Immune response of COVID-19 vaccines in solid cancer patients: A meta-analysis

ABSTRACT

Solid cancer patients, compared to their healthy counterparts, are at a greater risk of contracting and suffering from severe complications and poorer prognosis after COVID-19 infections. They also have different immune responses after doses of COVID-19 vaccination, but limited evidence is available to reveal the effectiveness and help to guide immunization programs for this subpopulation; MEDLINE, Embase, Web of Science, Cochrane Library databases, and clinicaltrials.gov were used to search literature. The pooled seroconversion rate was calculated using a random-effects model and reported with a 95% confidence interval (CI); The review includes 66 studies containing serological responses after COVID-19 vaccination in 13,050 solid cancer patients and 8550 healthy controls. The pooled seropositive rates after the first dose in patients with solid cancer and healthy controls are 55.2% (95% CI 45.9%–64.5% N = 18) and 90.2% (95% CI 80.9%–96.6% N = 13), respectively. The seropositive rates after the second dose in patients with solid cancer and healthy controls are 87.6% (95% CI 84.1%–90.7% N = 50) and 98.9% (95% CI 97.6%-99.7% N = 35), respectively. The seropositive rates after the third dose in patients with solid cancer and healthy controls are 91.4% (95% CI 85.4%–95.9% N = 21) and 99.8% (95% CI 98.1%-100.0% N = 4), respectively. Subgroup analysis finds that study sample size, timing of antibody testing, and vaccine type have influence on the results; Seroconversion rates after COVID-19 vaccination are significantly lower in patients with solid malignancies, especially after the first dose, then shrinking gradually after the following two vaccinations, indicating that subsequent doses or a booster dose should be considered for the effectiveness of this subpopulation.

KEYWORDS:

• COVID-19
• vaccine
• solid cancer

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Conceptualization, HTT and CF.; methodology, search, screening of results and data extraction, HTT, FY, and FR; quality assessment and software, HTT and FR; visualization, HTT and FR; writing – original draft preparation, HTT and FY; writing – review and editing, HTT and FY; supervision, CF. All authors have read and agreed to the published version of the manuscript.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2357424

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.