Effectiveness and safety of COVID-19 vaccination in people with blood cancer

Copland, Emma; Hirst, Jennifer; Mi, Emma; Patone, Martina; Chen, Daniel; Coupland, Carol; Hippisley-Cox, Julia

Abstract

Background
People with blood cancer have increased risk of severe COVID-19 outcomes and poor response to vaccination. We assessed the safety and effectiveness of COVID-19 vaccines in this vulnerable group compared to the general population.
Methods
Individuals aged ≥12 years as of 1st December 2020 in the QResearch primary care database were included. We assessed adjusted COVID-19 vaccine effectiveness (aVE) against COVID-19-related hospitalisation and death in people with blood cancer using a nested matched case-control study. Using the self-controlled case series methodology, we compared the risk of 56 pre-specified adverse events within 1–28 days of a first, second or third COVID-19 vaccine dose in people with and without blood cancer.
Findings
The cohort comprised 12,274,948 individuals, of whom 81,793 had blood cancer. COVID-19 vaccines were protective against COVID-19-related hospitalisation and death in people with blood cancer, although they were less effective, particularly against COVID-19-related hospitalisation, compared to the general population. In the blood cancer population, aVE against COVID-19-related hospitalisation was 64% (95% confidence interval [CI] 48%−75%) 14–41 days after a third dose, compared to 80% (95% CI 78%−81%) in the general population. Against COVID-19-related mortality, aVE was >80% in people with blood cancer 14–41 days after a second or third dose. We found no significant difference in risk of adverse events 1–28 days after any vaccine dose between people with and without blood cancer.
Interpretation
Our study provides robust evidence which supports the use of COVID-19 vaccinations for people with blood cancer.

• Journal Article Type: Article
• Acceptance Date: Feb 1, 2024
• Online Publication Date: Feb 5, 2024
• Publication Date: 2024-04
• Deposit Date: Feb 15, 2024
• Publicly Available Date: Feb 15, 2024
• Journal: European Journal of Cancer
• Print ISSN: 0959-8049
• Electronic ISSN: 1879-0852
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 201
• Article Number: 113603
• DOI: https://doi.org/10.1016/j.ejca.2024.113603
• Keywords: SARS-CoV-2; COVID-19; Blood cancer; Vaccine effectiveness; Vaccine safety
• Public URL: https://nottingham-repository.worktribe.com/output/31159842
• Publisher URL: https://www.ejcancer.com/article/S0959-8049(24)00079-0/fulltext