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Adverse Event Rates After Two Doses of mRNA COVID-19 Vaccine in Patients With vs Without Cancer


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New research published by Shulman et al in JNCCN—Journal of the National Comprehensive Cancer Network confirmed that mRNA vaccines for COVID-19 are just as safe for people with cancer as they are for cancer-free individuals. Researchers from a single institution tracked short-term side effects from more than 1,753 recipients of the Pfizer BNT162b2 vaccine and found no additional reactions for patients undergoing active cancer treatment (surgery, chemotherapy, immunotherapy, or radiation therapy) or who had completed treatment vs individuals with no history of cancer.

Survey Results

The results come from in-person, phone, and online surveys given to people who received two doses of the mRNA vaccine, 3 weeks apart, between February 16 and May 15, 2021. Nearly 1,200 people with a history of cancer responded to both surveys, with 17.8% then currently undergoing treatment. Respondents experienced pain at the injection site, muscle pain, joint pain, fever, chills, headache, nausea, and fatigue at similar rates as those reported by people without cancer from the original clinical trials of the vaccine. Adverse effects for people undergoing immunotherapy also mirrored those in the general population. 

KEY POINTS

  • Nearly 1,200 people with a history of cancer responded to surveys, with 17.8% then currently undergoing treatment.
  • Respondents experienced pain at the injection site, muscle pain, joint pain, fever, chills, headache, nausea, and fatigue at similar rates as those reported by people without cancer from the original clinical trials of the vaccine.
  • Adverse effects for people undergoing immunotherapy also mirrored those in the general population.

“Patients, their families, and their medical caregivers should absolutely find these results reassuring. We … found that patients with cancer aren’t at risk for any unexpected reactions to being vaccinated compared to people without cancer,” said senior study author Eric M. Horwitz, MD, FABS, FASTRO, Chair of the Department of Radiation Oncology, Fox Chase Cancer Center. “We now have the data and the clinical experience from thousands and thousands and thousands of patients with cancer who have been vaccinated. We know that the mRNA vaccines are safe and are absolutely the most effective way to prevent hospitalization and death from COVID-19.”

“It’s crucial that patients with cancer get vaccinated against COVID-19 because we know they can be particularly vulnerable to infection and its consequences, but some people have expressed concerns about possible reactions from the vaccines,” continued Dr. Horwitz. “Before this study, there wasn’t a lot of data specifically on the cancer population, so we made sure to collect and report this information to help both patients and physicians make informed decisions to get mRNA vaccines.”

Commentary

“The investigators convincingly showed no greater incidence of side effects in patients with a history of cancer, and in fact, recipients with a history of cancer had lower rates of pain at the injection site,” commented Natalie Callander, MD, of the University of Wisconsin Carbone Cancer Center, and a member of the NCCN Advisory Committee on COVID-19 Vaccination and Pre-exposure Prophylaxis, who was not involved in this research. “Over half the patients in this large prospective study had a history of cancer, and about 18% were on active treatment. This study demonstrates that patients with cancer experience no greater rate of complications, and should help to counteract misinformation about COVID-19 vaccinations. This report provides additional reassurance to practitioners and patients that COVID-19 vaccines are safe and should be offered without hesitation, in accordance with CDC and NCCN recommendations.”

Disclosure: For full disclosures of the study authors, visit jnccn.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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