Immune Response and Effects of COVID-19 Vaccination in Patients with Lung Cancer—COVID Lung Vaccine Study

SIMPLE SUMMARY: During the SARS-CoV-2 pandemic, lung cancer patients have been considered an especially vulnerable population and have been prioritized for vaccination. However, several aspects (degree of immunity, potential interaction with active anticancer therapy, safety, and tolerability of the vaccines) remained unclear. We sought to evaluate the immune response to vaccines in this population and detail vaccine-related adverse events. In our cohort of 126 lung cancer patients, SARS-CoV-2 vaccines were safe irrespective of the systemic therapy, and vaccine-related adverse events and efficacy were similar regardless the age. Most of the patients developed SARS-CoV-2 antibodies after first and second dose of the vaccine, which was maintained over time. Rates of infection after vaccination were low, more frequent with the Omicron variant, with a milder clinical course after vaccination. The rate of hospital admissions due to COVID-19 infection was very low, and no COVID-19-related deaths occurred in our cohort of patients. ABSTRACT: Lung cancer patients represent a subgroup of special vulnerability in whom the SARS-CoV-2 infection could attain higher rates of morbidity and mortality. Therefore, those patients were recommended to receive SARS-CoV-2 vaccines once they were approved. However, little was known at that time regarding the degree of immunity developed after vaccination or vaccine-related adverse events, and more uncertainty involved the real need for a third dose. We sought to evaluate the immune response developed after vaccination, as well as the safety and efficacy of SARS-CoV-2 vaccines in a cohort of patients with lung cancer. Patients were identified through the Oncology/Hematology Outpatient Vaccination Program. Anti-Spike IgG was measured before any vaccine and at 3–6-, 6–9- and 12–15-month time points after the 2nd dose. Detailed clinical data were also collected. In total, 126 patients with lung cancer participated and received at least one dose of the SARS-CoV-2 vaccine. At 3–6 months after 2nd dose, 99.1% of baseline seronegative patients seroconverted and anti-Spike IgG titers went from a median value of 9.45 to 720 UI/mL. At the 6–9-month time point, titers raised to a median value of 924 UI/mL, and at 12–15 months, after the boost dose, they reached a median value of 3064 UI/mL. Adverse events to the vaccine were mild, and no SARS- CoV-2 infection-related deaths were recorded. In this lung cancer cohort, COVID-19 vaccines were safe and effective irrespective of the systemic anticancer therapy. Most of the patients developed anti-Spike IgG after the second dose, and these titers were maintained over time with low infection and reinfection rates with a mild clinical course.