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

被引：74

作者：

Lee, Lennard Y. W. ^{[1
,2
]}

Starkey, Thomas ^{[2
]}

Ionescu, Maria C. ^{[5
]}

Little, Martin ^{[6
]}

Tilby, Michael ^{[7
]}

Tripathy, Arvind R. ^{[7
]}

Mckenzie, Hayley S. ^{[8
]}

Al-Hajji, Youssra ^{[4
]}

Barnard, Matthew ^{[5
]}

Benny, Liza ^{[5
]}

Burnett, Alexander ^{[9
,10
]}

Cattell, Emma L. ^{[11
]}

Charman, Jackie ^{[12
]}

Clark, James J. ^{[13
]}

Khan, Sam ^{[14
]}

Ghafoor, Qamar ^{[7
]}

Illsley, George ^{[5
]}

Harper-Wynne, Catherine ^{[15
,16
]}

Hattersley, Rosie J. ^{[17
]}

Lee, Alvin J. X. ^{[18
]}

Leonard, Pauline C. ^{[20
]}

Liu, Justin K. H. ^{[21
]}

Forum, N. C. R. I. Consumer

Pang, Matthew ^{[22
]}

Pascoe, Jennifer S. ^{[7
]}

Platt, James R. ^{[21
]}

Potter, Vanessa A. ^{[23
]}

Randle, Amelia ^{[24
]}

Rigg, Anne S. ^{[25
]}

Robinson, Tim M. ^{[26
]}

Roques, Tom W. ^{[27
]}

Roux, Rene L. ^{[6
]}

Rozmanowski, Stefan ^{[22
]}

Tuthill, Mark H. ^{[6
]}

Watts, Isabella ^{[28
]}

Williams, Sarah ^{[7
]}

Iveson, Tim ^{[29
]}

Lee, Siow Ming ^{[18
,19
]}

Middleton, Gary ^{[3
,7
]}

Middleton, Mark ^{[1
]}

Protheroe, Andrew ^{[6
]}

Fittall, Matthew W. ^{[30
]}

Fowler, Tom ^{[5
]}

Johnson, Peter ^{[9
,29
]}

机构：

[1] Univ Oxford, Dept Oncol, Oxford OX3 7DQ, England

[2] Univ Birmingham, Inst Canc & Genom Sci, Birmingham, W Midlands, England

[3] Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham, W Midlands, England

[4] Univ Birmingham, Med Sch Birmingham, Birmingham, W Midlands, England

[5] UK Hlth Secur Agcy, London, England

[6] Oxford Univ Hosp NHS Fdn Trust, Dept Oncol, Oxford, England

[7] Univ Hosp Birmingham NHS Fdn Trust, Dept Oncol, Birmingham, W Midlands, England

[8] Univ Hosp Southampton NHS Fdn Trust, Dept Oncol, Southampton, Hants, England

[9] NHS England, London, England

[10] NHS Improvement, London, England

[11] Taunton & Somerset NHS Fdn Trust, Dept Canc, Taunton, Somerset, England

[12] NHS Digital, Natl Dis Registrat Serv, London, England

[13] Imperial Coll London, Dept Surg & Canc, London, England

[14] Univ Leicester, Leicester Canc Res Ctr, Leicester, Leics, England

[15] Univ Kent, Kent Oncol Ctr, Maidstone, Kent, England

[16] Kent & Medway Med Sch, Maidstone, Kent, England

[17] Torbay Hosp NHS Fdn Trust, Dept Oncol, Torquay, England

[18] Univ Coll London Hosp NHS Trust, UCL Canc Inst, London, England

[19] Univ Coll London Hosp NHS Trust, CRUK Lung Canc Ctr Excellence, London, England

[20] Barking Havering & Redbridge Univ Hosp NHS Trust, Canc Serv, Romford, Essex, England

[21] Univ Leeds, Leeds Inst Med Res St Jamess, Leeds, W Yorkshire, England

[22] Dept Hlth & Social Care, London, England

[23] Univ Hosp Coventry & Warwickshire, Dept Oncol, Coventry, W Midlands, England

[24] Royal Coll Physicians, London, England

[25] Guys & St Thomas NHS Fdn Trust, Dept Oncol, London, England

[26] Univ Bristol, Populat Hlth Sci, Bristol, Avon, England

[27] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Canc Serv, Norwich, Norfolk, England

[28] Royal Free Hosp, Dept Acad Oncol, London, England

[29] Univ Southampton, Canc Sci, Southampton, Hants, England

[30] Royal Marsden NHS Fdn Trust, Canc Serv, London, England

来源：

LANCET ONCOLOGY | 2022年 / 23卷 / 06期

关键词：

D O I：

10.1016/S1470-2045(22)00202-9

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background People with cancer are at increased risk of hospitalisation and death following infection with SARS-CoV-2. Therefore, we aimed to conduct one of the first evaluations of vaccine effectiveness against breakthrough SARS-CoV-2 infections in patients with cancer at a population level.Methods In this population-based test-negative case-control study of the UK Coronavirus Cancer Evaluation Project (UKCCEP), we extracted data from the UKCCEP registry on all SARS-CoV-2 PCR test results (from the Second Generation Surveillance System), vaccination records (from the National Immunisation Management Service), patient demographics, and cancer records from England, UK, from Dec 8, 2020, to Oct 15, 2021. Adults (aged >= 18 years) with cancer in the UKCCEP registry were identified via Public Health England's Rapid Cancer Registration Dataset between Jan 1, 2018, and April 30, 2021, and comprised the cancer cohort. We constructed a control population cohort from adults with PCR tests in the UKCCEP registry who were not contained within the Rapid Cancer Registration Dataset. The coprimary endpoints were overall vaccine effectiveness against breakthrough infections after the second dose (positive PCR COVID-19 test) and vaccine effectiveness against breakthrough infections at 3-6 months after the second dose in the cancer cohort and control population.Findings The cancer cohort comprised 377 194 individuals, of whom 42 882 had breakthrough SARS-CoV-2 infections. The control population consisted of 28 010 955 individuals, of whom 5 748 708 had SARS-CoV-2 breakthrough infections. Overall vaccine effectiveness was 69middot8% (95% CI 69middot8-69middot9) in the control population and 65middot5% (65middot1-65middot9) in the cancer cohort. Vaccine effectiveness at 3-6 months was lower in the cancer cohort (47middot0%, 46middot3-47middot6) than in the control population (61middot4%, 61middot4-61middot5).Interpretation COVID-19 vaccination is effective for individuals with cancer, conferring varying levels of protection against breakthrough infections. However, vaccine effectiveness is lower in patients with cancer than in the general population. COVID-19 vaccination for patients with cancer should be used in conjunction with non-pharmacological strategies and community-based antiviral treatment programmes to reduce the risk that COVID-19 poses to patients with cancer.Funding University of Oxford, University of Southampton, University of Birmingham, Department of Health and Social Care, and Blood Cancer UK.Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

引用

页码：748 / 757

页数：10

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