Vaccine effectiveness against COVID-19 breakthrough infections in patients with cancer (UKCCEP): a population-based test-negative case-control study.
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Lee Lennard Y W, Starkey Thomas, Ionescu Maria C, Little Martin, Tilby Michael, Tripathy Arvind R, Mckenzie Hayley S, Al-Hajji Youssra, Barnard Matthew, Benny Liza, Burnett Alexander, Cattell Emma L, Charman Jackie, Clark James J, Khan Sam, Ghafoor Qamar, Illsley George, Harper-Wynne Catherine, Hattersley Rosie J, Lee Alvin J X, Leonard Pauline C, Liu Justin K H, NCRI Consumer Forum, Pang Matthew, Pascoe Jennifer S, Platt James R, Potter Vanessa A, Randle Amelia, Rigg Anne S, Robinson Tim M, Roques Tom W, Roux René L, Rozmanowski Stefan, Tuthill Mark H, Watts Isabella, Williams Sarah, Iveson Tim, Lee Siow Ming, Middleton Gary, Middleton Mark, Protheroe Andrew, Fittall Matthew W, Fowler Tom, Johnson Peter
Аннотация
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 69·8% (95% CI 69·8-69·9) in the control population and 65·5% (65·1-65·9) in the cancer cohort. Vaccine effectiveness at 3-6 months was lower in the cancer cohort (47·0%, 46·3-47·6) than in the control population (61·4%, 61·4-61·5).
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.