Letter comments on: Efficacy and safety of BNT162b2 vaccination in solid cancer patients receiving anti-cancer therapy - A single-centre prospective study

Sekkate, Sakina; Stoeklé, Henri‐Corto; Mabro, May; Billard, David; Kennel, Titouan; Vasse, Marc; Hervé, Christian; Beuzeboc, Philippe

doi:10.1016/j.ejca.2021.09.048

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…Cancer does not seem to be a direct, significant susceptibility factor for COVID‐19. 31 Instead, it seems to have only an indirect effect through the effects that most cancers and their treatments, particularly chemotherapy, 34 have in cancer patients. These effects include episodes of major fatigue, and the cancer patient needing to be bedridden in a confined environment and potentially exposed to the virus for too long a period, as occurs during hospitalization, or even sometimes at home, for these cancer patients.…”

Section: Resultsmentioning

confidence: 99%

Bio‐ethical issues in oncology during the first wave of the COVID‐19 epidemic: A qualitative study in a French hospital

Stoeklé

Ladrat

Landrin³

et al. 2022

Evaluation Clinical Practice

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Background Using a specific bioethical theory (=global bioethics) and method (=a posteriori), we try here to identify and evaluate the bio‐ethical issues raised by the COVID‐19 pandemic, and possible solutions, to improve the management of cancer patients at the hospital in future pandemics, before the emergence of vaccines or scientifically validated treatments. Materials & Methods Our work is based primarily on the clinical experience of three oncologists from the oncology department of Foch Hospital in France, who were on the frontline during the first wave of the epidemic. We compared their perceptions with published findings, to complete or nuance their views. Results Three bio‐ethical issues were identified, and possible solutions to these problems were evaluated: (1) scientific evidence versus lack of time → the creation of emergency multidisciplinary team meetings (MTM); (2) healthcare equality versus lack of resources → the development of telemedicine; (3) individual liberties versus risk of contamination → role of cancer patients' associations, psychologists and bioethicists. Conclusion We consider the creation of an emergency MTM, in particular, in addition to a true ethics committee with real competence in bioethics, to be a first solution that would be easy to implement in hospitals in many countries.

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Section: Resultsmentioning

confidence: 99%

Bio‐ethical issues in oncology during the first wave of the COVID‐19 epidemic: A qualitative study in a French hospital

Stoeklé

Ladrat

Landrin³

et al. 2022

Evaluation Clinical Practice

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“…Indeed, vaccine remains the major preventive treatment for COVID-19. Its efficacy has been demonstrated in immune-compromised adult patients and in patients with cancer who present less acute respiratory complications after vaccination [ 8 , 9 ]. Regarding the higher risk for severe COVID-19 and the available knowledge in adults with cancer, the benefits of vaccination were shown to outweigh the potential harms despite the need for more vaccine injections to acquire a lasting immune response.…”

Section: Introductionmentioning

confidence: 99%

BNT162b2 COVID-19 Vaccines in Children, Adolescents and Young Adults with Cancer—A 1-Year Follow-Up

et al. 2023

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(1) Background: Children and young adults with cancer are poorly represented in COVID-19 vaccination studies, and long-term protection conferred by vaccination is not known. (2) Objectives: 1. To determine the adverse effects associated with BNT162B2 vaccination in children and young adults with cancer. 2. To assess its efficacy in stimulating immunological response and in preventing severe COVID-19 disease. (3) Methods: Retrospective single-center study evaluating patients aged 8 to 22 years, with cancer, who underwent vaccination from January 2021 to June 2022. ELISA serologies and serum neutralization were collected monthly from the first injection. Serologies below 26 were considered negative, while those above 264 BAU/mL were considered positive and indicative of protection. Antibodies titers were considered positive above 20. Data on adverse events and infections were collected. (4) Results: 38 patients were included (M/F = 1.7, median age 16 years), of whom 63% had a localized tumor and 76% were undergoing treatment at the time of the first vaccination. Two or three vaccine injections were administered in 90% of patients. Adverse events were mainly systemic and not severe, except for seven grade 3 toxicities. Four cancer-related deaths were reported. Median serology was negative the month following the first vaccination and became protective during the third month. At 3 and 12 months, median serology was 1778 and 6437 BAU/mL, respectively. Serum neutralization was positive in 97% of the patients. COVID-19 infection occurred despite vaccination in 18%; all were mild forms. (5) Conclusions: In children and young adults with cancer, vaccination was well tolerated and conferred effective serum neutralization. COVID-19 infections were mild, and vaccine seroconversion persisted after 12 months in most patients. The value of additional vaccination should be further established.

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“…At the start of 2021, during the progressive deployment of anti-COVID-19 (coronavirus disease 2019) vaccination in France, cancer patients were among those prioritized for vaccination because of their high vulnerability to severe, or even fatal forms of this new viral infectious disease [1][2][3][4][5][6]. However, oncologists, including those from the oncology department of Foch Hospital, were confronted with a refusal or reluctance of some of their cancer patients to be vaccinated against COVID-19.…”

Section: Introductionmentioning

confidence: 99%

From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics

et al. 2022

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Background At the start of 2021, oncologists lacked the necessary scientific knowledge to adapt their clinical practices optimally when faced with cancer patients refusing or reluctant to be vaccinated against COVID-19, despite the marked vulnerability of these patients to severe, and even fatal forms of this new viral infectious disease. Oncologists at Foch Hospital were confronted with this phenomenon, which was observed worldwide, in both the general population and the population of cancer patients. Methods Between April and November 2021, the Ethics and Oncology Departments of Foch Hospital decided to investigate this subject, through an empirical and interdisciplinary study in bioethics. Our scientific objective was to try to identify and resolve the principal bio-ethical issues, with a view to improving clinical practices in oncology during future major pandemics of this kind, from a highly specific bio-ethical standpoint (= quality of life/survival). We used a mainly qualitative methodological approach based on questionnaires and interviews. Results In April 2021, 29 cancer patients refused or were reluctant to be vaccinated (5.6%; 29/522). Seventeen of these patients said that making vaccination mandatory would have helped them to accept vaccination. In October 2021, only 10 cancer patients continued to maintain their refusal (1.9%; 10/522). One of the main reasons for the decrease in refusals was probably the introduction of the “pass sanitaire” (health pass) in July 2021, which rendered vaccination indispensable for many activities. However, even this was not sufficient to convince these 10 cancer patients. Conclusion We identified a key bio-ethical issue, which we then tried to resolve: vaccination policy. We characterized a major tension between “the recommendation of anti-COVID-19 vaccination” (a new clinical practice) and “free will” (a moral value), and the duty to “protect each other” (a moral standard). Mandatory vaccination, at least in France, could resolve this tension, with positive effects on quality of life (i.e. happiness), or survival, in cancer patients initially refusing or reluctant to be vaccinated, but only if collective and individual scales are clearly distinguished.

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Letter comments on: Efficacy and safety of BNT162b2 vaccination in solid cancer patients receiving anti-cancer therapy - A single-centre prospective study

Cited by 5 publications

References 5 publications

Bio‐ethical issues in oncology during the first wave of the COVID‐19 epidemic: A qualitative study in a French hospital

Bio‐ethical issues in oncology during the first wave of the COVID‐19 epidemic: A qualitative study in a French hospital

BNT162b2 COVID-19 Vaccines in Children, Adolescents and Young Adults with Cancer—A 1-Year Follow-Up

From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics

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