The BNT162b2 mRNA COVID-19 vaccine in adolescents and young adults with cancer: A monocentric experience

Abstract

Background and Aims COVID-19 infection in pediatric cancer patients is severe or critical in 20% of the patients. It can therefore directly affect pediatric cancer patients and/or their care. We aimed at evaluating the safety and efficacy of BNT162b2 mRNA Covid-19 vaccine in AYA with solid tumor. Methods Retrospective analysis of safety and efficacy of BNT162b2 mRNA Covid-19 vaccine administered to patients, >= 16 years old, under treatment for a solid tumor or within 6 months’ post-treatment from 15/2/2021 to 15/4/2021. Two administrations of the vaccine 3 weeks apart were given. Sera were tested for anti-SARS-Cov-2 IgG antibodies directed against the S1 domain of the spike protein. In case of positive serology, neutralization of SARS-Cov-2 was tested. Results Twenty-three patients with solid tumors were identified and proposed to get vaccinated. Nine patients refused and 1 previously developed COVID-19 infection with positive serology. At time of writing, 13 patients (10 M/2F); median age: 17) started vaccination. All patient received 2 injections except 2 patients who stopped vaccination because of tumor progression. Ten patients were under treatment (chemotherapy-7pts, immunotherapy-2 pts, targeted therapy-2 pts-follow-up 3 patients). Overall, vaccines were well tolerated. Five patients did not report any side-effect after the first injection and 4 after the second injection. Main local reactivity symptom was mild pain at the site of injection (6 and 2 pts). Fatigue (2pts and 5 pts) was the most frequent systemic symptom. One patient refused serology testing. All patients but 1 had pre-vaccination negative serology, 7/10 tested had positive serology before second vaccine injection, 9/10 had positive serology one month after the second injection. All patients with seroconversion had positive COVID-19 neutralization test. No patient developed COVID infections. Conclusions We report the good safety profile and good efficacy BNT162B2 vaccine in AYA with solid tumors. Larger series and monitoring of the kinetics of anti-Sars-Cov-2 IgG antibodies for several months are mandatory to confirm these preliminary results and to determine long-term vaccination.

Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Children and Adolescents: A Systematic Review

“…Our initial search revealed 3092 records, of which 931 were excluded as duplicates. After screening the titles and, if necessary, full texts, eight published studies [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] with 2852 children or adolescents and 28 ongoing clinical studies targeting to recruit a total of 122,442 participants were included. The study selection process is shown in detail in Figure 1 .…”

“…Among the eight published studies included, two were RCTs [ 19 , 20 ], two were case series [ 21 , 22 ], and four were case reports [ 23 , 24 , 25 , 26 ]. Five studies were conducted in the United States, and one in China, France, and Israel each.…”

COVID-19 vaccines in adult cancer patients with solid tumours undergoing active treatment: Seropositivity and safety. A prospective observational study in Italy

“…People with cancer are at an increased risk of experiencing unfavorable outcomes resulting from COVID-19 infection, and recently published position papers, editorials, commentary, and reviews have supported the notion that patients with cancer must receive COVID-19 vaccination when possible [ 26 , 27 ]. However, available clinical data on COVID-19 vaccination in cancer patients are fragmentary and poor [ 18 , 19 , 20 , 21 ]. To our knowledge, this paper is one of the larger report of a prospective, single-center cohort study of anti-COVID-19 vaccination among patients with cancer in Europe.…”

“…Data on anti-COVID-19 vaccination in cancer patients are limited [ 18 , 19 , 20 , 21 ]. Revon-Riviere et al [ 19 ] reported a retrospective analysis of the safety and efficacy of BNT162b2 mRNA COVID-19 vaccines in adolescents and young adult patients with solid tumors with a median age of 17 years. Of the 10 patients tested, nine had positive serology one month after the second injection, and vaccines had a good safety profile.…”

“…In Phase III trials, these vaccines had 94.00% to 95.00% efficacy in preventing symptomatic SARS-CoV-2 infection independent of age [ 16 , 17 ]. Cancer patients undergoing active treatment make frequent visits to hospitals or clinics, which can increase the risk of COVID-19 exposure, so their prioritization for vaccination is imperative [ 7 ]; however, there is a paucity of data on the efficacy and safety of mRNA COVID-19 vaccines in cancer patients [ 18 , 19 , 20 , 21 ]. In this study, we have reported preliminary findings evaluating the BNT162b2 (Pfizer-Biontech) and mRNA-1273 (Moderna) vaccines against COVID-19 in terms of their antibody-mediated response and tolerability in patients with cancer.…”