection, hospitalisation and death is lower compared with the general population and also wanes more quickly, according to a study in which UCLH participated.

The study shows vaccine protection is significantly lower in cancer patients compared to the general population particularly in the subgroups of patients with lymphoma or leukaemia, and those with a recent cancer diagnosis receiving systemic anti-cancer or radiotherapy treatments within the past one year.

The study highlights the importance of continuing vaccination booster programmes for all cancer patients – especially for patients with lymphoma or leukaemia – and rapid access to COVID-19 treatments for patients developing symptomatic COVID infection due to waning vaccine protection.

The findings come from the UK Coronavirus Cancer Evaluation Project, the world’s largest analysis of the effect of COVID-19 vaccination on people with cancer, published in Lancet Oncology on 23 May 2022. The project was co-led by the Universities of Oxford, Birmingham and Southampton and the UK Health Security Agency.

Patients with cancer have a higher risk of developing severe COVID-19 disease and that the immune response in cancer patients following vaccination is lower. But no study had examined at short-term and long-term vaccine effectiveness and protection level after 2 doses of COVID-19 vaccine in cancer patients at real world population level.

This study involved 377,194 people across England with active or recent cancer who had received two doses of the COVID-19 vaccine. The numbers of COVID-19 infections and COVID-19-associated hospitalisations and deaths in this group of cancer patients were compared to a control population without cancer.

Overall vaccine effectiveness in the general population after two doses of vaccine over the study period was 69.8% and 65.5% in the cancer group.  However at 3-6 months after the second  dose, vaccine effectiveness was reduced to 61.4% in the general population and 47.0% in the cancer group with the worst outcome observed in the subgroups of cancer patients with lymphoma (12.8% effectiveness) and leukaemia (18.5% effectiveness).

Professor Siow Ming Lee, Consultant Medical Oncologist at UCLH, who was one of the study authors, said: “Our study offers some reassurance around the fact that COVID-19 vaccination does provide protection for most cancer patients. But it also highlights the need for vulnerable cancer patients to be prioritised for booster vaccinations, and COVID-19 prophylaxis when indicated, most importantly for lymphoma or leukaemia patients due to their rapidly waning vaccine effectiveness, and the importance of quick access to other COVID-19 treatments for cancer patients if they develop symptomatic infection, given the fact that their vaccine protection wanes more quickly overall than general population.”

Read the paper: Vaccine effectiveness against COVID-19 breakthrough infections in patients with cancer (UKCCEP): a population-based test-negative case-control study

Current NHS guidance says people who have cancer or have received treatment for certain types of cancer may be at higher risk from Covid-19.

The NHS advises people at high risk from Covid-19 to follow the same guidance as everyone else. Shielding is no longer advised, but the NHS advises measures including:

  • getting vaccinated and boosted
  • asking friends and family to take a lateral flow test before visiting you
  • limiting the number of people you meet in a crowded place
  • opening windows and doors to let in fresh air if meeting inside
  • washing your hands or sanitising regularly throughout the day