Humoral Immunity Response of COVID-19 Vaccine and Adverse Effect Among Solid Cancer Patient: A Prospective Cross-Sectional Study

Abstract

Background and aim: Patients with cancer are at an increased risk for morbidity and mortality from coronavirus disease 2019 (COVID-19). Although cancer patients should have the priority for vaccination against SARS-CoV-2, data on vaccine immunogenicity and safety against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are scarce. The aim of this prospective study was to investigate the safety and efficacy of Pfizer-BioNTech's COVID-19 vaccine (BNT162b2) in solid cancer patients receiving active chemotherapy. Methods: We evaluated the safety and immunogenicity of BNT162b2 vaccine in 51 solid cancer patients undergoing active therapy in Azadi Hematology – Oncology center in Duhok city. The serum IgG antibody titer for S1 protein was measured by using VIDAS at pre-vaccination and 14-30 days after the second dose. The adverse events of vaccine were collected by a standardized questionnaire. Results: From 51 patients, most were metastatic (35, 68.63%), stage IV (28,54.90%). Females were more than males (36, 70.59%), (15, 29.41%) respectively. The most common types of cancer were breast (16, 31.37%), colon (8, 15.69%). Anti-S1 antibody level was significantly high. Fifty patients were seropositive (98.04%). Vaccine showed high safety profile; most of the adverse effects were mild to moderate. Most of the side effects recovered over 1-3 days. Injection site reactions were the most frequent local adverse effects after first and second doses, 17.6% and 52.9, respectively. On the other hand, most prevalent systemic adverse effects were fever (17.65%, 44.00%), headache (16.00%, 21.57%), and myalgia (35.29%, 5.88%) after first and second doses, respectively. Conclusion: the COVID-19 vaccine acceptance rate was high (89.36%). The seropositivity, following BNT162b2 vaccine, was extremely high (98.04) among cancer patient on active chemotherapy. The vaccine showed good tolerance and an excellent safety profile. Hence, it should be strongly recommended for such a risky vulnerable group to SARS-CoV-2. Breast cancer showed significantly higher seropositivity in comparison to colon cancer, which may be attributed to chemotherapy regimen, degree of immunosuppression, and gender factors.