Delaying the second dose of the Pfizer/BioNTech vaccine must be urgently reviewed for cancer patients after a single shot was found to offer inadequate protection, researchers have said.
A study from King’s College London and the Francis Crick Institute – which has not yet been peer reviewed – found that three weeks after the first jab antibody responses were found in 39% of people with solid cancers and 13% of people with blood cancer.
This compared with 97% of people with no cancer, according to the research on 205 people – 151 with cancer and 54 healthy controls.
Cancer patients given a second dose of the vaccine three weeks after the first – as recommended by Pfizer – had a much better immune response, with 95% of those with solid tumours showing detectable antibodies.
The team said leaving up to a 12-week gap between doses – the government’s policy in the UK – is leaving cancer patients vulnerable to serious cases of Covid-19.
However, Cancer Research UK said the study was relatively small and people should continue to follow the advice of their doctors.
Dr Sheeba Irshad, senior clinical lecturer at King’s College London, said: “Our data provides the first real-world evidence of immune efficacy following one dose of the Pfizer vaccine in immunocompromised patient populations.
“We show that following first dose most solid and haematological [blood] cancer patients remained immunologically unprotected up until at least five weeks following primary injection; but this poor one-dose efficacy can be rescued with an early booster at day 21.
“Based on our findings, we would recommend an urgent review of the vaccine strategy for clinically extremely vulnerable groups.
“Until then, it is important that cancer patients continue to observe all public health measures in place such as social distancing and shielding when attending hospitals, even after vaccination.”
The government’s joint committee on vaccination and immunisation published a list of groups of to be prioritised to receive a vaccine for Covid-19 in the UK. The list is:
1. residents in a care home for older adults and their carers
2. all those 80 years of age and over and frontline health and social care workers
3. all those 75 years of age and over
4. all those 70 years of age and over and clinically extremely vulnerable individuals
5. all those 65 years of age and over
6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7. all those 60 years of age and over
8. all those 55 years of age and over
9. all those 50 years of age and over
As of 27 February 2021, at least 20 million adults had received one or more doses of a vaccine.
Once all the top nine priority groups have been offered at least one jab, it will then be given out to the rest of the adult population according to their age group. The age ranges, who expect to be invited for vaccination from around mid-April, are:
1.all those aged 40-49 years
2. all those aged 30-39 years
3. all those aged 18-29 years
Some have argued that there should be prioritisation according to people in vulnerable professions or from ethnicities facing a disproportionate effect from the virus, however the government has countered that to collect and act on this data will take longer than simply using existing NHS data on age.
Prof Adrian Hayday, from King’s College London and the Francis Crick Institute, said: “The vaccine is very impressive in its impact on healthy individuals and our study shows that it can clearly bring immense benefit to cancer patients too, but in most cases this is only after boosting.
“Cancer patients should be vaccinated and boosted quickly and their responses, particularly those of blood cancer patients, should be intensively monitored so that those who mix with family, friends and carers can be confident of their environment.”
Martin Ledwick, head information nurse at Cancer Research UK, said: “This is an interesting study and it’s important to assess how cancer patients are responding to the vaccines being rolled out.
“But at this stage, we are looking at data that hasn’t been peer reviewed, where other experts in the field would flag errors and limitations within the results.
“The numbers of patients looked at in the study are also relatively small, particularly for those with blood cancers.
“We know that this information could be worrying, but anyone undergoing cancer treatment should continue to follow the advice of their doctors, and we encourage all who can to take up the vaccine.”
A Department of Health and Social Care spokesman said: “We are focused on saving lives and the antibody response is only part of the protection provided by the vaccine.
“The independent Joint Committee on Vaccination and Immunisation, which advises government on vaccine use and prioritisation, regularly reviews data and evidence on vaccine efficacy and effectiveness.”