Impact of vaccine hesitancy on antibody response after SARS-CoV-2 vaccination in patients with cancer.

Authors

null

Oliver Overheu

Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany

Oliver Overheu , Simon Lendowski , Daniel R. Quast , Daniel Kuehn , Elena Vidal Blanco , Celine Lugnier , Anna-Lena Kraeft , Eike Steinmann , Eleni Kourti , Joerg Steinmann , Stephanie Pfaender , Anke C. Reinacher-Schick

Organizations

Department of Hematology and Oncology with Palliative Care, St. Josef Hospital, Ruhr University, Bochum, Germany, Department of Internal Medicine, St. Josef Hospital, Ruhr University, Bochum, Germany, Department of Molecular and Medical Virology, Ruhr University, Bochum, Germany, Institute of Clinical Hygiene, Medical Microbiology and Infectiology, Klinikum Nuremberg, Paracelsus Medical University, Nuremberg, Germany

Research Funding

No funding received
None.

Background: An influence of various psychological factors (e.g., stress or vaccine hesitancy) on antibody response following vaccinations (vac; e.g. influenza, diphteria) has previously been reported. However, these are the first data on vaccine hesitancy’s impact on SARS-CoV-2 vac in a cohort of cancer patients (pts). Methods: Cancer pts at our university oncology center were prospectively enrolled between 01/2021-02/2022. Medical data and blood samples were collected at time of enrollment and before and after every SARS-CoV-2 vac, at 3 and 6 months. Anti-SARS-CoV-2 IgG levels and neutralizing antibodies (nAb) were determined. Pts also completed a questionnaire containing eleven-level Likert items ranging from 1 (“totally disagree”) to 11 (“totally agree”) regarding their attitude towards COVID-19 and vac in general. Results: Samples and questionnaires from 148 pts (41% female) were collected. Mean age was 64 (24-87) years. Most patients suffered from solid tumors (85%), mainly gastrointestinal (GI) cancer (59%), and were on active therapy (92%), mainly chemotherapy (80%). Agreement with “I am against vac in general” was significantly correlated with decreased SARS-CoV-2 IgG titers following first vac (ρ = -0.411, p = 0.018), second vac (ρ = -0.399, p = 0.044) and at 3 months follow-up (ρ = -0.293, p = 0.007) as well as reduced nAb after second vac (ρ = -0.533, p = 0.005) and 3 months (ρ = -0.221, p = 0.043). In contrast, stating “I will definitely get vaccinated against COVID-19” was strongly correlated with increased IgG titers following second vac (ρ = 0.44, p = 0.025). Also, “everyday stress will keep me from getting vaccinated” was significantly associated with decreased IgG and nAb following second vac (ρ = -0.433, p = 0.027; ρ = -0.391, p = 0.048). Multivariate linear regression (MLR) revealed being “against vac in general” as an independent negative predictor of IgG levels after first SARS-CoV-2 vac (β = -0.437, p = 0.022) and at 3 months follow-up (β = -0.292, p = 0.007). Among pts with GI cancer, agreement with “being afraid of vac side effects (SE)” demonstrated significantly decreased IgG (ρ = -0.334, p = 0.025) and nAb titers (ρ = -0.424, p = 0.004) after 3 months. MLR indicated fear of vac SE as an independent negative predictor of nAb after 3 months in this subgroup (β = -0.355, p = 0.025). Additionally, fear of SE was negatively correlated with anti-SARS-CoV-2 antibodies after second vac (ρ = -0.515, p = 0.029) and 3 months in male (ρ = -0.368, p = 0.011), but not in female pts. However, agreement with “I am completely confident that the vac are safe” was only correlated with increased IgG titers at 3 months follow-up in women (ρ = -0.361, p = 0.031). Conclusions: The current study revealed vaccine hesitancy’s significant negative impact on immune response following SARS-CoV-2 vac in cancer pts. Increased efforts to fight vaccine hesitancy are necessary to not only enhance vac coverage but also immune response among cancer pts.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Quality Improvement

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e18719)

DOI

10.1200/JCO.2023.41.16_suppl.e18719

Abstract #

e18719

Abstract Disclosures

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