Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

COVID-19 vaccination in patients with solid tumours: development of an Australian position statement (#23)

Yada Kanjanapan 1 , Prunella Blinman 2 , Craig Underhill 3 , Deme Karikios 4 , Eva Segelov 5 , Desmond Yip 1
  1. Department of Medical Oncology, Canberra Hospital, Canberra, ACT
  2. Department of Medical Oncology, Concord Repatriation General Hospital, Sydney
  3. Border Medical Oncology, Albury-Wodonga
  4. Medical Oncology, Nepean Cancer Care Centre, Sydney
  5. Department of Oncology, Monash Health, Melbourne

Aims

People with cancer are at increased risk of severe disease and death from SARS-CoV-2 infection. Coronavirus disease 2019 (COVID-19) vaccination is key to protecting this vulnerable population. The Medical Oncology Group of Australia (MOGA) aimed to develop a statement addressing key issues relevant to COVID-19 vaccination in solid tumour patients, including vaccine safety, efficacy and delivery in the Australian context.

 

Methods

Representative MOGA members convened a working group to produce this position statement. Recommendations from key international oncology society groups (e.g. American Society of Clinical Oncology) were summarised and incorporated in the Australian context. Consultation from the Australasian Society of Clinical Immunology and Allergy was included. The statement was endorsed by COSA, with an initial version published in the Internal Medicine Journal and versions since regularly updated on the MOGA website.

 

Results

Safety of COVID-19 vaccination in the cancer population has been shown in registration trials (4% of BNT162b2 phase III study) and cohort studies of people with cancer. Allergy risks arise from shared constituents between COVID-19 vaccines and anti-neoplastic therapy. Whilst history of allergy to pegylated drugs require immunologist review, 30min post-vaccine observation is appropriate with past allergy to polysorbate (e.g. docetaxel) and polyxyl 35 castor oil (e.g. paclitaxel) containing medications. Early data shows reduced immunogenicity of COVID-19 vaccination in cancer patients, particularly chemotherapy recipients, although the impact of other anti-neoplastic therapy is less clear. Timely administration of the booster dose is important for seroconversion in cancer patients. Optimal timing of COVID-19 vaccination in relation to anti-neoplastic therapy remains undetermined. Avoidance of concurrent administration with anti-neoplastic therapy infusion and avoidance of nadir period maybe considered.

 

Conclusions

COVID-19 vaccination should be strongly encouraged in people with cancer. A position statement by MOGA addresses considerations relevant to healthcare professionals in implementing vaccine delivery in the Australian oncology population.