TY - JOUR
T1 - Antibody Response Following COVID-19 Vaccination in Malaysian Cancer Patients and Healthy Individuals
AU - Song, Chin Vern
AU - Ahmad Bustamam, Ros Suzanna
AU - Gin Gin, Gan
AU - Saad, Marniza
AU - Abdul Satar, Nur Fadhlina
AU - Ramasamy, Alagu Manthiram
AU - Sam, I-Ching
AU - Kong, Yek-Ching
AU - Alagir Rajah, Harenthri Devy
AU - Chan, Yoke Fun
AU - Fu, Jolene Yin Ling
AU - Tan, Cheng Siang
AU - Danaee, Mahmoud
AU - Yip, Cheng Har
AU - Van Gils, Carla H
AU - Bhoo-Pathy, Nirmala
N1 - Copyright © 2024, Song et al.
PY - 2024/11
Y1 - 2024/11
N2 - INTRODUCTION: There is a lack of real-world evidence on direct comparisons between COVID-19 vaccines in multiethnic low- and middle-income settings. Cancer patients have an impaired vaccine response due to the disease itself or the effects of treatment. Hence, identifying the best vaccine to use for cancer patients is important. We aimed to compare the antibody response between cancer patients and healthy individuals following COVID-19 vaccination and assess seroconversion rates, vaccine efficacy, and the impact of sex on antibody response, as well as document adverse events in cancer patients.MATERIALS AND METHODS: A prospective cohort study of cancer patients and healthy individuals receiving vaccines was conducted in Malaysia. All participants were aged 18 or above at recruitment and received at least two doses of vaccine. We excluded patients who had missing serum antibody data post-first dose and post-second dose. Sociodemographic and clinical data were collected at baseline, prior to vaccination. Data on self-reported breakthrough infection was collected at six months. Multivariable linear mixed-effects regression models were used to investigate the association between the type of vaccine and serum IgG titer.RESULTS: A total of 389 patients with solid (n=276, 71.0%) or hematologic cancers (n=113, 29.0%) were included, along with 246 healthy individuals. Most cancer patients received BNT162b2 (n=358, 92.0%), followed by AZ1222 (n=19, 4.9%) and Coronavac (n=12, 3.1%). Most healthy individuals received BNT162b2 (n=151, 61.4%), followed by Coronavac (n=95, 38.6%). Vaccination, after adjustment for confounders (pre-vaccine infection, age, ethnicity, comorbidity, timepoint, income, cancer type, and booster), with Coronavac was associated with lower log IgG titer (-3.09 U/ml, 95% confidence interval=-4.37 to -1.80, p<0.01) than that of BNT162b2 in patients with cancer and also lower log IgG titer (-2.64 U/ml, 95% confidence interval=-2.97 to -2.30, p<0.01) than that of BNT162b2 in healthy individuals. No effect modification by sex was observed. Among the cancer cohort, 76 patients (19.5%) reported breakthrough infections after vaccination, while 33 (13.4%) participants in the healthy cohort reported breakthrough infections after vaccination. Coronavac was associated with greater odds of breakthrough infection among healthy individuals (odds ratio=7.34 compared to BNT162b2, confidence interval=1.40 to 33.49, p=0.02).CONCLUSION: Vaccination with BNT162b2 yields higher IgG titer than Coronavac in all groups and fewer breakthrough infections in healthy subjects. The effect of vaccination is not modified by sex.
AB - INTRODUCTION: There is a lack of real-world evidence on direct comparisons between COVID-19 vaccines in multiethnic low- and middle-income settings. Cancer patients have an impaired vaccine response due to the disease itself or the effects of treatment. Hence, identifying the best vaccine to use for cancer patients is important. We aimed to compare the antibody response between cancer patients and healthy individuals following COVID-19 vaccination and assess seroconversion rates, vaccine efficacy, and the impact of sex on antibody response, as well as document adverse events in cancer patients.MATERIALS AND METHODS: A prospective cohort study of cancer patients and healthy individuals receiving vaccines was conducted in Malaysia. All participants were aged 18 or above at recruitment and received at least two doses of vaccine. We excluded patients who had missing serum antibody data post-first dose and post-second dose. Sociodemographic and clinical data were collected at baseline, prior to vaccination. Data on self-reported breakthrough infection was collected at six months. Multivariable linear mixed-effects regression models were used to investigate the association between the type of vaccine and serum IgG titer.RESULTS: A total of 389 patients with solid (n=276, 71.0%) or hematologic cancers (n=113, 29.0%) were included, along with 246 healthy individuals. Most cancer patients received BNT162b2 (n=358, 92.0%), followed by AZ1222 (n=19, 4.9%) and Coronavac (n=12, 3.1%). Most healthy individuals received BNT162b2 (n=151, 61.4%), followed by Coronavac (n=95, 38.6%). Vaccination, after adjustment for confounders (pre-vaccine infection, age, ethnicity, comorbidity, timepoint, income, cancer type, and booster), with Coronavac was associated with lower log IgG titer (-3.09 U/ml, 95% confidence interval=-4.37 to -1.80, p<0.01) than that of BNT162b2 in patients with cancer and also lower log IgG titer (-2.64 U/ml, 95% confidence interval=-2.97 to -2.30, p<0.01) than that of BNT162b2 in healthy individuals. No effect modification by sex was observed. Among the cancer cohort, 76 patients (19.5%) reported breakthrough infections after vaccination, while 33 (13.4%) participants in the healthy cohort reported breakthrough infections after vaccination. Coronavac was associated with greater odds of breakthrough infection among healthy individuals (odds ratio=7.34 compared to BNT162b2, confidence interval=1.40 to 33.49, p=0.02).CONCLUSION: Vaccination with BNT162b2 yields higher IgG titer than Coronavac in all groups and fewer breakthrough infections in healthy subjects. The effect of vaccination is not modified by sex.
KW - antibody
KW - cancer
KW - cohort study
KW - covid-19
KW - vaccine
U2 - 10.7759/cureus.73528
DO - 10.7759/cureus.73528
M3 - Article
C2 - 39669806
SN - 2168-8184
VL - 16
JO - Cureus
JF - Cureus
IS - 11
M1 - e73528
ER -