癌症患者与新冠疫苗接种:从安全性到方案依从性——一份真实病例报告
Cancer patients and COVID-19 vaccination, from safety to protocol adherence: A real-life setting report.
作者信息
Lamtai Haitam, Boutayeb Saber, Mrabti Hind, El Ghissassi Ibrahim, Errihani Hassan
机构信息
Department of Medical Oncology, National Institute of Oncology, University Mohammed V, Rabat, Morocco.
出版信息
Front Oncol. 2022 Oct 3;12:1014786. doi: 10.3389/fonc.2022.1014786. eCollection 2022.
BACKGROUND
The SARS-CoV-2 pandemic has slowed down cancer prevention and treatment strategies; consequently, cancer patients are prioritized to get the COVID-19 vaccines. Being constantly threatened by a new outbreak, the dive within the immunogenicity response is of great value; nonetheless, evaluating the side effects of these vaccines on fragile patients will assure their adherence to the vaccination protocol.
OBJECTIVES
This study sets out to investigate the adverse events reported about the vaccine according to its doses and types, and to compare the prevalence and severity of toxicities across two subgroups of cancer patients, those who received the injection during active therapy cycles, and those who have not started the therapy yet at vaccination time, moreover, this paper examines the will and commitment of this population to the vaccination schemes.
METHODS
This is an observational, retrospective, cohort study, in which we conducted a semi-constructed interview with 415 random solid cancer patients treated at the National Institute of Oncology in Morocco. The assessment of adverse events was carried out with a standardized scale.
RESULTS
Eleven months after the launch of the campaign, 75.2% of patients received at least one dose of the vaccine. Altogether, the analysis demonstrates a significant difference between the adverse effects reported post the second dose compared to the first one (p=0.004; odds ratio=2 [95% CI: 1.23 - 3.31]). Besides, the results indicate an increase in the rank of the severity of systemic events (p<0.001, r=0.28) after the second dose, but not for the local events (p=0.92, r=0.005). In the adjusted subgroup analysis, no effect was detected linking active therapy with the occurrence of toxicity (p=0.51, v=0.04) as well as with the level of severity reported after both; the first and second dose. Due to the fear of interactions with the therapy, we noticed a significant trend to delay the booster dose among the participants who completed the initial vaccine protocol.
CONCLUSION
A considerable body of evidence exists to persuade cancer patients to take the Coronavirus vaccines, and to also follow their vaccination schemes under the supervision of their treating physicians.
背景
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行减缓了癌症预防和治疗策略;因此,癌症患者被优先安排接种新冠疫苗。由于不断受到新疫情爆发的威胁,深入研究免疫原性反应具有重要价值;尽管如此,评估这些疫苗对脆弱患者的副作用将确保他们遵守疫苗接种方案。
目的
本研究旨在根据疫苗剂量和类型调查报告的不良事件,并比较两组癌症患者的毒性发生率和严重程度,一组是在积极治疗周期内接受注射的患者,另一组是在接种疫苗时尚未开始治疗的患者。此外,本文还考察了该人群对疫苗接种方案的意愿和承诺。
方法
这是一项观察性、回顾性队列研究,我们对摩洛哥国家肿瘤研究所治疗的415名随机选择的实体癌患者进行了半结构化访谈。采用标准化量表对不良事件进行评估。
结果
在疫苗接种活动开展11个月后,75.2%的患者至少接种了一剂疫苗。总体而言,分析表明,与第一剂相比,第二剂后报告的不良反应存在显著差异(p = 0.004;优势比 = 2 [95%置信区间:1.23 - 3.31])。此外,结果表明,第二剂后全身事件的严重程度等级有所增加(p < 0.001,r = 0.28),但局部事件没有增加(p = 0.92,r = 0.005)。在调整后的亚组分析中,未发现积极治疗与毒性发生(p = 0.51,v = 0.04)以及第一剂和第二剂后报告的严重程度水平之间存在关联。由于担心与治疗相互作用,我们注意到完成初始疫苗接种方案的参与者中有显著的延迟接种加强剂的趋势。
结论
有大量证据说服癌症患者接种新冠疫苗,并在治疗医生的监督下遵循他们的疫苗接种方案。
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