Sarah Cannon Research Institute, Nashville, Tennessee, USA.
American Society of Clinical Oncology, Alexandria, Virginia, USA.
Cancer. 2023 Jun 1;129(11):1752-1762. doi: 10.1002/cncr.34726. Epub 2023 Mar 15.
The availability of safe and effective COVID-19 vaccines has enabled protections against serious COVID-19 outcomes, which are particularly important for patients with cancer. The American Society of Clinical Oncology Registry enabled the study of COVID-19 vaccine uptake in patients with cancer who were positive for severe acute respiratory syndrome-coronavirus 2.
Medical oncology practices entered data on patients who were in cancer treatment. The cohort included patients who had severe acute respiratory syndrome-coronavirus 2 infection in 2020 and had visits and vaccine data after December 31, 2020. The primary end point was the time to first vaccination from January 1, 2021. Cumulative incidence estimates and Cox regression with death as a competing risk were used to describe the time to vaccine uptake and factors associated with vaccine receipt.
The cohort included 1155 patients from 56 practices. Among 690 patients who received the first vaccine dose, 92% received the second dose. The median time to vaccine was 99 days. After adjustment, older patients were associated with a higher likelihood of vaccination compared with patients younger than 50 years in January through March 2021, and age exhibited a linear effect, with older patients showing higher rates of vaccination. Metastatic solid tumors (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.73-0.98) or non-B-cell hematologic malignancies (HR, 0.71; 95% CI, 0.54-0.93) compared with nonmetastatic solid tumors, and any comorbidity (HR, 0.83; 95% CI, 0.73-0.95) compared with no comorbidity, were associated with lower vaccination rates. Area-level social determinants of health (lower education attainment and higher unemployment rates) were associated with lower vaccination rates.
Patient age, cancer type, comorbidity, area-level education attainment, and unemployment rates were associated with differential vaccine uptake rates. These findings should inform strategies to communicate about vaccine safety and efficacy to patients with cancer.
安全有效的 COVID-19 疫苗的出现使人们能够预防严重的 COVID-19 后果，这对于癌症患者尤其重要。美国临床肿瘤学会注册中心能够研究在 SARS-CoV-2 检测呈阳性的癌症患者中 COVID-19 疫苗的接种情况。
肿瘤内科医生在癌症治疗中记录患者的数据。该队列包括 2020 年 SARS-CoV-2 感染的患者，以及在 2020 年 12 月 31 日之后进行了就诊和接种疫苗的数据。主要终点是从 2021 年 1 月 1 日起首次接种疫苗的时间。使用累积发生率估计和以死亡为竞争风险的 Cox 回归来描述疫苗接种时间以及与疫苗接种相关的因素。
该队列包括来自 56 个诊所的 1155 名患者。在 690 名接受第一剂疫苗的患者中，92%接受了第二剂疫苗。接种疫苗的中位时间为 99 天。调整后，与 2021 年 1 月至 3 月年龄小于 50 岁的患者相比，年龄较大的患者更有可能接种疫苗，并且年龄呈线性影响，年龄较大的患者接种疫苗的比例更高。与非转移性实体瘤相比，转移性实体瘤（HR，0.85；95%CI，0.73-0.98）或非 B 细胞血液恶性肿瘤（HR，0.71；95%CI，0.54-0.93），以及任何合并症（HR，0.83；95%CI，0.73-0.95）与无合并症相比，接种疫苗的比例较低。地区社会决定因素（较低的教育程度和较高的失业率）与较低的疫苗接种率相关。
患者年龄、癌症类型、合并症、地区教育程度和失业率与疫苗接种率的差异有关。这些发现应告知与癌症患者沟通疫苗安全性和有效性的策略。
