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Effectiveness of COVID-19 vaccines against severe outcomes in cancer patients: Real-world evidence from self-controlled risk interval and retrospective cohort studies

Title
Effectiveness of COVID-19 vaccines against severe outcomes in cancer patients: Real-world evidence from self-controlled risk interval and retrospective cohort studies
Authors
LeeHui-EonJeongNa-YoungParkMinahLimEunsunKimJeong AhWonHeehyunChung-JongSang MinChoiNam-Kyong
Ewha Authors
최남경김충종박민아
SCOPUS Author ID
최남경scopus; 김충종scopus; 박민아scopus
Issue Date
2024
Journal Title
Journal of Infection and Public Health
ISSN
1876-0341JCR Link
Citation
Journal of Infection and Public Health vol. 17, no. 5, pp. 854 - 861
Keywords
CancerCOVID-19EffectivenessSARS-CoV-2Vaccine
Publisher
Elsevier Ltd
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Background: The effectiveness of COVID-19 vaccines is generally reduced in cancer patients compared to the general population. However, there are only a few studies that compare the relative risk of breakthrough infections and severe COVID-19 outcomes in fully vaccinated cancer patients versus their unvaccinated counterparts. Methods: To assess the effectiveness of COVID-19 vaccines in cancer patients, we employed (1) a self-controlled risk interval (SCRI) design, and (2) a retrospective matched cohort design. A SCRI design was used to compare the risk of breakthrough infection in vaccinated cancer patients during the period immediately following vaccination (“control window”) and the period in which immunity is achieved (“exposure windows”). The retrospective matched cohort design was used to compare the risk of severe COVID-19 outcomes between vaccinated and unvaccinated cancer patients. For both studies, data were extracted from the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service cohort, including demographics, medical history, and vaccination records of all individuals confirmed with COVID-19. We used conditional Poisson regression to calculate the incidence rate ratio (IRR) for breakthrough infection and Cox regression to estimate the hazard ratio (HR) for severe outcomes. Results: Of 14,448 cancer patients diagnosed with COVID-19 between October 2020 and December 2021, a total of 217 and 3996 cancer patients were included in the SCRI and cohort study respectively. While the risk of breakthrough infections, measured by the incidence rate in the control and exposure windows, did not show statistically significant difference in vaccinated cancer patients (IRR=0.88, 95% CI: 0.64–1.22), the risk of severe COVID-19 outcomes was significantly lower in vaccinated cancer patients compared to those unvaccinated (HR=0.27, 95% CI: 0.22–0.34). Conclusion: COVID-19 vaccines significantly reduce the risk of severe outcomes in cancer patients, though their efficacy against breakthrough infections is less evident. © 2024 The Authors
DOI
10.1016/j.jiph.2024.03.015
Appears in Collections:
신산업융합대학 > 융합보건학과 > Journal papers
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